A potential benefit from infectious disease specialist and stationary ward in rational antibiotic therapy of complicated skin and skin structure infections

Jääskeläinen, Iiro H.; Hagberg, Lars; Schyman, Tommy; Järvinen, Asko

doi:10.1080/23744235.2017.1362706

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Our results agree with previously published studies showing that the presence of IDDs (either as the main or consulting physician) was associated with more rational treatment, ie, treatment in accordance with antibiotic stewardship principles, in patients with various infections hospitalized in and outside of intensive care units (16)(17)(18)(19).…”

Section: Discussionsupporting

confidence: 92%

Outpatient treatment of pneumonia in a setting with and without an infectious disease doctor

Kusulja

Žarković²,

Kudoić³

et al. 2023

Croat Med J

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Aim To compare the outpatient treatment of community acquired pneumonia (CAP) by infectious disease doctors (IDDs) and doctors of other specialties (nIDDs). Methods We retrospectively identified 600 outpatients with CAP: 300 treated by IDDs and 300 by nIDDs in two tertiary hospitals during 2019. The two groups were compared in terms of adherence to guidelines, antibiotic group prescription, frequency of combined treatment, and treatment duration. Results IDDs prescribed significantly more first-line treatment ( P < 0.001) and alternative treatment ( P = 0.008). NIDDs prescribed more reasonable ( P < 0.001) and unnecessary ( P = 0.002) second-line treatment, and inadequate treatment ( P = 0.004). IDDs significantly more frequently prescribed amoxicillin ( P < 0.001) for typical and doxycycline ( P = 0.045) for atypical CAP, while nIDDs significantly more frequently prescribed amoxicillin-clavulanate ( P < 0.001) for typical and fluoroquinolones for both typical ( P < 0.001) and atypical ( P < 0.001) CAP. No significant differences were found in the frequency of combined treatment, which exceeded 50% in both groups, or in treatment duration. Conclusions Outpatient treatment of CAP in the absence of IDDs meant more broad-spectrum antibiotic prescription and more disregard for national guidelines. Our results highlight the need for antibiotic stewardship, especially in settings with no IDDs.

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Section: Discussionsupporting

confidence: 92%

Outpatient treatment of pneumonia in a setting with and without an infectious disease doctor

Kusulja

Žarković²,

Kudoić³

et al. 2023

Croat Med J

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“…Blood cultures were drawn from 258 (51.6%) patients and they were positive in 61 (23.6%). Although there was some heterogeneity in the patient populations between the two centres [ 18 ], proportion of positive blood cultures was almost equal, in Helsinki 22.9% and 25% in Gothenburg. Blood culture isolates were Streptococcus pyogenes 19 cases (31.1%), Staphylococcus aureus 19 (31.1%), non-A beta-hemolytic streptococci 12 (19.7%), Streptococcus pneumoniae 1 (1.6%), Enterobacteriaceae spp.…”

Section: Resultsmentioning

confidence: 99%

Factors associated with blood culture positivity in patients with complicated skin and skin structure infection—a population-based study

Halavaara

Jääskeläinen

Hagberg

et al. 2019

Eur J Clin Microbiol Infect Dis

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Skin and skin structure infection (SSSI) is classified as complicated (cSSSI) if it involves deep subcutaneous tissue or requires surgery. Factors associated with blood culture sampling and bacteremia have not been established in patients with cSSSI. Moreover, the benefit of information acquired from positive blood culture is unknown. The aim of this study was to address these important issues. In this retrospective population-based study from two Nordic cities, a total of 460 patients with cSSSI were included. Blood cultures were drawn from 258 (56.1%) patients and they were positive in 61 (23.6%) of them. Factors found to be associated with more blood culture sampling in multivariate analysis were diabetes, duration of symptoms shorter than 2 days and higher C-reactive protein (CRP) level. Whereas factors associated with less frequent blood culture sampling were peripheral vascular disease and a surgical wound infection. In patients from whom blood cultures were taken, alcohol abuse was the only factor associated with culture positivity, as CRP level was not. Patients with a positive blood culture had antibiotic streamlining more often than non-bacteremic patients. A high rate of blood culture positivity in patients with cSSSI was observed. Factors related to more frequent blood culture sampling were different from those associated with a positive culture.

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Ensuring access to ‘access’ antibiotics: an imminent consideration for sustainable antimicrobial stewardship in the developing world

Kakkar

Shafiq

Malhotra

2019

Infectious Diseases

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A potential benefit from infectious disease specialist and stationary ward in rational antibiotic therapy of complicated skin and skin structure infections

Cited by 3 publications

References 24 publications

Outpatient treatment of pneumonia in a setting with and without an infectious disease doctor

Outpatient treatment of pneumonia in a setting with and without an infectious disease doctor

Factors associated with blood culture positivity in patients with complicated skin and skin structure infection—a population-based study

Ensuring access to ‘access’ antibiotics: an imminent consideration for sustainable antimicrobial stewardship in the developing world

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