ArticleCJEM2022
Antibiotic prescribing and outcomes for patients with uncomplicated purulent skin and soft tissue infections in the emergency department.
Article in CJEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed, 5 citations in OpenAlex.
- Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World.Microorganisms · 2023Article
- Antimicrobial Management of Skin and Soft Tissue Infections among Surgical Wards in South Africa: Findings and Implications.Antibiotics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCurrent guidelines suggest adjuvant antibiotics after incision and drainage (I&D) of small, uncomplicated abscesses may improve patient outcomes, minimize pain, and prevent recurrence. The objective was to explore antibiotic prescribing at ED discharge and describe patient outcomes.
methodsThis was a health records review of adult patients (≥ 18 years) discharged from an academic hospital ED (annual census 65,000) over a 2-year period with diagnosis of an uncomplicated skin abscess. Outcomes included any unplanned return ED visits within 30 days, repeat I&D, and escalation to intravenous (IV) antibiotics.
resultsOf 389 ED visits, 85.6% patients underwent I&D, of which 62.2% were prescribed antibiotics at discharge. Of these patients, 36.7% received guideline recommended antibiotics (TMP-SMX or clindamycin). Of all patients who underwent I&D, 13.2% had an unplanned return ED visit within 30 days, 6.9% required repeat I&D, and 0.6% patients were escalated to IV antibiotics. Patients treated with cefalexin were more likely to have an unplanned return ED visit within 30 days (20.0 vs 5.3%; Δ14.7, 95% CI 4.6-24.4), and were more likely to have a repeat I&D within 30 days (13.7 vs 0%; Δ13.7, 95% CI 6.4-22.0), compared to patients prescribed guideline recommended antibiotics. Treatment with guideline recommended antibiotics reduced treatment failure significantly in MRSA positive patients (0.0 vs 44.4%; Δ44.4, 95% CI 13.4-73.3).
conclusionsAntibiotics were prescribed for most abscesses that underwent I&D. Less than half of the patients received antibiotics that were guideline recommended. Compared to those who received cefalexin, patients prescribed TMP-SMX or clindamycin had fewer return ED visits and were less likely to have a repeat I&D within 30 days. However, adjuvant antibiotic use did not significantly improve outcomes overall, with most patients not requiring a change in management irrespective of antibiotic use.
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