Document Detail

Soft tissue infections in the emergency department: the case for the use of 'simple' antibiotics.
MedLine Citation:
PMID:  1948213     Owner:  NLM     Status:  MEDLINE    
Cellulitis, infected wounds, abscesses, and other bacterial infections of skin and soft tissue are commonly seen in the practice of emergency medicine. Informal observations in a teaching hospital suggest that newer agents having a broader antibiotic spectrum are frequently used for empiric outpatient treatment of mild to moderate soft tissue infections, so information from a prospective study was analyzed to determine whether this practice is appropriate. Healthy adult volunteers were enrolled in a study of the aerobic bacteriology and response to treatment of skin and soft tissue infections. Patients were randomized to receive a 10-day regimen of cephalexin (500 mg bid or qid) or ofloxacin (300 or 400 mg bid). Clinical response was assessed on two follow-up visits. Of 72 patients enrolled, 45 (63%) had cultures positive for pathogens. Cultures in 31 patients (43%) were positive for Staphylococcus aureus, five (7%) grew gram-negative rods, and five (7%) grew streptococcal species. Clinical response rates exceeded 95% in both the cephalexin- and ofloxacin-treated patients. Pathogens isolated from skin and soft tissue infections treated in the emergency department are not exotic or multiply resistant. The bacteriologic profile and clinical course of uncomplicated soft tissue infections indicate that treatment with a "simple" antibiotic, such as cephalexin, will result in resolution of the infection in nearly all cases. Broader spectrum antibiotics are not required for initial treatment of soft tissue infections in the emergency department.
R D Powers
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Southern medical journal     Volume:  84     ISSN:  0038-4348     ISO Abbreviation:  South. Med. J.     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-12-26     Completed Date:  1991-12-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1313-5     Citation Subset:  AIM; IM    
Department of Medicine, University of Virginia Health Sciences Center, Charlottesville.
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MeSH Terms
Ambulatory Care
Bacterial Infections / drug therapy*
Cephalexin / therapeutic use*
Connective Tissue Diseases / drug therapy*,  microbiology
Drug Administration Schedule
Emergency Service, Hospital
Follow-Up Studies
Middle Aged
Ofloxacin / therapeutic use*
Prospective Studies
Skin Diseases, Infectious / drug therapy*,  microbiology
Treatment Outcome
Wound Infection / drug therapy
Reg. No./Substance:
15686-71-2/Cephalexin; 82419-36-1/Ofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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