Academic Journal
A prescription for resistance: Management of staphylococcal skin abscesses by general practitioners in Australia
| العنوان: | A prescription for resistance: Management of staphylococcal skin abscesses by general practitioners in Australia |
|---|---|
| المؤلفون: | C Parrott, G Wood, E Bogatyreva, GW Coombs, PDR Johnson, Catherine Bennett |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Microbiology not elsewhere classified, Environmental management not elsewhere classified, Soil sciences not elsewhere classified, Science & Technology, Life Sciences & Biomedicine, Microbiology, antibiotic resistance, Staphylococcus aureus, skin and soft tissue infections, community medicine, boils and abscesses, SOFT-TISSUE INFECTIONS, AUREUS INFECTIONS, AMBULATORY RESEARCH, PRIMARY-CARE, PATTERNS, EMERGENCY-DEPARTMENT, 111799 Public Health and Health Services not elsewhere classified, 920499 Public Health (excl. Specific Population Health) not elsewhere classified, Population Health, School of Health and Social Development, 4206 Public health, 4203 Health services and systems |
| الوصف: | Objectives: We investigated the management of staphylococcal abscesses (boils) by general practitioners (GPs) in the context of rising antibiotic resistance in community strains of Staphylococcus aureus. Design, Setting, Participants: We analyzed patient-reported management of 66 cases of uncomplicated skin abscesses from the frequency matched methicillinresistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) Community- Onset Staphylococcus aureus Household Cohort (COSAHC) study (Melbourne, Australia, 2008–2012). Susceptibilities in all cases were known: 50/66 abscesses were caused by MRSA. In order to investigate GP-reported management of staphylococcal abscesses, we surveyed a random subset of GPs, from the COSAHC study (41), and of GPs (39) who used the same community-based pathology service (December 2011– May 2012). Main outcome measures: Patient outcomes, antibiotics prescribed, antibiotic resistance profiles of infecting strains, rates of incision and drainage (I&D), and attitudes to ordering microbiological cultures. Results: MRSA was three times more likely to be cultured from an abscess than MSSA. Patient-reported management revealed 100% were prescribed antibiotics and only 60.6% had I&D. Of those 85% who remembered their prescription(s), 81% of MRSA cases and 23% of MSSA cases initially received inactive antibiotics. Repeat GP visits where antibiotics were changed occurred in 45 MRSA and 7 MSSA cases, although at least 33% of subsequent prescriptions were inactive for the MRSA infections. Patients treated with I&D and antibiotics did no better than those treated with only I&D, regardless of the antibiotic activity. In the GP surveys, 89% reported I&D, with or without antibiotics, to be their preferred management. Only 29.9% of GPs would routinely swab abscesses. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| Relation: | http://hdl.handle.net/10536/DRO/DU:30084681; https://figshare.com/articles/journal_contribution/A_prescription_for_resistance_Management_of_staphylococcal_skin_abscesses_by_general_practitioners_in_Australia/20879179 |
| الاتاحة: | http://hdl.handle.net/10536/DRO/DU:30084681 https://figshare.com/articles/journal_contribution/A_prescription_for_resistance_Management_of_staphylococcal_skin_abscesses_by_general_practitioners_in_Australia/20879179 |
| Rights: | CC BY 4.0 |
| رقم الانضمام: | edsbas.9BD661D2 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |