Trimethoprim-Sulfamethoxazole or Clindamycin for Community-Associated MRSA (CA-MRSA) Skin Infections

Christopher R. Frei; Monica L. Miller; James S. Lewis; Kenneth A. Lawson; Jonathan M. Hunter; Christine U. Oramasionwu; Robert L. Talbert

doi:10.3122/jabfm.2010.06.090270

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Figure 1.
Days to composite failure for patients with community-associated methicillin-resistant Staphylococcus aureus skin infections treated in ambulatory settings. TMP-SMX, trimethoprim-sulfamethoxazole; CLIN, clindamycin.

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Table 1.

Baseline Characteristics for Patients with Community-associated Methicillin-resistant Staphylococcus aureus Skin Infections Who Were Treated in Ambulatory Settings

Characteristic	Antibiotic Regimen		P^*
Characteristic	TMP-SMX (n = 87)	CLIN (n = 34)	P^*
Age, median years (interquartile range)	38 (27–48)	35 (24–46)	.3
Male (%)	55	53	.8
Hispanic (%)	72	71	.8
No insurance (%)	45	47	.8
Incision and drainage (%)	62	59	.7
Comorbidities (%)
Diabetes	15	15	1.0
Hypertension	23	18	.5
Hyperlipidemia	9	12	.7
Hepatitis C	5	0	.6
Depression	6	12	.3
HIV	2	0	1.0
Drug abuse	9	9	1.0
Alcohol abuse	3	6	.6
Smoker	25	24	.8
Previous skin infection	5	6	.7
None	25	32	.4
Baseline pain (interquartile range)	8 (7–9)	8 (6–10)	.4

All data provided as % unless otherwise indicated.
* Statistical comparisons between groups were made using the χ², Fisher's Exact, and Wilcoxon Rank Sum tests.
TMP-SMX, trimethoprim-sulfamethoxazole; CLIN, clindamycin; HIV, human immunodeficiency virus.

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Table 2.
Antimicrobial Susceptibilities for Community-associated Methicillin-resistant Staphylococcus aureus Isolates Obtained from Patients Who Were Treated for Skin Infections in Ambulatory Settings
Drug TMP-SMX Cohort (%) CLIN Cohort (%)
Vancomycin 100 100
TMP-SMX 100 100
Doxycycline 99 97
CLIN 94 94
TMP-SMX, trimethoprim-sulfamethoxazole; CLIN, clindamycin.

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Table 3.

Health Outcomes for Patients with Community-associated Methicillin-resistant Staphylococcus aureus Skin Infections Treated in Ambulatory Settings

Outcome	Antibiotic Regimen		P^*
Outcome	TMP-SMX (n = 87)	CLIN (n = 34)	P^*
Composite failure (%)	39	32	.5
Microbiologic failure	10	9	1.0
IP intervention	13	6	.3
Additional OP intervention	26	26	1.0
Interventions (median [interquartile range])	1 (1–2)	1 (1–2)	.7
Days to composite failure (median [interquartile range])	8 (4–36)	4 (3–22)	.08

* Statistical comparisons between groups were made using χ², Fisher's Exact, and Wilcoxon Rank Sum tests.
IP, inpatient visit; OP, outpatient visit; TMP-SMX, trimethoprim-sulfamethoxazole; CLIN, clindamycin.