Antimicrobial treatment decision for non-purulent skin and soft tissue infections in the emergency department

CJEM. 2017 May;19(3):175-180. doi: 10.1017/cem.2016.347. Epub 2016 Aug 17.

Abstract

Objectives: We surveyed Canadian emergency physicians to determine how skin and soft tissue infections (SSTIs) are managed and which risk factors were felt to be important in predicting failure with oral antibiotics.

Methods: We performed an electronic survey of physician members of the Canadian Association of Emergency Physicians (CAEP) using the modified Dillman method.

Results: The survey response rate was 36.9% (n=391) amongst CAEP members. There was a lack of consensus regarding management of SSTIs. CAEP respondents identified 14 risk factors for predicting treatment failure with oral antibiotics, including hypotension, tachypnea, and patient reported severity of pain >8 of 10.

Conclusions: The survey demonstrates significant variability regarding physician management of SSTIs, and we have identified several perceived risk factors for treatment failure with oral antibiotics that should be assessed in future studies.

Keywords: antibiotics; cellulitis; intravenous; skin and soft tissue infections; treatment failure.

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Attitude of Health Personnel*
  • Canada
  • Clinical Decision-Making
  • Cross-Sectional Studies
  • Emergency Medicine / methods
  • Emergency Service, Hospital
  • Female
  • Humans
  • Incidence
  • Male
  • Microbial Sensitivity Tests
  • Prognosis
  • Risk Assessment
  • Skin Diseases, Bacterial / diagnosis
  • Skin Diseases, Bacterial / drug therapy*
  • Skin Diseases, Bacterial / epidemiology
  • Soft Tissue Infections / drug therapy*
  • Soft Tissue Infections / epidemiology
  • Soft Tissue Infections / microbiology
  • Surveys and Questionnaires*
  • Treatment Outcome

Substances

  • Anti-Infective Agents