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A Prescription for Resistance: Management of Staphylococcal Skin Abscesses by General Practitioners in Australia

Overview of attention for article published in Frontiers in Microbiology, June 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • High Attention Score compared to outputs of the same age and source (90th percentile)

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Title
A Prescription for Resistance: Management of Staphylococcal Skin Abscesses by General Practitioners in Australia
Published in
Frontiers in Microbiology, June 2016
DOI 10.3389/fmicb.2016.00802
Pubmed ID
Authors

Christine Parrott, Gillian Wood, Ekaterina Bogatyreva, Geoffrey W. Coombs, Paul D. R. Johnson, Catherine M. Bennett

Abstract

We investigated the management of staphylococcal abscesses (boils) by general practitioners (GPs) in the context of rising antibiotic resistance in community strains of Staphylococcus aureus. We analyzed patient-reported management of 66 cases of uncomplicated skin abscesses from the frequency matched methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) Community-Onset Staphylococcus aureus Household Cohort (COSAHC) study (Melbourne, Australia, 2008-2012). Susceptibilities in all cases were known: 50/66 abscesses were caused by MRSA. In order to investigate GP-reported management of staphylococcal abscesses, we surveyed a random subset of GPs, from the COSAHC study (41), and of GPs (39) who used the same community-based pathology service (December 2011-May 2012). Patient outcomes, antibiotics prescribed, antibiotic resistance profiles of infecting strains, rates of incision and drainage (I&D), and attitudes to ordering microbiological cultures. MRSA was three times more likely to be cultured from an abscess than MSSA. Patient-reported management revealed 100% were prescribed antibiotics and only 60.6% had I&D. Of those 85% who remembered their prescription(s), 81% of MRSA cases and 23% of MSSA cases initially received inactive antibiotics. Repeat GP visits where antibiotics were changed occurred in 45 MRSA and 7 MSSA cases, although at least 33% of subsequent prescriptions were inactive for the MRSA infections. Patients treated with I&D and antibiotics did no better than those treated with only I&D, regardless of the antibiotic activity. In the GP surveys, 89% reported I&D, with or without antibiotics, to be their preferred management. Only 29.9% of GPs would routinely swab abscesses. The recommended management of uncomplicated Staphylococcus abscesses is I&D without antibiotics to reduce exposure to unnecessary antibiotics. In our study, I&D was performed in only 60.6% of 66 patients, and antibiotics were always prescribed. The prescribed antibiotics were frequently inactive and often changed, and did not appear to affect patient recovery. Our results show that community GPs can confidently reduce their use of antibiotics for patients with skin abscesses and should be aware that MRSA is a much more common in this type of infection.

X Demographics

X Demographics

The data shown below were collected from the profiles of 11 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 33%
Other 2 13%
Researcher 2 13%
Professor 1 7%
Professor > Associate Professor 1 7%
Other 0 0%
Unknown 4 27%
Readers by discipline Count As %
Nursing and Health Professions 3 20%
Medicine and Dentistry 3 20%
Agricultural and Biological Sciences 3 20%
Veterinary Science and Veterinary Medicine 1 7%
Pharmacology, Toxicology and Pharmaceutical Science 1 7%
Other 2 13%
Unknown 2 13%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 July 2016.
All research outputs
#2,402,526
of 25,250,629 outputs
Outputs from Frontiers in Microbiology
#1,842
of 28,982 outputs
Outputs of similar age
#41,241
of 348,687 outputs
Outputs of similar age from Frontiers in Microbiology
#54
of 550 outputs
Altmetric has tracked 25,250,629 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 28,982 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 348,687 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 550 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.