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. 2024 Feb 7;68(2):e0128223.
doi: 10.1128/aac.01282-23. Epub 2024 Jan 3.

Doxycycline versus cephalexin treatment of presumed streptococcal skin and soft tissue infection among adults presenting to the emergency department

Eric Taylor  1 , Michael D Nailor  1 , Michelle Feider  1 , Shannon Sullivan  1 , Kellie J Goodlet  2
Affiliations

Doxycycline versus cephalexin treatment of presumed streptococcal skin and soft tissue infection among adults presenting to the emergency department

Eric Taylor et al. Antimicrob Agents Chemother. .

Abstract

Among 100 propensity score-matched emergency department patients receiving ≤14 days doxycycline versus cephalexin monotherapy for outpatient treatment of nonpurulent (presumed streptococcal) skin and soft tissue infection, a low rate of 14-day clinical failure was observed [6% each group; odds ratio (OR), 1.34 (0.21-8.69); P = 0.745], defined as hospital admission, i.v. antibiotic therapy, or change in oral antibiotic. Doxycycline may represent a reasonable therapeutic alternative for this indication in regions with low tetracycline resistance.

Keywords: Streptococcus pyogenes; cellulitis; emergency medicine; tetracyclines.

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Conflict of interest statement

Dr. Nailor has served as a consultant for Shionogi, AbbVie, and Merck. All other authors declare no conflicts of interest.

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