1. Decreased Antibiotic Utilization After Implementation of a Guideline for Inpatient Cellulitis and Cutaneous Abscess
- Author
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Walter L. Biffl, Allison L. Sabel, Connie S. Price, Steven J. Morgan, Jason S. Haukoos, Ellen Sarcone, William J. Burman, Philip S. Mehler, Jeremy Long, Timothy C. Jenkins, Bryan Knepper, and Andrew W. Steele
- Subjects
Adult ,Male ,medicine.medical_specialty ,Skin Diseases ,Pharmacotherapy ,Interquartile range ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Abscess ,Retrospective Studies ,Inpatients ,business.industry ,Cellulitis ,Retrospective cohort study ,Guideline ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,Surgery ,Skin Abscess ,Practice Guidelines as Topic ,Cohort ,Female ,business - Abstract
BACKGROUND Cellulitis and cutaneous abscess are among the most common infections leading to hospitalization, yet optimal management strategies have not been adequately studied. We hypothesized that implementation of an institutional guideline to standardize and streamline the evaluation and treatment of inpatient cellulitis and abscess would decrease antibiotic and health care resource utilization. METHODS A retrospective preintervention-postintervention study was performed to compare management before and after implementation of the guideline (January 1, 2007-December 31, 2007, and July 9, 2009-July 8, 2010). RESULTS A total of 169 patients (66 with cellulitis, 103 with abscess) were included in the baseline cohort, and 175 (82 with cellulitis, 93 with abscess) were included in the intervention cohort. The intervention led to a significant decrease in use of microbiological cultures (80% vs 66%; P = .003) and fewer requests for inpatient consultations (46% vs 30%; P = .004). The median duration of antibiotic therapy decreased from 13 days (interquartile range [IQR], 10-15 days) to 10 days (IQR, 9-12 days) (P
- Published
- 2011
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