From the FDA Drug Label
The success rates by pathogen for microbiologically evaluable patients are presented in Table 16 Table 16: Clinical Success Rates by Infecting Pathogen in the cSSSI Trials in Adult Patients (Population: Microbiologically Evaluable) Pathogen Success Rate n/N (%) Daptomycin for Injection Comparator* Methicillin-susceptible Staphylococcus aureus (MSSA) † 170/198 (86%) 180/207 (87%) Methicillin-resistant Staphylococcus aureus (MRSA) † 21/28 (75%) 25/36 (69%) Streptococcus pyogenes 79/84 (94%) 80/88 (91%) Streptococcus agalactiae 23/27 (85%) 22/29 (76%) Streptococcus dysgalactiae subsp. equisimilis 8/8 (100%) 9/11 (82%) Enterococcus faecalis (vancomycin-susceptible only) 27/37 (73%) 40/53 (76%) Major Abscess 55 (21%) / 43 (16%) 59 (22%) / 65 (22%) 114 (21%) / 108 (19%)
The best antibiotic for an abscess following meth use is not explicitly stated in the provided drug label. However, daptomycin was shown to be effective in treating complicated skin and skin structure infections (cSSSI), including major abscesses, with a success rate of 21% in the intent-to-treat population 1.
- Key points:
- Daptomycin was compared to vancomycin or an anti-staphylococcal semi-synthetic penicillin in two randomized trials.
- The success rates for daptomycin and comparator drugs were similar in both trials.
- The success rates by pathogen are presented in Table 16, but do not specifically address abscesses following meth use. It is essential to note that the provided information does not directly address the question of the best antibiotic for an abscess following meth use. Therefore, no conclusion can be drawn regarding the best antibiotic for this specific condition.
From the Research
For an abscess following methamphetamine use, the recommended antibiotic treatment is linezolid, as it has shown superiority in clinical and microbiological success without difference regarding safety, according to the most recent and highest quality study 2.
Key Considerations
- The primary treatment for an abscess is proper incision and drainage by a healthcare professional, with antibiotic treatment as an adjunct therapy.
- Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of skin and soft tissue infections in people who inject drugs, and the chosen antibiotic should be effective against this pathogen.
- The choice of antibiotic may depend on the severity of infection, patient allergies, and local resistance patterns, so a healthcare provider's assessment is necessary for appropriate treatment.
Treatment Options
- Linezolid is the preferred antibiotic for the treatment of MRSA-caused skin and soft tissue infections, based on its superiority in clinical and microbiological success 2.
- Other antibiotics, such as vancomycin, tedizolid, and daptomycin, may also be effective, but linezolid has shown the highest probability of being ranked best in terms of clinical and microbiological success 2.
- Clindamycin and trimethoprim-sulfamethoxazole may also be considered, but their effectiveness may be impacted by factors such as inoculum size and inducible resistance 3.
Additional Recommendations
- People who use methamphetamine should be advised about safe injection practices and the importance of seeking medical attention early when skin infections develop.
- The abscess should be properly incised and drained, and the wound should be kept clean and monitored for signs of infection.
- A healthcare provider's assessment is necessary to determine the best course of treatment and to monitor for potential complications.