title: Antibiotic therapy and staphylococcal skin infections in a tropical malarial zone (Guyana). Practices in conventional and exceptional situations.
abstract: A problem of community-acquired Staphylococcus aureus skin infections emerged in the French armed forces in 2004, in a malaria-endemic areas. The high incidence rate led us to evaluate military staff practices. This was a cross-sectional survey of doctors and nurses deployed as officers in French Guyana since 2006. The definition of skin and soft-tissue infection came from the criteria for epidemiological surveillance of the armed forces. We studied the management of antibiotic therapy and its related difficulties. In all, 47 officers responded. At the Military Medical Center (MMC), 23.4% of respondents routinely prescribed antibiotics, compared with 36.2% when stationed in the jungle (p<0.05%). Complication led 68.1 of staff to prescribe antibiotic prescriptions at the MMC, compared with 46.8% in the jungle (p<0.05%). Finally, 22.5% of those at MMC prescribed antibiotic coverage of surgical drainage, compared with 14.8% in the jungle (p<0.05%). Pristinamycin and fusidic acid were the preferred antibiotics. Two-thirds of the staff reported difficulties in jungle management. This first study indicates the need for an update of military medical recommendations. Personnel training must continue to enable them to provide appropriate aggressive management in the current endemic context.
authors.affiliation: Antenne médicale de Poitiers-Ladmirault, France.
authors.forename: S-P
authors.initials: SP
authors.lastname: Corcostegui
authors.affiliation: Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Lefort
authors.affiliation: Centre d'épidémiologie et de santé publique des armées, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Dia
authors.affiliation: Centre d'épidémiologie et de santé publique des armées, Marseille, France.
authors.forename: V Pommier de
authors.initials: VP
authors.lastname: Santi
authors.affiliation: Centre médical des armées de Ventiseri-Solenzara, Solenzara, France.
authors.forename: C
authors.initials: C
authors.lastname: Carfantan
authors.affiliation: Centre médical interarmées de Kourou, BP 737-973, Kourou, France.
authors.forename: J
authors.initials: J
authors.lastname: Galant
authors.affiliation: Service de dermatologie, Hôpital d'instruction des armées, Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Lightburne
authors.affiliation: Centre médical des armées de Bordeaux-Merignac (Cazaux), La Teste, France.
authors.forename: P
authors.initials: P
authors.lastname: Guénot
authors.affiliation: Centre d'épidémiologie et de santé publique des armées, Marseille, France.
authors.forename: X
authors.initials: X
authors.lastname: Deparis
authors.affiliation: Direction centrale du service de santé des armées, Vincennes, France.
authors.forename: R
authors.initials: R
authors.lastname: Migliani
authors.affiliation: Service de dermatologie, Hôpital d'instruction des armées, Sainte-Anne, Toulon, France.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Morand
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006172:Guyana / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D008288:Malaria / Q000453:epidemiology; D008297:Male; D008889:Military Personnel; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'; D013207:Staphylococcal Skin Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus
chemical_list: D000900:Anti-Bacterial Agents
keywords: Guyana; Panton-Valentine leukocidin; community-acquired Staphylococcus aureus skin infections; doxycyclin