title: Skin and soft tissue infection management, outcomes, and follow-up in the emergency department of an urban academic hospital.
abstract: Skin and soft tissue infections (SSTIs) are among the most common infections treated by emergency department clinicians. The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) as the cause of these infections prompted the Centers for Disease Control and Prevention and the Infectious Disease Society of America to publish guidelines for the outpatient management of SSTIs. This study describes the management and outcomes of emergency department patients treated for uncomplicated SSTIs who returned within 30 days of the initial visit. The study found that of 857 eligible patients, only 17.6% returned and of these, 80% had their wound checked or packing removed. The clinicians prescribed antibiotics for the majority of patients, and the selection of antibiotics typically was active against CA-MRSA. Of 91 lesions drained, 24 specimens were obtained for culture and sensitivity. The majority of the initial treatment of patients consisted of incision and drainage with antibiotic prescription.
authors.affiliation: Emergency Department, Hahnemann University Hospital, Philadelphia, Pennsylvania (Dr Seeleang); Thomas Jefferson University, Jefferson School of Nursing, Philadelphia, Pennsylvania (Drs Seeleang, Manning, and Winstead); Department of Emergency Medicine, Crozer-Chester Medical Center, Chester, Pennsylvania (Dr Saks); Emergency Medicine Drexel University College of Medicine, Philadelphia, Pennsylvania (Dr Saks); and Aria Health, Philadelphia, Pennsylvania (Dr Winstead).
authors.forename: Kanokwan
authors.initials: K
authors.lastname: Seeleang
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Manning
authors.forename: Mark
authors.initials: M
authors.lastname: Saks
authors.forename: Yvette
authors.initials: Y
authors.lastname: Winstead
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000382:microbiology / Q000628:therapy*; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000382:microbiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents