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skin and soft tissue infections guidelines

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https://www.readbyqxmd.com/read/29485428/optimal-timing-of-initial-debridement-for-necrotizing-soft-tissue-infection-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#1
Rondi B Gelbard, Paula Ferrada, D Dante Yeh, Brian Williams, Michele Loor, James Yon, Caleb Mentzer, Kosar Khwaja, Mansoor Khan, Anirudh Kohli, Eileen M Bulger, Bryce R H Robinson
BACKGROUND: Necrotizing soft tissue infections (NSTI) are rare, life-threatening, soft-tissue infections characterized by rapidly spreading inflammation and necrosis of the skin, subcutaneous fat, and fascia. While it is widely accepted that delay in surgical debridement contributes to increased mortality, there are currently no practice management guidelines regarding the optimal timing of surgical management of this condition. Although debridement within 24 hours of diagnosis is generally recommended, the time ranges from 3 hours to 36 hours in the existing literature...
February 27, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29447384/antimicrobial-prophylaxis-with-combat-related-open-soft-tissue-injuries
#2
Bradley A Lloyd, Clinton K Murray, Faraz Shaikh, M Leigh Carson, Dana M Blyth, Elizabeth R Schnaubelt, Timothy J Whitman, David R Tribble
Introduction: All Department of Defense (DoD) guidance documents recommend cefazolin or clindamycin as post-trauma antibiotic prophylaxis for open soft-tissue injuries. Although not advocated, some patients with open soft-tissue injuries also received expanded Gram-negative coverage (EGN) prophylaxis based on the judgment of front-line trauma providers. During the study period, revised guidelines in 2011/2012 re-emphasized recommendations for using cefazolin or clindamycin, and stewardship efforts in the DoD trauma community aimed to reduce the practice of adding EGN to guideline-recommended antibiotic prophylaxis...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29417764/prospective-evaluation-of-ceftriaxone-use-in-medical-and-emergency-wards-of-gondar-university-referral-hospital-ethiopia
#3
Asnakew Achaw Ayele, Begashaw Melaku Gebresillassie, Daniel Asfaw Erku, Eyob Alemayehu Gebreyohannes, Dessalegn Getnet Demssie, Amanual Getnet Mersha, Henok Getachew Tegegn
Ceftriaxone is among the most commonly utilized antibiotics owing to its high potency, wide spectrum of activity, and low risk of toxicity. It is used to treat different types of bacterial infections including pneumonia, bone infections, abdominal infections, Skin and soft tissue infections, urinary tract infections. However, evidence around the globe shows the misuse of Ceftriaxone. This study aimed at evaluating the appropriateness of ceftriaxone use in medical and emergency wards of Gondar university referral hospital (GURH), Northwest Ethiopia...
February 2018: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/29373647/eggerthella-lenta-bloodstream-infections-are-associated-with-increased-mortality-following-empiric-piperacillin-tazobactam-tzp-monotherapy-a-population-based-cohort-study
#4
Alejandra Ugarte-Torres, Mark R Gillrie, Thomas P Griener, Deirdre L Church
Background: Eggerthella lenta is a non-sporulating anaerobic gram-positive bacilli associated with polymicrobial intra-abdominal infections. Recently, E. lenta has been recognized as an important cause of anaerobic blood-stream infections (BSI) associated with high mortality. E. lenta has been reported to have high minimal inhibitory concentrations (MICs) to piperacillin-tazobactam (TZP), a broad-spectrum antibiotic with anaerobic coverage commonly used in multiple centers for empiric treatment of abdominal sepsis...
January 24, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29354655/guidelines-vs-actual-management-of-skin-and-soft-tissue-infections-in-the-emergency-department
#5
Rahul S Kamath, Deepthi Sudhakar, Julianna G Gardner, Vagish Hemmige, Hossam Safar, Daniel M Musher
Background: Infections of skin and soft tissue (SSTI) commonly cause visits to hospital emergency departments (EDs). The Infectious Diseases Society of America (IDSA) has published guidelines for the management of SSTI, but it is unclear how closely these guidelines are followed in practice. Methods: We reviewed records of patients seen in the ED at a large tertiary care hospital to determine guidelines adherence in 4 important areas: the decision to hospitalize, choice of antibiotics, incision and drainage (I&D) of abscesses, and submission of specimens for culture...
January 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29324505/when-to-switch-to-an-oral-treatment-and-or-to-discharge-a-patient-with-skin-and-soft-tissue-infections
#6
Matteo Bassetti, Christian Eckmann, Maddalena Peghin, Alessia Carnelutti, Elda Righi
PURPOSE OF REVIEW: Skin and soft tissue infections prevalence is increasing and represent a frequent cause of hospital admission. New guidelines have become available in order to better define these infections and their response to antimicrobial treatment. Gram-positive bacteria, in particular Staphylococcus aureus, remain the most frequently isolated pathogens in skin and soft tissue infections. To treat complicated forms and infections caused by drug-resistant bacteria, hospital admission and administration of intravenous antibiotics are often required, impacting on healthcare costs and patients' morbidity...
