Administration of first dose antibiotic in the emergency department in patients with minor skin and soft tissue infections Ahmed Altyar PharmD, Hussain T. Bakhsh PharmD, Abdulaziz Mohammed PharmD, Grant Skrepnek Ph.D., Asad E. Patanwala PharmD PII: DOI: Reference:

S0735-6757(15)00456-8 doi: 10.1016/j.ajem.2015.05.035 YAJEM 55034

To appear in:

American Journal of Emergency Medicine

Received date: Revised date: Accepted date:

6 April 2015 18 May 2015 23 May 2015

Please cite this article as: Altyar Ahmed, Bakhsh Hussain T., Mohammed Abdulaziz, Skrepnek Grant, Patanwala Asad E., Administration of first dose antibiotic in the emergency department in patients with minor skin and soft tissue infections, American Journal of Emergency Medicine (2015), doi: 10.1016/j.ajem.2015.05.035

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Ahmed Altyar, PharmDa,b (email: [email protected]) Hussain T. Bakhsh, PharmDa,b (email: [email protected]) Abdulaziz Mohammed, PharmDa,b (email: [email protected]) Grant Skrepnek, Ph.D.c (email: [email protected]) Asad E. Patanwala, PharmDa (email: [email protected])

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Title: Administration of first dose antibiotic in the emergency department in patients with minor skin and soft tissue infections

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Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85721, USA b Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, P.O.Box 80260, Jeddah 21589, Saudi Arabia c The University of Oklahoma Health Sciences Center, College of Pharmacy & Stephenson Cancer Center, 1110 N. Stonewall Ave., Oklahoma City, Oklahoma 73117 USA

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Corresponding Author and Reprints: Asad E. Patanwala, PharmD Address: 1295 N. Martin, PO Box 210202, Tucson, AZ 85721 Fax: 520-626-7355 Phone: 520-626-5404 Email: [email protected] Funding/Support: None Conflicts of Interest: None of the authors have any conflicts of interest Poster Presentation: American College of Clinical Pharmacy Virtual Poster Symposium on May 21st, 2014 Key Terms (MeSH): emergency service, hospital; length of stay; anti-bacterial agents; infection; cellulitis; abscess

Running Head: Antibiotic use and length of stay

ACCEPTED MANUSCRIPT ABSTRACT Background: Patients who present to the emergency department (ED) with mild skin and

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soft tissue infections (SSTIs) are often given a single dose of an antibiotic before being

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discharged home on oral antibiotics. The objective of this study was to determine if administration of antibiotics in the ED increases length of stay.

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Methods: This was cross-sectional study using data from the National Hospital

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Ambulatory Medical Care Survey. Patients with SSTIs who were discharged home with antibiotics were included. Patients were categorized into two groups based on whether

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any antibiotics were administered in the ED. The ED length of stay was compared between the groups. A multivariate analysis was conducted to adjust for pertinent

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confounders.

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Results: There were 3,000,895 cases of patients with SSTIs who presented to the ED and directly discharged home on antibiotic therapy from 2008-2010. Of these, 46.8% (n =

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1,403,710) involved the administration of an antibiotic in the ED, whereas the others only

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received antibiotic prescriptions upon discharge. The mean ED length of stay was 83.8 ± 160.6 minutes with no antibiotics versus 112.2 ± 193.6 minutes for antibiotic use in the ED (p

Administration of first dose antibiotic in the ED in patients with minor skin and soft tissue infections.

Patients who present to the emergency department (ED) with mild skin and soft tissue infections (SSTIs) are often given a single dose of an antibiotic...
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