Type

Journal Article

Authors

Abel Wakai
Ian Stiell
Arnold Hill
Ronan O'Sullivan
Tom Fahey
Fiona Boland
Michael Quirke

Subjects

Medicine & Nursing

Topics
female administration oral medicine and health sciences methicillin resistant staphylococcus aureus male independent study risk factors prospective studies pilot projects prevalence administration emergency service cellulitis emergency department emergency treatment staphylococcal infections anti bacterial agents ambulatory care odds ratio hospital oral adult treatment failure humans emergency service hospital surgery follow up

Prevalence and predictors of initial oral antibiotic treatment failure in adult emergency department patients with cellulitis: a pilot study. (2015)

Abstract Assessment of cellulitis severity in the emergency department (ED) setting is problematic. Given the lack of research performed to describe the epidemiology and management of cellulitis, it is unsurprising that heterogeneous antibiotic prescribing and poor adherence to guidelines is common. It has been shown that up to 20.5% of ED patients with cellulitis require either a change in route or dose of the initially prescribed antibiotic regimen. The current treatment failure rate for empirically prescribed oral antibiotic therapy in Irish EDs is unknown. The association of patient risk factors with treatment failure has not been described in our setting. Lower prevalence of community-acquired methicillin-resistant Staphylococcus aureus-associated infection, differing antibiotic prescribing preferences and varying availability of outpatient intravenous therapy programmes may result in different rates of empiric antibiotic treatment failure from those previously described. Consecutive ED patients with cellulitis will be enrolled on a 24/7 basis from 3 Irish EDs. A prespecified set of clinical variables will be measured on each patient discharged on empiric oral antibiotic therapy. A second independent study recruiter will assess at least 10% of cases for each of the predictor variables. Follow-up by telephone call will occur at 14 days for all discharged patients where measurement of the primary outcome will occur. Our primary outcome is treatment failure, defined as a change in route of antibiotic administration from oral to intravenous antibiotic. Our secondary outcome is change in dose or type of prescribed antibiotic. A cohort of approximately 152 patients is required to estimate the proportion of patients failing oral antibiotic treatment with a margin of error of 0.05 around the estimate. Full ethics approval has been granted. An integrated dissemination plan, involving diverse clinical specialties and enrolled patients, is described. NCT 02230813.
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Ireland -> Royal College of Surgeons in Ireland -> Division of Population Health Sciences
Ireland -> Royal College of Surgeons in Ireland -> Department of General Practice
Ireland -> Royal College of Surgeons in Ireland -> General Practice Articles
Ireland -> Royal College of Surgeons in Ireland -> Surgery Articles

Full list of authors on original publication

Abel Wakai, Ian Stiell, Arnold Hill, Ronan O'Sullivan, Tom Fahey, Fiona Boland, Michael Quirke

Experts in our system

1
Abel Wakai
Royal College of Surgeons in Ireland
Total Publications: 38
 
2
Arnold D K Hill
Royal College of Surgeons in Ireland
Total Publications: 110
 
3
Ronan O'Sullivan
University College Cork
Total Publications: 42
 
4
Tom Fahey
Royal College of Surgeons in Ireland
Total Publications: 162
 
5
Fiona Boland
Royal College of Surgeons in Ireland
Total Publications: 61
 
6
Michael Quirke
Royal College of Surgeons in Ireland
Total Publications: 17