title: Management of cutaneous abscesses by dermatologists.
abstract: OBJECTIVE
  There is currently no data detailing the degree to which dermatologists follow CDC/Infectious Diseases Society of America (IDSA) guidelines in the treatment of abscesses, which recommend that incision and drainage (I+D) as primary therapy for skin and soft tissue infections (SSTI).
  
  
  OBJECTIVE
  To evaluate the management of skin abscesses by dermatologists.
  
  
  METHODS
  A national email survey of 780 dermatologists was conducted from May-June 2012. Awareness, experience, and preparedness of respondents for abscess treatment, as well as the treatment practices in different clinical scenarios were evaluated. Response rate = 65% (n=510).
  
  
  METHODS
  board certified/eligible dermatologists practicing in US. Main practice affiliation: solo (20%), group (33%), university health system/academic (32%), multi-specialty (13%), and other (2%). Main practice setting: urban (49%), suburban (42%), and rural (9%).
  
  
  METHODS
  Practitioner report of: awareness of national guidelines, use of I+D in initial management of uncomplicated abscess found on face, trunk, and extremity on patients age 6 months, 3, 15, 50, and 80 years, and use of antibiotics in the initial management.
  
  
  RESULTS
  99% of respondents were capable of performing I+D in their practice. The IDSA recommends cultures in all patients treated with antibiotic therapy, and does not recommend antibiotics for the treatment of simple abscess. 18% of respondents reported culturing abscesses less than 50% of the time, while 91% incorporated antibiotics into initial treatment. Nearly a quarter (24%) of respondents would choose an initial antibiotic that would not cover Methicillin-resistant Staphylococcus aureus (MRSA). For facial abscesses, as the age of the patient increased from infant, respondents were more likely to incorporate I+D into their initial treatment. For abscesses on the trunk and extremities, respondents were less likely to I+D infants and toddlers, compared to adolescents, adults and the elderly.
  
  
  CONCLUSIONS
  Although most dermatologists were prepared to manage uncomplicated abscesses (98%), this survey identifies gaps in clinical standards of care established by the CDC/IDSA. Identification of these practice gaps may impact physician practice and dermatology residency curricula, and may serve to improve abscess management and antibacterial stewardship in the outpatient setting.
authors: Jason
authors: J
authors: Chouake
authors: Aimee
authors: A
authors: Krausz
authors: Brandon L
authors: BL
authors: Adler
authors: Hillel W
authors: HW
authors: Cohen
authors: Joshua D
authors: JD
authors: Nosanchuk
authors: Adam
authors: A
authors: Friedman
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000628:therapy*; D000293:Adolescent; D000367:Age Factors; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D003880:Dermatology / Q000706:statistics & numerical data; D004322:Drainage / Q000379:methods; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012874:Skin Diseases, Infectious / Q000382:microbiology / Q000628:therapy; D018461:Soft Tissue Infections / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents