Clinical and Epidemiologic Characteristics as Predictors of Treatment Failures in Uncomplicated Skin Abscesses within Seven Days after Incision and Drainage
The Journal of Emergency Medicine, 06/15/2012
Olderog CK et al. – Cellulitis and abscess size do not predict treatment failures within 7days, nor do they predict which patients will have methicillin–resistant Staphylococcus aureus (MRSA). MRSA–positive patients are more likely to fail treatment within 7 days of incision and drainage.Methods
- Logistic regression models were used to examine clinical variables as predictors of treatment failure within 7days after incision and drainage and MRSA by wound culture.
- Of 212 study participants, 190 patients were analyzed and 22 were lost to follow-up.
- Patients who grew MRSA, compared to those who did not, were more likely to fail treatment (31% to 10%, respectively; 95% confidence interval [CI] 8–31%).
- The failure rates for abscesses ≥5cm and <5cm were 26% and 22%, respectively (95% CI-11–26%).
- The failure rates for cellulitis ≥5cm and <5cm were 27% and 16%, respectively (95% CI-2–22%).
- Larger abscesses were no more likely to grow MRSA than smaller abscesses (55% vs. 53%, respectively; 95% CI-22–23%).
- The patients with larger-diameter cellulitis demonstrated a slightly higher rate of MRSA-positive culture results compared to patients with smaller-diameter cellulitis (61% vs. 46%, respectively; 95% CI-0.3–30%), but the difference was not statistically significant.