Comparative Study of Drainage and Antibiotics versus Drainage Only in the Management of Primary Subcutaneous Abscesses.

BACKGROUND: Skin and soft tissue infections are common problems dealt with in emergency departments and medical offices. It is routine practice to prescribe antibiotic agents after incision and drainage of cutaneous abscesses. However, current evidence does not support prescribing oral antibiotic agents after surgical debridement. The aim of the present study was to determine the actual role of antibiotic agents after drainage of cutaneous abscesses. PATIENTS AND METHODS: This was a prospective study of patients undergoing incision and drainage (I&D) of a subcutaneous abscess. Patients were randomly assigned either to receive antibiotic agents (group 1) or placebo (group 2) after I&D. The primary end point was resolution rate of the abscess at the seventh day. Secondary end points were pain at the seventh day and total time to full healing of the wound. P value <0.05 was considered statistically significant. RESULTS: One hundred sixty-five patients were included for analysis. Age, gender, body mass index (BMI), and comorbidities did not differ substantially between groups. Chest and peri-anal abscesses were statistically more frequent in group 2, whereas neck abscesses were more frequent in group 1 (p = 0.02). Leukocyte count was also statistically higher in group 1 (p = 0.005). Resolution rate was 96% in group 1 and 93% in group 2, with no statistical difference between both (p = 0.28). Neither pain at seventh day nor time to full healing differed statistically between groups. CONCLUSIONS: Antibiotic agents are not necessary for uncomplicated subcutaneous abscesses after I&D. These cases can be managed safely on an outpatient basis without any increase in morbidity.

African Dust Storms Reaching Puerto Rican Coast Stimulate the Secretion of IL-6 and IL-8 and Cause Cytotoxicity to Human Bronchial Epithelial Cells (BEAS-2B).

African dust storm events (ADE) travel across the Atlantic Ocean (ADEAO) and reach the Puerto Rican coast (ADEPRC), potentially impacting air quality and human health. To what extent seasonal variations in atmospheric particulate matter (PM) size fractions, composition and sources trigger respiratory-adverse effects to Puerto Ricans is still unclear. In the present study, we investigated the pro-inflammatory and cytotoxic effects of PM samples harvested during ADEAO (PM10), ADEPRC (PM2.5 and PM10) and Non-ADE (Preand Post-ADEAO and Non-ADEPRC), using BEAS-2B cells. Endotoxins (ENX) in PM2.5 and PM10 extracts and traces of metals (TMET) in PM2.5 extracts were also examined. IL-6 and IL-8 secretion and cytotoxicity were used as endpoints. ADEAO and ADEPRC extracts were found to be more cytotoxic than Non-ADE and ADEAO were more toxic than ADEPRC extracts. PM10 extracts from ADEAO and Post-ADEAO caused significant secretion of IL-8. IL-6 and IL-8 secretion was higher following treatment with PM10 and PM2.5 ADEPRC than with Non-ADEPRC extracts. ENX levels were found to be higher in PM10 ADEAO than in the rest of the samples tested. TMET levels were higher in PM2.5 ADEPRC than in Non-ADEPRC extracts. Deferoxamine significantly reduced cytotoxicity and IL-6 and IL-8 secretion whereas Polymyxin B did not. TMET in PM2.5 fractions is a major determinant in ADEPRC-induced toxicity and work in conjunction with ENX to cause toxicity to lung cells in vitro. ENX and TMET may be responsible, in part, for triggering PM-respiratory adverse responses in susceptible and predisposed individuals.