| Practice patterns and management strategies for purulent skin and soft-tissue infections in an urban academic ED. | |
| | |
MedLine Citation:
|
PMID: 21277138 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of purulent skin and soft-tissue infections (SSTIs) in the Unites States. Little is known regarding health care provider management strategies for abscesses in the emergency department (ED). Understanding variability in practice patterns could be an important step in implementing evidence-based guidelines. OBJECTIVES: The objectives of this study are to describe practice patterns for purulent SSTI in a single, urban, academic ED, including antibiotic selection and incision and drainage (I & D) technique, and to compare these practices with current evidence. METHODS: Prospective data were collected on a convenience sample of adults presenting to our urban, academic ED (annual volume, 65 000 per year) between June 2009 and May 2010. Characteristics of patients and their providers were collected as well as specific management strategies including use of irrigation, packing, and antibiotics. RESULTS: One hundred forty-five patients were enrolled. Most SSTIs were single (80.4% abscesses), most commonly on the extremities (29.8%). Both I & D and antibiotics were used 79.9% of the time, with the largest predictor for the addition of antibiotics being erythema more than 2 cm (odds ratio, 4.52; 95% confidence interval, 1.39-14.7); I & D technique varied by provider-type and experience. Providers suspected MRSA in 75% of cases, despite only 48% demonstrating MRSA on culture. Many patients received antimicrobials after I & D, even in those with 2 cm or less abscesses (57.5%). CONCLUSIONS: Practice patterns vary significantly, especially antibiotic overuse, at least in this urban academic ED. Further study should be undertaken to evaluate factors that influence management strategies for SSTI. |
| | |
Authors:
|
Larissa May; Katherine Harter; Kabir Yadav; Ryan Strauss; Jameel Abualenain; Amy Keim; Gillian Schmitz |
Related Documents
:
|
20473848 - Canine atopic dermatitis: what's new? 22025798 - Medicines, travellers and the introduction and spread of 'modern' medicine in the mt ev... 22330268 - Preparing the next generation in academic medicine: recruiting and retaining the best. 20853588 - Joint commission suspends 'auto' adverse decision. 20473848 - Canine atopic dermatitis: what's new? 2500518 - Road safety management: interviewing casualties. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-1-27 |
Journal Detail:
|
Title: The American journal of emergency medicine Volume: - ISSN: 1532-8171 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2011-1-31 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2010. Published by Elsevier Inc. |
Affiliation:
|
Department of Emergency Medicine, The George Washington University, Washington, DC, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Analysis of lawsuits filed against emergency physicians for point-of-care emergency ultrasound exami...
Next Document: Early embolization without external fixation in pelvic trauma.