Comparative efficacy of antibiotic therapy strategies for skin and soft tissue infections in children
The purpose of the retrospective cohort study was to compare the efficacy of clindamycin, trimethoprim / sulfamethoxazole (cotrimoxazole) and β-lactams in the treatment of skin and soft tissue infections (ICMT) in children.
The study analyzed data from a cohort of children aged 0 to 17 years, who were diagnosed with skin and soft tissue infections from 2004 to 2007. and clindamycin, cotrimoxazole or β- lactams are prescribed. As results, treatment failure and relapse rate were assessed, which was defined as reinfection of the skin or soft tissue within 14 days and during the period 15-365 after the first episode of ICMT, respectively.
Among the data analyzed from 6407 children who had drainage, clinical treatment failure was observed in 568 patients (8.9%) and relapses were recorded in 994 people (22.8%). The correlated odds ratio for treatment failure was 1.92 (95% confidence interval 1.49-2.47) for cotrimoxazole and 2.23 (95% CI 1.71-2, 9) for β-lactams. The adjusted risk ratio for relapse was 1.26 (95% CI 1.06-1.49) for cotrimoxazole and 1.42 (95% CI 1.19-1.69) for β lactam.
Among the 41094 undrained children, the odds ratio was 1.67 (95% CI 1.44-1.95) for cotrimoxazole and 1.22 (95% CI 1.06-1.41) β-lactams. The adjusted risk ratio for relapse was 1.3 (95% CI 1.18-1.44) for cotrimoxazole and 1.08 (95% CI 0.99-1.18) for β lactam.
Thus, compared to clindamycin, the use of cotrimoxazole or β-lactams led to an increased risk of therapeutic failure and relapse, and the relationship was more pronounced in patients in drainage.