Antibiotics Versus Placebo in the Treatment of Abscesses in the Emergency Department

NCT ID: NCT00867789

Last Updated: 2021-01-26

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-03-31

Study Completion Date

2012-10-31

Brief Summary

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The purpose of this study is to determine if there is a difference between an antibiotic, trimethoprim-sulfamethoxazole versus placebo in healing outcomes of soft tissue abscesses following incision and drainage.

Detailed Description

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Conditions

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Abscess

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Sugar pill

Incision and drainage of the abscess and treatment with oral placebo (100 patients)

Group Type PLACEBO_COMPARATOR

Sugar pill

Intervention Type DRUG

10mg/kg/day divided twice daily for ten days. Placebo liquid will contain simple syrup, lactose powder, grape flavor, and food coloring. Placebo capsules will contain lactose powder.

Trimethoprim-sulfamethaxazole

Incision and drainage of the abscess and treatment with oral TMP-SMX (100 patients)

Group Type EXPERIMENTAL

Trimethoprim-sulfamethoxazole

Intervention Type DRUG

10mg/kg/day (based on trimethoprim component), divided twice daily for ten days (maximum dose: 160mg (TMP component) per dose)

Interventions

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Trimethoprim-sulfamethoxazole

10mg/kg/day (based on trimethoprim component), divided twice daily for ten days (maximum dose: 160mg (TMP component) per dose)

Intervention Type DRUG

Sugar pill

10mg/kg/day divided twice daily for ten days. Placebo liquid will contain simple syrup, lactose powder, grape flavor, and food coloring. Placebo capsules will contain lactose powder.

Intervention Type DRUG

Other Intervention Names

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Bactrim

Eligibility Criteria

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Inclusion Criteria

* Age 3 months to 17 years
* Single, localized soft tissue abscesses requiring incision and drainage with purulent material obtained
* Diameter of the abscess less than 5cm as measured by the treating physician

Exclusion Criteria

* Signs of systemic illness or ill-appearing, as determined by the treating physician
* Admission to the hospital following treatment in the Emergency Department
* Known sulfa allergy
* Immunocompromised patients
* Soft tissue abscesses involving the perineum (labia, scrotum, penis, perirectal)
* Previous antibiotic use (for any reason) in the past seven days
* Non-English speaking patients and families
Minimum Eligible Age

3 Months

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Blue Cross Blue Shield

OTHER

Sponsor Role collaborator

Children's Mercy Hospital Kansas City

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joan E Giovanni, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Mercy Hospital Kansas City

Locations

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Children's Mercy Hospitals and Clinics

Kansas City, Missouri, United States

Site Status

Countries

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United States

References

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McCaig LF, McDonald LC, Mandal S, Jernigan DB. Staphylococcus aureus-associated skin and soft tissue infections in ambulatory care. Emerg Infect Dis. 2006 Nov;12(11):1715-23. doi: 10.3201/eid1211.060190.

Reference Type BACKGROUND
PMID: 17283622 (View on PubMed)

Halvorson GD, Halvorson JE, Iserson KV. Abscess incision and drainage in the emergency department--Part I. J Emerg Med. 1985;3(3):227-32. doi: 10.1016/0736-4679(85)90077-0.

Reference Type BACKGROUND
PMID: 4093575 (View on PubMed)

Meislin HW, McGehee MD, Rosen P. Management and microbiology of cutaneous abscesses. JACEP. 1978 May;7(5):186-91. doi: 10.1016/s0361-1124(78)80097-5.

Reference Type BACKGROUND
PMID: 349218 (View on PubMed)

Macfie J, Harvey J. The treatment of acute superficial abscesses: a prospective clinical trial. Br J Surg. 1977 Apr;64(4):264-6. doi: 10.1002/bjs.1800640410.

Reference Type BACKGROUND
PMID: 322789 (View on PubMed)

Burney RE. Incision and drainage procedures: soft tissue abscesses in the emergency service. Emerg Med Clin North Am. 1986 Aug;4(3):527-42. No abstract available.

Reference Type BACKGROUND
PMID: 3720656 (View on PubMed)

Llera JL, Levy RC, Staneck JL. Cutaneous abscesses: natural history and management in an outpatient facility. J Emerg Med. 1984;1(6):489-93. doi: 10.1016/0736-4679(84)90002-7.

