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Arch Surg. 2006 Sep;141(9):850-4; discussion 855-6.

Inappropriate antibiotic use in soft tissue infections.

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  • 1Division of Infectious Diseases, Department of Surgery, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA.

Abstract

HYPOTHESIS:

Many soft tissue infections treated with surgical drainage resolve even when treated with antibiotics not active against the organism isolated from the infection.

DESIGN:

Retrospective.

SETTING:

Integrated Soft Tissue Infection Services clinic.

PATIENTS:

All patients treated from July 19, 2000, to August 1, 2001, who underwent surgical drainage of a soft tissue infection and had microbiological culture results.

MAIN OUTCOME MEASURES:

Documented resolution of the infection with drainage of the abscess and antibiotic therapy alone was deemed a cure. An infection resulting in death or other surgical therapy was deemed a failure. Therapy was appropriate when the organism was sensitive to prescribed antibiotics and was inappropriate when the organism was insensitive.

RESULTS:

The study included 376 patients with 450 infections. Staphylococcus aureus as the primary organism was isolated from 441 of the cultures. Methicillin sodium-sensitive S aureus and methicillin-resistant S aureus were found in 157 and 284 of these isolates, respectively. Appropriate antibiotics were prescribed in 153 infections with methicillin-sensitive S aureus and in 25 with methicillin-resistant S aureus. Of 441 episodes, 408 were clinically evaluated for cure. Three patients failed treatment, 2 in the appropriately treated group (resulting in death and amputation) and 1 patient with osteomyelitis in the inappropriately treated group. The cure rate for infections treated appropriately or inappropriately was the same.

CONCLUSIONS:

Treatment of soft tissue infections after surgical drainage, even with inappropriate antibiotics, has a high cure rate. Further studies to evaluate the efficacy of treating these infections without antibiotics are needed.

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PMID:
16983028
[PubMed - indexed for MEDLINE]
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