Iclaprim holds its own against vancomycin for serious skin infections
Pooling three randomised trials with 1,260 adults, a meta-analysis finds similar cure rates and side effects.
Skin infections such as cellulitis, abscesses and infected wounds are among the commonest reasons for antibiotics, and resistant bacteria such as MRSA keep narrowing the options.
A team from China and Taiwan, writing in The Ulutas Medical Journal in 2022, combined the three randomised trials that compared the newer antibiotic iclaprim with the standard drug vancomycin in adults.
Cure rates were almost identical: 81.0% with iclaprim and 82.3% with vancomycin. The picture held across infection types, for MRSA and other bacteria, and in people with diabetes.
Side effects were similar overall. In the two larger trials, no iclaprim patient developed drug-related kidney damage, compared with 0.3% of those on vancomycin, a gap too small to be statistically meaningful. Among trials reporting deaths, none occurred with iclaprim and three with vancomycin.
Caveat: the analysis rests on just three trials, and only one of them reported how well the bacteria were cleared.
Source: Shao-Huan Lan et al. Iclaprim Versus Vancomycin for the Treatment of Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Ulutas Med J 2022. doi:10.5455/umj.20220613080211.
Image: Figure 3 of the article, CC BY-NC 4.0.
