A prescription for resistance: management of Staphylococcal skin abscesses by general practitioners in Australia
Data(s) |
06/06/2016
|
---|---|
Resumo |
Objectives: We investigated the management of staphylococcal abscesses (boils) by general practitioners (GPs) in the context of rising antibiotic resistance in community strains of Staphylococcus aureus.<br />Design, Setting, Participants: We analyzed patient-reported management of 66 cases of uncomplicated skin abscesses from the frequency matched methicillinresistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) Community- Onset Staphylococcus aureus Household Cohort (COSAHC) study (Melbourne, Australia, 2008–2012). Susceptibilities in all cases were known: 50/66 abscesses were caused by MRSA. In order to investigate GP-reported management of staphylococcal abscesses, we surveyed a random subset of GPs, from the COSAHC study (41), and of GPs (39) who used the same community-based pathology service (December 2011– May 2012). Main outcome measures: Patient outcomes, antibiotics prescribed, antibiotic resistance profiles of infecting strains, rates of incision and drainage (I&D), and attitudes to ordering microbiological cultures.<br />Results: MRSA was three times more likely to be cultured from an abscess than MSSA. Patient-reported management revealed 100% were prescribed antibiotics and only 60.6% had I&D. Of those 85% who remembered their prescription(s), 81% of MRSA cases and 23% of MSSA cases initially received inactive antibiotics. Repeat GP visits where antibiotics were changed occurred in 45 MRSA and 7 MSSA cases, although at least 33% of subsequent prescriptions were inactive for the MRSA infections. Patients treated with I&D and antibiotics did no better than those treated with only I&D, regardless of the antibiotic activity. In the GP surveys, 89% reported I&D, with or without antibiotics, to be their preferred management. Only 29.9% of GPs would routinely swab abscesses. |
Identificador | |
Idioma(s) |
eng |
Publicador |
Frontiers Research Foundation |
Relação |
http://dro.deakin.edu.au/eserv/DU:30084681/parrott-prescriptionfor-2016.pdf http://dx.doi.org/10.3389/fmicb.2016.00802 |
Direitos |
2016, The Authors |
Palavras-Chave | #Science & Technology #Life Sciences & Biomedicine #Microbiology #antibiotic resistance #Staphylococcus aureus #skin and soft tissue infections #community medicine #boils and abscesses #SOFT-TISSUE INFECTIONS #AUREUS INFECTIONS #EMERGENCY-DEPARTMENT #AMBULATORY RESEARCH #PRIMARY-CARE #PATTERNS |
Tipo |
Journal Article |