Topical fresh Taraxacum mongolicum wet dressing as an adjunct to ceftriaxone for localized skin and soft tissue infections: A single-center assessor-blinded randomized controlled trial

Background: Localized skin and soft tissue infections may need systemic antibacterials, but local inflammation can delay symptom recovery. We evaluated whether topical fresh Taraxacum mongolicum wet dressing added to ceftriaxone was associated with short-term benefit in selected clinically stable adults. Methods: In this single-center, assessor-blinded, three-arm randomized trial, 180 adults aged 18-74 years were randomized 1:1:1 to topical T. mongolicum plus intravenous ceftriaxone, topical T. mongolicum alone, or ceftriaxone alone for 7 days. The primary outcome was day-7 clinical response assessed by blinded independent assessors using prespecified global clinical improvement criteria. Analyses followed the intention-to-treat principle; sensitivity analyses assessed robustness. Results: Day-7 clinical response rates were 91.67% (55/60), 76.67% (46/60), and 68.33% (41/60) in the combined, T. mongolicum, and ceftriaxone groups, respectively (overall P = 0.006). Compared with ceftriaxone alone, combined therapy had a higher response rate (risk difference, 23.3 percentage points; 95% CI, 9.6 to 37.0; risk ratio, 1.34; 95% CI, 1.11 to 1.62). Sensitivity analyses were directionally consistent. Secondary outcomes and bacterial clearance favored the combined group. No serious adverse events were reported. Conclusions: In selected clinically stable adults with localized skin and soft tissue infections, adjunctive topical fresh T. mongolicum plus ceftriaxone was associated with improved short-term outcomes compared with ceftriaxone alone. Findings require cautious interpretation because this was a single-center, partially blinded trial without a placebo dressing control. The dressing should not replace antibiotics, drainage, or urgent care when indicated. Trial registration: International Traditional Medicine Clinical Trial Registry, ITMCTR2026000549.