April 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29299899/clinical-guidelines-for-the-antibiotic-treatment-for-community-acquired-skin-and-soft-tissue-infection
#7
Yee Gyung Kwak, Seong Ho Choi, Tark Kim, Seong Yeon Park, Soo Hong Seo, Min Bom Kim, Sang Ho Choi
Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. This clinical guideline provides recommendations for the diagnosis and management of SSTI, including impetigo/ecthyma, purulent skin and soft tissue infection, erysipelas and cellulitis, necrotizing fasciitis, pyomyositis, clostridial myonecrosis, and human/animal bite. This guideline targets community-acquired skin and soft tissue infection occurring among adult patients aged 16 years and older...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29261121/six-year-retrospective-review-of-hospital-data-on-antimicrobial-resistance-profile-of-staphylococcus-aureus-isolated-from-skin-infections-from-a-single-institution-in-greece
#8
Christina Stefanaki, Alexandra Ieronymaki, Theoni Matoula, Chrysseis Caroni, Evaggelia Polythodoraki, Stella-Eugenia Chryssou, George Kontochristopoulos, Christina Antoniou
Objective: To determine the prevalence of resistant strains of Staphylococcus aureus ( S. aureus ) isolated from Skin and soft tissue infections (SSTI) to various antibiotics. Material and Methods: All culture-positive results for S. aureus from swabs taken from patients presenting at one Greek hospital with a skin infection between the years 2010-2015 were examined retrospectively. Bacterial cultures, identification of S. aureus and antimicrobial susceptibility testing were performed using the disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines and European Committee on Antimicrobial testing (EUCAST) breakpoints...
December 20, 2017: Antibiotics
https://www.readbyqxmd.com/read/29219814/cellulitis-current-insights-into-pathophysiology-and-clinical-management
#9
D R Cranendonk, A P M Lavrijsen, J M Prins, W J Wiersinga
Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired. Diabetes, obesity and old age are associated with defects in all of these areas and as a result are major predisposing factors for cellulitis. In this review, we summarise current insights into the pathophysiology of cellulitis and place the Dutch guidelines on the clinical management of cellulitis of the lower extremities in perspective. Recent evidence on diagnostic strategies is discussed, the importance of which is underscored by findings that venous insufficiency, eczema, deep vein thrombosis and gout are frequently mistaken for cellulitis...
November 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29102120/antimicrobial-resistance-in-clinical-escherichia-coli-isolated-from-companion-animals-in-australia
#10
Sugiyono Saputra, David Jordan, Tahlia Mitchell, Hui San Wong, Rebecca J Abraham, Amanda Kidsley, John Turnidge, Darren J Trott, Sam Abraham
Multidrug-resistant (MDR) Escherichia coli have become a major public health concern to both humans and animal health. While the frequency of antimicrobial resistance (AMR) in clinical E. coli is monitored regularly in human medicine, current frequency of AMR in companion animals remains unknown in Australia. In this study we conducted antimicrobial susceptibility testing (AST) and where possible, determined potential risk factors for MDR infection among 883 clinical Escherichia coli isolated from dogs (n=514), cats (n=341) and horses (n=28)...
November 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/29052109/assessments-of-opportunities-to-improve-antibiotic-prescribing-in-an-emergency-department-a-period-prevalence-survey
#11
Tristan T Timbrook, Aisling R Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L LaPlante
INTRODUCTION: Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. METHODS: A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015...
December 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29020285/impact-of-systemic-antibiotics-on-staphylococcus-aureus-colonization-and-recurrent-skin-infection
#12
Patrick G Hogan, Marcela Rodriguez, Allison M Spenner, Jennifer M Brenneisen, Mary G Boyle, Melanie L Sullivan, Stephanie A Fritz
Background: Staphylococcus aureus colonization poses risk for subsequent skin and soft tissue infection (SSTI). We hypothesized that including systemic antibiotics in the management of S. aureus SSTI, in conjunction with incision and drainage, would reduce S. aureus colonization and incidence of recurrent infection. Methods: We prospectively evaluated 383 children with S. aureus SSTI requiring incision and drainage and S. aureus colonization in the anterior nares, axillae, or inguinal folds at baseline screening...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28941632/professional-practice-evaluation-of-emergency-department-prescriptions-for-community-acquired-infections-in-lebanon
#13
Iqbal Fahs, Zeina Shrayteh, Rima Abdulkhalek, Pascale Salameh, Souheil Hallit, Diana Malaeb
BACKGROUND: Selecting the appropriate antibiotic regimen is extremely important in improving patient outcomes, minimizing antimicrobial resistance, and reducing costs. This study was conducted to evaluate current prescribing practices for empiric antibiotics at the time of admission to the emergency department (ED) and to assess their appropriateness in Lebanon. METHODS: A retrospective observational study was conducted at three different Lebanese hospitals between June and December 2016...
