LOS ANGELES Taking cefdinir once instead of twice daily for 7 instead of 10 days successfully treated uncomplicated skin and skin structure infections in a small randomized study.
The study of 64 clinically evaluable patients who were randomized to treatment with one of two oral cephalosporins was not powered to endorse the shorter therapy conclusively. That would require thousands of patients, Dr. George J. Murakawa said at the annual meeting of the Society for Investigational Dermatology.
Previous studies, however, have proved the efficacy of treating uncomplicated skin and skin structure infections with either cephalexin 250 mg q.i.d. for 10 days or cefdinir 300 mg b.i.d. for 10 days. The current study randomized patients to the standard cephalexin regimen or two capsules of cefdinir (600 mg) once daily for 7 days.
The treatment cured the infections in 31 of 32 patients on cephalexin and 30 of 32 patients on cefdinir, said Dr. Murakawa of Michigan State University, East Lansing. Dr. Murakawa is a speaker for Abbott Laboratories, which markets cefdinir and funded this study.
"You don't necessarily need to use the standard 10-day course" of cefdinir, he said. "Once-daily doses worked very well. All patients cleared, even those with methicillin-resistant Staphylococcus aureus."
A physician in the audience said that the high rate of cure seen with cephalexin suggests that it, too, might work with fewer daily doses and a shorter course of therapy.
The infections included folliculitis (10 patients), abscesses (8), cellulitis (6), furuncle or carbuncle (13), impetigo (19), paronychia (2), and wound infection (6).
The treating physician was blinded to the medication, which was dispensed by a third party. Patients were asked not to disclose information about randomization. The physician incised and drained pustules. A specimen was collected from all patients for culture, and 50 grew out an organism.
Of 26 cultures that grew S. aureus, 7 were resistant to methicillin. All patients with S. aureus infection were cured in both treatment groups regardless of methicillin resistance, Dr. Murakawa said.
More patients were compliant with the cefdinir regimen than with cephalexin.
Bacterial skin infections are one of the most common problems seen by physicians, comprising 14% of all skin-related visits to internists, he noted.