Reference Type BACKGROUND
PMID: 6444142 (View on PubMed)

Llera JL, Levy RC. Treatment of cutaneous abscess: a double-blind clinical study. Ann Emerg Med. 1985 Jan;14(1):15-9. doi: 10.1016/s0196-0644(85)80727-7.

Reference Type BACKGROUND
PMID: 3880635 (View on PubMed)

Frank AL, Marcinak JF, Mangat PD, Tjhio JT, Kelkar S, Schreckenberger PC, Quinn JP. Clindamycin treatment of methicillin-resistant Staphylococcus aureus infections in children. Pediatr Infect Dis J. 2002 Jun;21(6):530-4. doi: 10.1097/00006454-200206000-00010.

Reference Type BACKGROUND
PMID: 12182377 (View on PubMed)

Frank AL, Marcinak JF, Mangat PD, Schreckenberger PC. Community-acquired and clindamycin-susceptible methicillin-resistant Staphylococcus aureus in children. Pediatr Infect Dis J. 1999 Nov;18(11):993-1000. doi: 10.1097/00006454-199911000-00012.

Reference Type BACKGROUND
PMID: 10571437 (View on PubMed)

Frazee BW, Lynn J, Charlebois ED, Lambert L, Lowery D, Perdreau-Remington F. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med. 2005 Mar;45(3):311-20. doi: 10.1016/j.annemergmed.2004.10.011.

Reference Type BACKGROUND
PMID: 15726056 (View on PubMed)

Mishaan AM, Mason EO Jr, Martinez-Aguilar G, Hammerman W, Propst JJ, Lupski JR, Stankiewicz P, Kaplan SL, Hulten K. Emergence of a predominant clone of community-acquired Staphylococcus aureus among children in Houston, Texas. Pediatr Infect Dis J. 2005 Mar;24(3):201-6. doi: 10.1097/01.inf.0000151107.29132.70.

Reference Type BACKGROUND
PMID: 15750454 (View on PubMed)

Fergie JE, Purcell K. Community-acquired methicillin-resistant Staphylococcus aureus infections in south Texas children. Pediatr Infect Dis J. 2001 Sep;20(9):860-3. doi: 10.1097/00006454-200109000-00007.

Reference Type BACKGROUND
PMID: 11734764 (View on PubMed)

Sattler CA, Mason EO Jr, Kaplan SL. Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children. Pediatr Infect Dis J. 2002 Oct;21(10):910-7. doi: 10.1097/00006454-200210000-00005.

Reference Type BACKGROUND
PMID: 12394811 (View on PubMed)

Purcell K, Fergie J. Epidemic of community-acquired methicillin-resistant Staphylococcus aureus infections: a 14-year study at Driscoll Children's Hospital. Arch Pediatr Adolesc Med. 2005 Oct;159(10):980-5. doi: 10.1001/archpedi.159.10.980.

Reference Type BACKGROUND
PMID: 16203945 (View on PubMed)

Kaplan SL. Treatment of community-associated methicillin-resistant Staphylococcus aureus infections. Pediatr Infect Dis J. 2005 May;24(5):457-8. doi: 10.1097/01.inf.0000164162.00163.9d. No abstract available.

Reference Type BACKGROUND
PMID: 15876948 (View on PubMed)

Gonzalez BE, Martinez-Aguilar G, Hulten KG, Hammerman WA, Coss-Bu J, Avalos-Mishaan A, Mason EO Jr, Kaplan SL. Severe Staphylococcal sepsis in adolescents in the era of community-acquired methicillin-resistant Staphylococcus aureus. Pediatrics. 2005 Mar;115(3):642-8. doi: 10.1542/peds.2004-2300.

Reference Type BACKGROUND
PMID: 15741366 (View on PubMed)

Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, Harrison LH, Lynfield R, Dumyati G, Townes JM, Craig AS, Zell ER, Fosheim GE, McDougal LK, Carey RB, Fridkin SK; Active Bacterial Core surveillance (ABCs) MRSA Investigators. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA. 2007 Oct 17;298(15):1763-71. doi: 10.1001/jama.298.15.1763.

Reference Type BACKGROUND
PMID: 17940231 (View on PubMed)

Lee MC, Rios AM, Aten MF, Mejias A, Cavuoti D, McCracken GH Jr, Hardy RD. Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 2004 Feb;23(2):123-7. doi: 10.1097/01.inf.0000109288.06912.21.

Reference Type BACKGROUND
PMID: 14872177 (View on PubMed)

Other Identifiers

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0810-162

Identifier Type: -

Identifier Source: org_study_id

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