September 21, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28870242/intraoperative-wound-irrigation-to-prevent-surgical-site-infection-after-laparotomy-iowisi-study-protocol-for-a-randomized-controlled-trial
#14
Tara C Mueller, Ulrich Nitsche, Victoria Kehl, Rebekka Schirren, Beate Schossow, Ruediger Goess, Helmut Friess, Daniel Reim
BACKGROUND: Postoperative surgical site infection (SSI) is one of the most common hospital infections and contributes substantially to postoperative morbidity and mortality. In addition, SSIs dramatically increase the treatment cost and length of hospital stay. Following visceral surgery by laparotomy, SSI rates are especially high (14-25%). Therefore, measures to prevent SSI in this field are urgently needed. Prophylactic intraoperative wound irrigation (IOWI) of the subcutaneous soft tissue before skin closure hypothetically represents an easy and economical option to reduce SSI rates and is already frequently used in clinical practice...
September 4, 2017: Trials
https://www.readbyqxmd.com/read/28745729/highlights-of-skin-disease-education-foundation-s-41st-annual-hawaii-dermatology-seminar%C3%A2
#15
Kenneth B Gordon, Craig L Leonardi, Daniel E Furst, Neal Bhatia, Lawrence F Eichenfield, Katie Beleznay
New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology of psoriasis has facilitated the development of increasingly efficacious medications. Skin clearance used to be regarded as an impractical goal for psoriasis therapy...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28592371/low-yield-of-blood-and-wound-cultures-in-patients-with-skin-and-soft-tissue-infections
#16
Jesus Torres, Nathaniel Avalos, Lamarr Echols, Jillian Mongelluzzo, Robert M Rodriguez
BACKGROUND: Current guidelines recommend blood cultures in skin and soft-tissue infection (SSTI) patients only with signs of systemic toxicity and wound cultures for severe purulent infections. Our objectives were to determine: 1) blood and wound culture yields in patients admitted with SSTIs; 2) whether injection drug users (IDUs) and febrile patients had higher blood culture yields; and 3) whether blood and wound cultures grew organisms sensitive to typical SSTI empiric antibiotics...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28589426/clinical-condition-and-comorbidity-as-determinants-for-blood-culture-positivity-in-patients-with-skin-and-soft-tissue-infections
#17
F V van Daalen, M C Kallen, C M A van den Bosch, M E J L Hulscher, S E Geerlings, J M Prins
The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including patients with cellulitis and wound infection who had been enrolled in three Dutch multicenter studies between 2011 and 2015. Patients' acute clinical condition was assessed using the Modified Early Warning Score (MEWS; severe: MEWS ≥2) and comorbidity with the Charlson Comorbidity Index (CCI; severe: CCI ≥2)...
October 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28570348/early-infectious-outcomes-after-addition-of-fluoroquinolone-or-aminoglycoside-to-posttrauma-antibiotic-prophylaxis-in-combat-related-open-fracture-injuries
#18
Bradley A Lloyd, Clinton K Murray, Faraz Shaikh, M Leigh Carson, Dana M Blyth, Elizabeth R Schnaubelt, Timothy J Whitman, David R Tribble
BACKGROUND: We examined combat-related open extremity fracture infections as a function of whether posttrauma antimicrobial prophylaxis included expanded Gram-negative (EGN) coverage. METHODS: Military personnel with open extremity fractures sustained in Iraq and Afghanistan (2009-2014) who transferred to participating hospitals in the United States were assessed. The analysis was restricted to patients with a U.S. hospitalization period of ≥7 days. Prophylaxis was classified as narrow (e...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28480249/a-proposed-new-classification-of-skin-and-soft-tissue-infections-modeled-on-the-subset-of-diabetic-foot-infection
#19
REVIEW
Benjamin A Lipsky, Michael H Silverman, Warren S Joseph
Schemes for classifying skin and soft tissue infections (SSTIs) pose limitations for clinicians and regulatory agencies. Diabetic foot infections (DFIs) are a subset of SSTIs. We developed and are proposing a classification to harmonize current schemes for SSTIs and DFIs. Existing schemes for classifying SSTIs are limited in both their usefulness to clinicians and to regulatory agencies. The guidelines on SSTI from the Infectious Diseases Society of America (IDSA) and the guidance from the US Food and Drug Administration do not adequately address many types of wound infections...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28440855/accuracy-of-current-diagnostic-criteria-for-acute-bacterial-infection-in-older-adults-in-the-emergency-department
#20
Jeffrey M Caterino, Robert Leininger, David M Kline, Lauren T Southerland, Salman Khaliqdina, Christopher W Baugh, Daniel J Pallin, Kurt B Stevenson
OBJECTIVES: To compare the accuracy of the Loeb criteria, emergency department (ED) physicians' diagnoses, and Centers for Disease Control and Prevention (CDC) guidelines for acute bacterial infection in older adults with a criterion standard expert review. DESIGN: Prospective, observational study. SETTING: Urban, tertiary-care ED. PARTICIPANTS: Individuals aged 65 and older in the ED, excluding those who were incarcerated, underwent a trauma, did not speak English, or were unable to consent...
August 2017: Journal of the American Geriatrics Society
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