Variability in Emergency Medicine Provider Decisions on Hospital Admission and Antibiotic Treatment in a Survey Study for Acute Bacterial Skin and Skin Structure Infections: Opportunities for Antimicrobial Stewardship Education
| Autor: | Safa Almarzoky Abuhussain, David P. Nicolau, Katelyn R. Keyloun, Michael D Nailor, Kelsey N. Kohman, Gabrielle Jacknin, Serina Tart, Joseph L. Kuti, Michelle A. Burak, Danyel K. Adams, Athena L V Hobbs |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Antibiotics abscess antibiotics Major Articles Sepsis 03 medical and health sciences 0302 clinical medicine Clinical pathway Diabetes mellitus medicine Antimicrobial stewardship 030212 general & internal medicine cellulitis Abscess education business.industry 030208 emergency & critical care medicine Emergency department medicine.disease Infectious Diseases Oncology Cellulitis Emergency medicine business |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| Popis: | Background Acute bacterial skin and skin structure infections (ABSSSIs) are a frequent cause of emergency department (ED) visits. Providers in the ED have many decisions to make during the initial treatment of ABSSSI. There are limited data on the patient factors that influence these provider decisions. Methods An anonymous survey was administered to providers at 6 EDs across the United States. The survey presented patient cases with ABSSSIs ≥75 cm2 and escalating clinical scenarios including relapse, controlled diabetes, and sepsis. For each case, participants were queried on their decision for admission vs discharge and antibiotic therapy (intravenous, oral, or both) and to rank the factors that influenced their antibiotic decision. Results The survey was completed by 130 providers. For simple ABSSSI, the majority of providers chose an oral antibiotic and discharged patients home. The presence of recurrence or controlled diabetes resulted in more variation in responses. Thirty-four (40%) and 51 (60%) providers chose intravenous followed by oral antibiotics and discharged the recurrence and diabetes cases, respectively. Presentation with sepsis resulted in initiation with intravenous antibiotics (122, 95.3%) and admission (125, 96.1%) in most responses. Conclusions Variability in responses to certain patient scenarios suggests opportunities for education of providers in the ED and the development of an ABSSSI clinical pathway to help guide treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
| Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |