Cephalexin does not help heal skin and soft tissue abscesses related to MRSA

Empirical use of beta-lactams as the main antimicrobial agents for the treatment of uncomplicated skin and soft tissue infections may not be a reasonable choice for this type of infection in the future due to the prevalence growing strains of Staphylococcus aureus (MRSA) acquired in the community and resistant to methicillin.. However, retrospective studies indicate that good results are obtained with beta-lactams.

American researchers conducted a randomized double-blind study comparing placebo and cephalexin at a dose of 500 mg orally 4 times a day for 7 days after opening and drainage of abscesses of the skin and soft tissues, at which 166 outpatients participated, the results of which were published in the November issue of Antimicrobial Agents and Chemotherapy. The treatment outcome was evaluated by clinical recovery after 7 days of cephalexin / placebo.

In a culture study, Staphylococcus aureus was isolated in 70.4% of cases, of which 87.8% were MRSA. The clinical recovery rate was 90.5% (95% confidence interval (CI) 0.82-0.96) in 84 patients who received placebo and 84.1% (95% CI 0.74- 0.91) in 82 patients receiving cephalexin (p = 0.25).

None of the groups studied recorded significant NLR or cases of spread of infection with the occurrence of pneumonia or meningitis.

In their study, the authors conclude that after surgical debridement of uncomplicated skin and soft tissue abscesses caused by community acquired MRSA strains, antibiotics can be suppressed. Nevertheless, the authors are convinced that there is virtually no chance that clinicians will stop prescribing antibiotics for uncomplicated skin and soft tissue infections.