TY - JOUR
T1 - Sulfamethoxazole-Trimethoprim (Cotrimoxazole) for Skin and Soft Tissue Infections including Impetigo, Cellulitis, and Abscess
AU - Bowen, Asha C.
AU - Carapetis, Jonathan R.
AU - Currie, Bart J.
AU - Fowler, Vance
AU - Chambers, Henry F.
AU - Tong, Steven Y.C.
PY - 2017
Y1 - 2017
N2 - Skin and soft tissue infections (SSTI) affect millions of people globally, which represents a significant burden on ambulatory care and hospital settings. The role of sulfamethoxazole-trimethoprim (SXT) in SSTI treatment, particularly when group A Streptococcus (GAS) is involved, is controversial. We conducted a systematic review of clinical trials and observational studies that address the utility of SXT for SSTI treatment, caused by either GAS or Staphylococcus aureus, including methicillin-resistant (MRSA). We identified 196 studies, and 15 underwent full text review by 2 reviewers. Observational studies, which mainly focused on SSTI due to S aureus, supported the use of SXT when compared with clindamycin or β-lactams. Of 10 randomized controlled trials, 8 demonstrated the efficacy of SXT for SSTI treatment including conditions involving GAS. These findings support SXT use for treatment of impetigo and purulent cellulitis (without an additional β-lactam agent) and abscess and wound infection. For nonpurulent cellulitis, β-lactams remain the treatment of choice.
AB - Skin and soft tissue infections (SSTI) affect millions of people globally, which represents a significant burden on ambulatory care and hospital settings. The role of sulfamethoxazole-trimethoprim (SXT) in SSTI treatment, particularly when group A Streptococcus (GAS) is involved, is controversial. We conducted a systematic review of clinical trials and observational studies that address the utility of SXT for SSTI treatment, caused by either GAS or Staphylococcus aureus, including methicillin-resistant (MRSA). We identified 196 studies, and 15 underwent full text review by 2 reviewers. Observational studies, which mainly focused on SSTI due to S aureus, supported the use of SXT when compared with clindamycin or β-lactams. Of 10 randomized controlled trials, 8 demonstrated the efficacy of SXT for SSTI treatment including conditions involving GAS. These findings support SXT use for treatment of impetigo and purulent cellulitis (without an additional β-lactam agent) and abscess and wound infection. For nonpurulent cellulitis, β-lactams remain the treatment of choice.
KW - group A Streptococcus (GAS)
KW - impetigo
KW - skin and soft tissue infections
KW - Staphylococcus aureus
KW - sulfamethoxazole- trimethoprim
UR - http://www.scopus.com/inward/record.url?scp=85063652475&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofx232
DO - 10.1093/ofid/ofx232
M3 - Article
C2 - 29255730
AN - SCOPUS:85063652475
SN - 2328-8957
VL - 4
SP - 1
EP - 7
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 4
M1 - ofx232
ER -