{"id":1487,"date":"2011-04-01T06:13:10","date_gmt":"2011-04-01T10:13:10","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=1487"},"modified":"2015-06-04T15:23:48","modified_gmt":"2015-06-04T19:23:48","slug":"clindamycin-or-cephealexin-for-mostly-mrsa","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/clindamycin-or-cephealexin-for-mostly-mrsa\/2011\/04\/01\/","title":{"rendered":"Clindamycin or Cephalexin for (Mostly) MRSA?"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2011\/04\/its-not-a-spider-bite1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-1489\" title=\"it's not a spider bite\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2011\/04\/its-not-a-spider-bite1.jpg\" alt=\"\" width=\"300\" height=\"200\" \/><\/a>Over on the <em>Journal Watch Pediatrics<\/em> site, there&#8217;s a <a href=\"http:\/\/pediatrics.jwatch.org\/cgi\/content\/full\/2011\/330\/1?q=featured_pa\" target=\"_blank\">summary of a study<\/a> that compared clindamycin with cephalexin for purulent skin infections in kids age 6 months to 18 years.\u00a0 The results?<\/p>\n<blockquote><p>MRSA and methicillin-susceptible <em>Staphylococcus aureus<\/em> (MSSA) were isolated from 70% and 19% of children, respectively &#8230; The primary outcome \u2014 clinical improvement at 48 to 72 hours \u2014 was  similar in the cephalexin and clindamycin groups (94% and 97%,  respectively), as was the secondary outcome \u2014 resolution of infection at  7 days (97% and 94%).<\/p><\/blockquote>\n<p>Should we be surprised that cephalexin &#8212; an antibiotic with notoriously poor systemic absorption &#8212; did so well vs. infections that were 70% resistant to the antibiotic?<\/p>\n<p>Not really &#8212; after all, if antibiotics were <em>required<\/em> for skin and soft tissue infections, we would have perished as a species in the many thousands of years before the discovery of penicillin.\u00a0 Most of the cure comes from the local care, which was done in 97% of patients.<\/p>\n<p>Plus, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2151464\/?tool=pubmed\" target=\"_blank\">this study<\/a> of cephalexin vs placebo in adults found the same exact thing.<\/p>\n<p>Finally, it proves something that Primary Care Providers, Emergency Room Doctors, Surgeons, and Pediatricians have known for some time:\u00a0 If you want to use a weak antibiotic (i.e., almost a placebo) &#8220;just in case,&#8221; hardly anything beats our old friend &#8220;Keflex.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Over on the Journal Watch Pediatrics site, there&#8217;s a summary of a study that compared clindamycin with cephalexin for purulent skin infections in kids age 6 months to 18 years.\u00a0 The results? MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) were isolated from 70% and 19% of children, respectively &#8230; The primary outcome \u2014 clinical improvement at [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[375,612,630],"class_list":["post-1487","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","tag-furuncles","tag-methcillin-resistant-staph-aureus","tag-mrsa"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1487","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=1487"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1487\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=1487"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=1487"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=1487"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}