title: Administration of first dose antibiotic in the ED in patients with minor skin and soft tissue infections.
abstract: BACKGROUND
  Patients who present to the emergency department (ED) with mild skin and soft tissue infections (SSTIs) are often given a single dose of an antibiotic before being discharged home on oral antibiotics. The objective of this study was to determine if administration of antibiotics in the ED increases length of stay.
  
  
  METHODS
  This was cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey. Patients with SSTIs who were discharged home with antibiotics were included. Patients were categorized into 2 groups based on whether any antibiotics were administered in the ED. The ED length of stay was compared between the groups. A multivariate analysis was conducted to adjust for pertinent confounders.
  
  
  RESULTS
  There were 3000895 cases of patients with SSTIs who presented to the ED and directly discharged home on antibiotic therapy from 2008 to 2010. Of these, 46.8% (n = 1403710) involved the administration of an antibiotic in the ED, whereas the others only received antibiotic prescriptions upon discharge. The mean ED length of stay was 83.8 ± 160.6 minutes with no antibiotics vs 112.2 ± 193.6 minutes for antibiotic use in the ED (P < .05). After adjusting for confounders, there was a 43% increase in ED length of stay associated with administration of first dose of antibiotics in the ED (exp[b] = 1.43; 95% confidence interval, 1.19-1.70; P < .001).
  
  
  CONCLUSIONS
  The administration of an antibiotic in the ED before discharge is associated with an increased ED length of stay in patients with SSTIs.
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85721, USA; Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, PO Box 80260, Jeddah 21589, Saudi Arabia. Electronic address: aealtyar@kau.edu.sa.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Altyar
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85721, USA; Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, PO Box 80260, Jeddah 21589, Saudi Arabia. Electronic address: bakhsh@pharmacy.arizona.edu.
authors.forename: Hussain T
authors.initials: HT
authors.lastname: Bakhsh
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85721, USA; Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, PO Box 80260, Jeddah 21589, Saudi Arabia. Electronic address: amohammed1@kau.edu.sa.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Mohammed
authors.affiliation: The University of Oklahoma Health Sciences Center, College of Pharmacy & Stephenson Cancer Center, 1110 N Stonewall Ave, Oklahoma City, OK 73117 USA. Electronic address: Grant-Skrepnek@ouhsc.edu.
authors.forename: Grant
authors.initials: G
authors.lastname: Skrepnek
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85721, USA. Electronic address: patanwala@pharmacy.arizona.edu.
authors.forename: Asad E
authors.initials: AE
authors.lastname: Patanwala
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D004636:Emergency Service, Hospital; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents