| Autor: |
Urania Rappo, H. Bryant Nguyen, Sailaja Puttagunta, Caroline Ojaimi, Karthik Akinapelli, Michael W. Dunne |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Western Journal of Emergency Medicine, Vol 21, Iss 4 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
1936-9018 |
| DOI: |
10.5811/westjem.2020.5.46046 |
| Popis: |
Introduction: A small percentage of patients with skin infections later develop necrotizing fasciitis (NF). Diagnostic testing is needed to identify patients with skin infections at low risk of NF who could be discharged from the emergency department (ED) after antibiotic initiation. Elevated lactate has been associated with NF; existing estimates of the frequency of NF are based on retrospective reviews, and cases often lack testing for lactate. We present the incidence of patients with skin infections who developed NF and their baseline lactates. Methods: In four phase-3 trials, 2883 adults with complicated or acute bacterial skin and skin structure infections were randomized to dalbavancin or comparator, with early and late follow-up visits through Day 28. We prospectively collected baseline plasma lactates in one trial to assess an association with NF. Results: NF was diagnosed in 3/2883 patients (0.1%); all three survived. In the study with prospectively collected baseline lactates (n = 622), 15/622 (2.4%) had a lactate ≥4 millimoles per liter (mmol/L), including 3/622 (0.5%) with a lactate ≥7 mmol/L. NF was not seen in patients with a lactate |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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