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Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations
INTRODUCTION: Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians consi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Department of Emergency Medicine, University of California, Irvine
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236143/ https://www.ncbi.nlm.nih.gov/pubmed/22224123 http://dx.doi.org/10.5811/westjem.2011.2.2115 |
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author | Ong, Samuel Moran, Gregory J Krishnadasan, Anusha Talan, David A |
author_facet | Ong, Samuel Moran, Gregory J Krishnadasan, Anusha Talan, David A |
author_sort | Ong, Samuel |
collection | PubMed |
description | INTRODUCTION: Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians considered when prescribing antibiotics, and factors associated with patient satisfaction. METHODS: Adults and children presenting to 10 academic EDs with acute lacerations were enrolled. Enrolled patients were interviewed before and after their physician encounter in the ED and 2 weeks later. Physicians were interviewed in the ED after the patient encounter about factors that influenced their management decisions, including their perceptions of patients' expectations. We included patients with uncomplicated lacerations (without contamination, infection, bone, tendon, or joint involvement) for analysis. RESULTS: Of 436 patients enrolled, 260 had uncomplicated lacerations, and of these, 55 (21%) were treated with antibiotics in the ED or by prescription. Physicians were more likely to use antibiotics when the wound was more than 8 hours old, involved a puncture or amputation, and when the patient lacked medical insurance. A treatment course of 7 days or greater was given to 24 of 45 patients (53%) receiving outpatient prescriptions. Patient satisfaction was not associated with antibiotic use. CONCLUSION: Antibiotics were used for about one fifth of ED patients with uncomplicated lacerations despite a lack of evidence for efficacy. |
format | Online Article Text |
id | pubmed-3236143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Department of Emergency Medicine, University of California, Irvine |
record_format | MEDLINE/PubMed |
spelling | pubmed-32361432012-01-05 Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations Ong, Samuel Moran, Gregory J Krishnadasan, Anusha Talan, David A West J Emerg Med Clinical Practice INTRODUCTION: Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians considered when prescribing antibiotics, and factors associated with patient satisfaction. METHODS: Adults and children presenting to 10 academic EDs with acute lacerations were enrolled. Enrolled patients were interviewed before and after their physician encounter in the ED and 2 weeks later. Physicians were interviewed in the ED after the patient encounter about factors that influenced their management decisions, including their perceptions of patients' expectations. We included patients with uncomplicated lacerations (without contamination, infection, bone, tendon, or joint involvement) for analysis. RESULTS: Of 436 patients enrolled, 260 had uncomplicated lacerations, and of these, 55 (21%) were treated with antibiotics in the ED or by prescription. Physicians were more likely to use antibiotics when the wound was more than 8 hours old, involved a puncture or amputation, and when the patient lacked medical insurance. A treatment course of 7 days or greater was given to 24 of 45 patients (53%) receiving outpatient prescriptions. Patient satisfaction was not associated with antibiotic use. CONCLUSION: Antibiotics were used for about one fifth of ED patients with uncomplicated lacerations despite a lack of evidence for efficacy. Department of Emergency Medicine, University of California, Irvine 2011-11 /pmc/articles/PMC3236143/ /pubmed/22224123 http://dx.doi.org/10.5811/westjem.2011.2.2115 Text en the authors http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Clinical Practice Ong, Samuel Moran, Gregory J Krishnadasan, Anusha Talan, David A Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations |
title | Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations |
title_full | Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations |
title_fullStr | Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations |
title_full_unstemmed | Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations |
title_short | Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations |
title_sort | antibiotic prescribing practices of emergency physicians and patient expectations for uncomplicated lacerations |
topic | Clinical Practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236143/ https://www.ncbi.nlm.nih.gov/pubmed/22224123 http://dx.doi.org/10.5811/westjem.2011.2.2115 |
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