Trial reportPediatrics2011
Randomized controlled trial of cephalexin versus clindamycin for uncomplicated pediatric skin infections.
Trial report in Pediatrics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Interventions for bacterial folliculitis and boils (furuncles and carbuncles).The Cochrane database of systematic reviews · 2021Pooled it
- Antibiotic therapy for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in non surgical wounds.The Cochrane database of systematic reviews · 2013Pooled it
- Interventions for impetigo.The Cochrane database of systematic reviews · 2012Pooled it
- Development and maintenance of consensus recommendations on pediatric outpatient antibiotic therapy in Germany: a framework for rational use.European journal of pediatrics · 2025Article
- [Bacterial cutaneous infections in diabetes mellitus and treatment].Dermatologie (Heidelberg, Germany) · 2025Review
- Secondary Bacterial Infections in Patients with Atopic Dermatitis or Other Common Dermatoses.American journal of clinical dermatology · 2024Review
- Therapeutic Options and Outcomes for the Treatment of Children with Gram-Positive Bacteria with Resistances of Concern: A Systematic Review.Antibiotics (Basel, Switzerland) · 2023Review
- Treatment of methicillin-resistantJAC-antimicrobial resistance · 2021Review
- Specific staphylococcal cassette chromosome mec (SCCmec) types and clonal complexes are associated with low-level amoxicillin/clavulanic acid and cefalotin resistance in methicillin-resistant Staphylococcus pseudintermedius.The Journal of antimicrobial chemotherapy · 2020Article
- Ability of Bicarbonate Supplementation To Sensitize Selected Methicillin-ResistantAntimicrobial agents and chemotherapy · 2020Article
- Calculated initial parenteral treatment of bacterial infections: Skin and soft tissue infections.GMS infectious diseases · 2020Article
- Antibiotic Susceptibility and Treatment Response in Bacterial Skin Infection.Annals of dermatology · 2018Article
- Impact of Systemic Antibiotics on Staphylococcus aureus Colonization and Recurrent Skin Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
- The rise of methicillin resistant Staphylococcus aureus: now the dominant cause of skin and soft tissue infection in Central Australia.Epidemiology and infection · 2017Article
- Prevention of Recurrent Staphylococcal Skin Infections.Infectious disease clinics of North America · 2015Review
- Treatment outcome measures for randomized controlled trials of antibiotic treatment for acute bacterial skin and skin structure infections in the emergency department setting.International journal of emergency medicine · 2015Article
- Clinical management of skin and soft tissue infections in the U.S. Emergency Departments.The western journal of emergency medicine · 2014Article
- [Systemic therapy with antibiotics. Overview of important antibiotics in dermatology].Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete · 2014Review
- Update on Epidemiology and Treatment of MRSA Infections in Children.Current pediatrics reports · 2013Article
- A prospective, multicenter, observational study of complicated skin and soft tissue infections in hospitalized patients: clinical characteristics, medical treatment, and outcomes.BMC infectious diseases · 2012Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo compare clindamycin and cephalexin for treatment of uncomplicated skin and soft tissue infections (SSTIs) caused predominantly by community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA). We hypothesized that clindamycin would be superior to cephalexin (an antibiotic without MRSA activity) for treatment of these infections. PATIENTS AND
methodsPatients aged 6 months to 18 years with uncomplicated SSTIs not requiring hospitalization were enrolled September 2006 through May 2009. Eligible patients were randomly assigned to 7 days of cephalexin or clindamycin; primary and secondary outcomes were clinical improvement at 48 to 72 hours and resolution at 7 days. Cultures were obtained and tested for antimicrobial susceptibilities, pulsed-field gel electrophoresis type, and Panton-Valentine leukocidin status.
resultsOf 200 enrolled patients, 69% had MRSA cultured from wounds. Most MRSA were USA300 or subtypes, positive for Panton-Valentine leukocidin, and clindamycin susceptible, consistent with CA-MRSA. Spontaneous drainage occurred or a drainage procedure was performed in 97% of subjects. By 48 to 72 hours, 94% of subjects in the cephalexin arm and 97% in the clindamycin arm were improved (P = .50). By 7 days, all subjects were improved, with complete resolution in 97% in the cephalexin arm and 94% in the clindamycin arm (P = .33). Fevers and age less than 1 year, but not initial erythema > 5 cm, were associated with early treatment failures, regardless of antibiotic used.
conclusionsThere is no significant difference between cephalexin and clindamycin for treatment of uncomplicated pediatric SSTIs caused predominantly by CA-MRSA. Close follow-up and fastidious wound care of appropriately drained, uncomplicated SSTIs are likely more important than initial antibiotic choice.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.