Off-patent antibiotics fight community-associated MRSA

National Institutes of Health researchers found that clindamycin and trimethoprim–sulfamethoxazole (TMP-SMX) work equally well to treat uncomplicated skin infections, including cellulitis and abscesses.

There is no standard treatment for community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin infections. Clindamycin and TMP-SMX are older antibiotics, no longer under patent. Both are recommended to treat community-associated MRSA, but it was unclear if they were equally effective.

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Researchers tested the two antibiotics in 466 adults and children with uncomplicated skin infections. All those with abscesses underwent incision and drainage, and subjects were randomly assigned to receive either clindamycin or TMP-SMX for 10 days.

They report in a study in the New England Journal of Medicine that the cure rate, determined seven to 10 days after treatment, was 89.5% for clindamycin and 88.2% for TMP-SMX. Side effects from the drugs were comparable, suggesting either of the antibiotics offers an inexpensive and effective treatment for uncomplicated skin infectious acquired outside of hospitals.

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“These drugs have a proven safety record, they are inexpensive and they are effective. In addition, the results show that there are now many choices to treat these infections. What was lacking were data about efficacy. Now that this is in hand, clinicians can be confident in using these drugs,” study author Henry F. Chambers, M.D., professor of medicine, University of California San Francisco School of Medicine, San Francisco, Calif., writes in an email to Dermatology Times. “Case series, observational data and limited clinical trial data suggested these drugs should be effective. And, now, with this large, well-designed, high quality study there is confirmation of this.”