No Need For Antibiotics

The researchers at University of Texas' Southwestern Medical Center in Dallas say that doctors don't have to prescribe antibiotic therapy when treating skin infections in children. These findings appeared in the February 2004 issue of The Pediatric Infectious Disease Journal.

The article states that the most appropriate way to treat a soft-tissue abscess or boil is to drain the pus and pack the wound with gauze. It seems this is sufficient treatment for simple skin infections, and a follow-up with antibiotics isn't necessary, though seeking medical attention is indicated. The researchers found that this traditional treatment is effective even should the abscess be found to be caused by methicillin resistant Staphylococcus aureus (MRSA). Kids get boils from a pin prick, or even from just a scratch, though there may be no signs of any trauma to the skin before the boil appears.

Worrisome Problem

Antibiotic-resistant bacteria have become a worrisome problem, and thought to be much more persistent than their precursors. This is according to Dr. R. Doug Hardy, the study's lead author and an assistant professor of internal medicine and pediatrics. Doctors are not sure how aggressive they need to be in treating these new bacteria. "We were surprised. What we found is that if a physician adequately drains the abscess, it will most likely get better with or without effective antibiotics," said Dr. Hardy.

At the study's inception, the researchers had focused on finding drugs that would serve to treat MRSA. Abscesses caused by MRSA have become quite prevalent in children.  Co-author of the study, Dr. Michael C. Lee, an assistant professor of pediatrics stated, "We needed a plan, and we needed to know how to deal with it better on a day-to-day basis."

This study is the first of its kind and attempts to find the appropriate means for managing antibiotic-resistant skin infections in children. Prior research focused on how to determine the presence of MRSA, discovering the frequency of such infections, and determining the risk factors for such infections.

Ineffectual Antibiotics

The study included 69 children with an average age of 5 years. Physicians treated all the children in the same manner. Incisions were made, and the abscesses were drained either by expression or through spontaneous drainage. Most of the children were given ineffectual antibiotics prior to the discovery that the infections stemmed from antibiotic-resistant bacteria. However, in 21 child participants, the prescriptions were changed during a follow-up visit to antibiotics that are effective against MRSA. In 37 of the children, the medications were not switched.

During a further visit, the researchers discovered that there was no difference between the two groups, and no matter which antibiotic had been received, there was no apparent disparity in symptoms such as fever, pain at the site of the infection, discharge, or size of the area of infection.

During the first follow-up visit, four of the children were hospitalized due to an increase in the size of the abscess or because of a general lack of expected improvement. A total of one third of the patients were hospitalized because of a combination of abscess and cellulitis totaling an area greater than 5 centimeters in diameter. But it was apparent that ineffectual antibiotic treatment at the first visit had no bearing on the eventual need to hospitalize a child with an abscess.