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

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

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.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Cephalexin
  • Doxycycline / therapeutic use
  • Emergency Service, Hospital
  • Humans
  • Soft Tissue Infections* / drug therapy
  • Streptococcal Infections* / drug therapy
  • Streptococcus

Substances

  • Cephalexin
  • Doxycycline
  • Anti-Bacterial Agents