Dermatologists Overuse Antibiotics in Treatment of Skin and Soft Tissue Infections

National survey shows frequent antibiotic use strays from national guidelines

Released: 5-Feb-2014 12:00 PM EST
Source Newsroom: Montefiore Medical Center
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Citations Journal of Drugs in Dermatology

Newswise — NEW YORK (February 5, 2014) – Results of a new survey to assess treatment of skin and soft tissue infections shows 90% of dermatologists said they would initially prescribe an antibiotic for a routine, uncomplicated cutaneous abscess; however, guidelines recommend antibiotic use only in complicated cases. Research shows the use of antibiotics for uncomplicated abscesses may contribute to the increased incidence of multi-drug resistant pathogens in the general population. These findings, from researchers at Montefiore Medical Center, were published today in the Journal of Drugs in Dermatology.

Methicillin resistant Staphyloccus aureus (MRSA) is now the major source of skin infection in the U.S. These infections are generally uncomplicated at the time of initial presentation and can be managed in the outpatient setting. National guidelines for clinical care indicate incision and drainage (I+D) alone for the primary treatment of uncomplicated skin and soft tissue infections. Antibiotic treatment is recommended after I+D only in certain populations, including those who present with symptoms such as fever, patients who are elderly or very young, patients with abscesses in difficult to drain areas, or patients who do not respond to I+D alone. Nearly all dermatologists surveyed (99%) were capable of performing I+D and were likely to incorporate I+D into their initial treatment alongside antibiotic use. Read the abstract here.

“Dermatologists are reluctant to rely on incision and drainage alone, despite the fact that studies spanning more than 30 years fail to show antibiotics provide added benefit in the treatment of routine skin infections,” said Adam Friedman, M.D., director of dermatologic research, Montefiore, assistant professor of medicine, Albert Einstein College of Medicine of Yeshiva University, and lead author. “These findings shine a light on discrepancies between clinical guidelines and clinical practice at a time when widespread misuse of antibiotics is contributing to the increased role of antibiotic resistance across the country.”

This is the first published data on the extent to which dermatologists follow national guidelines in the treatment of abscesses. Other key takeaways reveal gaps in dermatologist adherence to clinical guidelines including the frequent prescription of antibiotics that are ineffective against MRSA and the decreased likelihood of performing I+D procedures on infants.

“These results add to a growing body of research suggesting that, across specialties, antibiotics are being used as a safety net in the management of routine skin infections even though incision and drainage alone is the gold standard,” said Dr. Friedman. “Comprehensive efforts to educate healthcare practitioners about local rates of antibiotic resistance could impact clinical practice.”

About Montefiore Medical Center
As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Recognized among the top hospitals nationally and regionally by U.S. News & World Report, Montefiore provides compassionate, patient- and family-centered care and educates the healthcare professionals of tomorrow. The Children's Hospital at Montefiore is consistently named in U.S. News' "America's Best Children's Hospitals," and is second among those in the New York metro area. With four hospitals, 1,491 beds and 90,000 annual admissions, Montefiore is an integrated health system seamlessly linked by advanced technology. State-of-the-art primary and specialty care is provided through a network of more than 130 locations across the region, including the largest school health program in the nation and a home health program. Montefiore's partnership with Einstein advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. The medical center derives its inspiration for excellence from its patients and community, and continues to be on the frontlines of developing innovative approaches to care. For more information please visit www.montefiore.org and www.montekids.org. Follow us on Twitter; like us on Facebook; view us on YouTube.

About the Journal of Drugs in Dermatology (JDD)
The Journal of Drugs in Dermatology (JDD) is a full-color, peer-reviewed publication indexed with MEDLINE®/PubMed®. Founded by the renowned Dr. Perry Robins, MD and now in its 12th year, it offers one of the fastest routes to disseminate dermatologic information, and is considered the fastest growing publication in dermatology. JDD presents original articles, award-winning case reports, and timely features pertaining to new methods, techniques, and drug therapy in dermatology. Articles are reviewed by an International Editorial Board of over 150 renowned experts. JDD reaches around 14,500 dermatology healthcare professionals and has been recognized as the official publication of the International Society of Dermatologic Surgery (ISDS) and the Orlando Dermatology Aesthetic and Clinical (ODAC) Conference. Visit JDDOnline.com for article archives, access to CME activities, supplements and author instructions. For more information, visit JDDonline.com. Follow us on Twitter; like us on Facebook.

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