Increased US Emergency Department Visits for Skin and Soft Tissue Infections, and Changes in Antibiotic Choices, During the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus

Pallin, Daniel J.; Egan, Daniel J.; Pelletier, Andrea J.; Espinola, Janice A.; Hooper, David C.; Camargo, Carlos A.

doi:10.1016/j.annemergmed.2007.12.004

Cited by 410 publications

(256 citation statements)

References 10 publications

Supporting

Mentioning

248

Contrasting

Unclassified

Order By: Relevance

“…The risk of SSTI-related hospitalisation is more than twice as high in diabetic than in non-diabetic patients [8]. Diabetes is independently associated with increased emergency department visits for SSTIs [9], longer hospital stays [8] and infection-attributable death [10,11]. The rising prevalence of diabetes [7,12] is likely to cause increasing numbers of diabetes-related SSTIs in hospitalised patients.…”

Section: Introductionmentioning

confidence: 99%

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

Tabak²,

et al. 2010

View full text Add to dashboard Cite

Aims/hypothesis Skin and soft tissue infections (SSTIs) cause substantial morbidity in persons with diabetes. There are few data on pathogens or risk factors associated with important outcomes in diabetic patients hospitalised with SSTIs. Methods Using a clinical research database from CareFusion, we identified 3,030 hospitalised diabetic patients with positive culture isolates and a diagnosis of SSTI in 97 US hospitals between 2003 and 2007. We classified the culture isolates and analysed their association with the anatomic location of infection, mortality, length of stay and hospital costs. Results The only culture isolate with a significantly increased prevalence was methicillin-resistant Staphylococcus aureus (MRSA); prevalence for infection of the foot was increased from 11.6 to 21.9% (p<0.0001) and for non-foot locations from 14.0% to 24.6% (p=0.006). Patients with non-foot (vs foot) infections were more severely ill at presentation and had higher mortality rates (2.2% vs 1.0%, p<0.05). Significant independent risk factors associated with higher mortality rates included having a polymicrobial culture with Pseudomonas aeruginosa (OR 3

show abstract

Section: Introductionmentioning

confidence: 99%

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

Tabak²,

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Antibiotics for skin and soft tissue abscesses CJEM JCMU 2015;17 (4)retrospective [13][14][15]17 -that primarily assessed antibiotic effect on treatment success. Data from subgroups of two studies that did not primarily examine antibiotic use were also included.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…One of these studies was a trial of abscess drainage techniques, 16 and the other study was a large cohort study of skin and soft tissue infections. 3 The use of appropriate antibiotics was compared to inappropriate antibiotics in four studies, [13][14][15]17 to no antibiotics in two studies, 12,16 and to inappropriate or no antibiotics in one. 3 Details of these studies are shown in Table 3, and a quality assessment summary is shown in Table 4.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Of the 12 included studies, only 6 reported loss to follow-up. [8][9][10][11]13,14 Among those who did report, not all classified from which arm that the loss came.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…12 In the United States, emergency physicians prescribe antibiotics for roughly 75% of abscess/cellulitis cases, increasingly choosing an antibiotic active against MRSA. 13 As the prevalence of these infections has increased, so has the number of antibiotic prescriptions.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis

Fahimi

Singh

Frazee

2015

CJEM

View full text Add to dashboard Cite

Objective: To perform a review and meta-analysis on the effect of antibiotics on treatment of skin and soft tissue abscesses (SSTAs) after incision and drainage. Methods: We searched MEDLINE, EMBASE, Web of Knowledge, and Google Scholar databases to identify randomized controlled trials (RCTs) and observational studies. For RCTs, we included studies comparing any antibiotic (treatment) to placebo (control). For observational studies, treatment was the use of appropriate antibiotics effective against bacterial isolate, and control was the use of inappropriate (ineffective) or no antibiotics. Outcome was treatment success during follow-up. Two investigators reviewed records, assessed quality (according to Cochrane and NewcastleOttawa tools), and extracted treatment success rates. Primary analysis was the effect of treatment among RCTs. Secondary analyses included the effect of treatment in 1) observational studies of confirmed methicillin-resistant Staphylococcus aureus (MRSA) infection (MRSA-only) and 2) all studies after 1998 (MRSA-era). We used random effects modelling, except when no heterogeneity was present when we used fixed effects. Results: We screened 1,968 records. Twelve were included (five RCTs, seven observational studies), representing 1,969 subjects. Seven enrolled from emergency departments, two from surgical clinics, and three from ambulatory clinics. Le résultat recherché était la réussite du traitement pendant le suivi. Deux chercheurs ont passé en revue les documents relevés, évalué la qualité (selon les outils Cochrane et Newcastle-Ottawa) et dégagé les taux de réussite des traitements. L'analyse principale avait pour objet l'effet du traitement dans les ECRA; les analyses secondaires portaient sur l'effet du traitement dans: 1) les études d'observation de cas d'infection avérée à Staphylococcus aureus résistant à la méthicilline (SARM seul); 2) toutes les études menées après 1998 (époque des infections à SARM). Les auteurs ont eu recours au modèle à effets aléatoires, sauf dans les cas où le modèle à effets fixes ne décelait aucune hétérogénéité. Résultats: Ont été relevés 1968 documents; 12 recherches (5 ECRA, 7 études d'observation) totalisant 1969 sujets ont été retenues. Dans 7 recherches, les patients provenaient de services d'urgence; dans 2 recherches, de centres ou de services de chirurgie; et dans 3 recherches, de services de soins ambulatoires. Trois recherches ne portaient que sur les enfants. Le risque relatif (RR) global de la réussite du traitement dans les ECRA était de 1,03 (CI à 95 %: 0,97 − 1,08), et celui dans les analyses secondaires, de 1,05 (CI à 95 %: 0,96 − 1,15) dans les cas de SARM seul, et de 0,99 (CI à 95 %: 0,98 − 1,01) dans les cas traités durant l'époque des infections à SARM. Conclusion: Malgré les faiblesses de la réunion des données existantes, rien n'étaye l'emploi des antibiotiques dans le traitement des APTM sans complications.

show abstract

Effect of Cephalexin Plus Trimethoprim-Sulfamethoxazole vs Cephalexin Alone on Clinical Cure of Uncomplicated Cellulitis

Moran

Krishnadasan

Mower

et al. 2017

JAMA

View full text Add to dashboard Cite

show abstract

Increased US Emergency Department Visits for Skin and Soft Tissue Infections, and Changes in Antibiotic Choices, During the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus

Cited by 410 publications

References 10 publications

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis

Effect of Cephalexin Plus Trimethoprim-Sulfamethoxazole vs Cephalexin Alone on Clinical Cure of Uncomplicated Cellulitis

Contact Info

Product

Resources

About