Category Skin/soft tissue
We’ve previously addressed this topic here. It’s certainly the case that chronic skin ulcers (leg or elsewhere) drive an enormous amount of antibiotic prescribing, perhaps because these ulcers are so hard to heal and a degree of therapeutic impatience occurs. The annual survey of chronic wounds last year in our health district indicated that 28% of inpatients […]
Are you following best practice in the management of boils or recurrent skin infection? We’ve previously addressed this matter detailing a NEJM study that indicated that a majority of US doctors surveyed use incision and drainage only. This recent Australian study investigated treatment of community staphylococcal skin abscesses by GPs and showed that a majority do not follow […]
This posting concerns betahaemolytic species of streptococci including S. pyogenes (Lancefield group A strep), S. agalactiae ((group B strep), S. dysgalactiae group (betahaemolytic large colony, groups C or G) (several species included) which are usually associated with pyogenic infection, especially of skin and soft tissue. S. pneumoniae (the pneumococcus ) is also considered. A key misunderstanding about […]
The 2016 Northern Territory Healthy Skin Workshop proceedings are available here and have great relevance for all practitioners in other regions (especially Hunter New England) who care for similar patients. The workshop aimed to develop a framework to enable a coordinated approach to Healthy Skin in the Top End. The proceedings highlight many useful resources and describe […]
Originally posted on Microbiology and Infectious Diseases postgraduate teaching:
Guest posting: Dr Leah Clifton, NEWCASTLE DEPARTMENT OF FORENSIC MEDICINE, Forensic Pathology Registrar Kawasaki disease is characterized with acute systemic vasculitis, occurs predominantly in children between 6 months to 5 years of age. Patients with this disease recover well and the disease is self-limited in most cases .…
Skin (staphylococcal) abscesses (boils) are often treated with antimicrobials, but are they really needed? The New England Journal of Medicine recently presented a case vignette and asked prescribers to weigh in on whether they thought antibiotics were needed or if incision and drainage alone were enough.
The recommended treatment for mild paronychia is conservative. Warm compresses or soaks are used, along with topical antibiotics with or without topical steroids. If an abscess has formed around the nail, incision and drainage is added. Oral antibiotics are only recommended in refractory cases or in patients with comorbidities such as diabetes or immunosuppression. We […]
New advice from NPS Medicinewise is available regarding treatment of skin and soft tissue infections, including bites. High rates of resistance are making it harder to empirically select antibiotics to treat Staphylococcus infections. As the skin is one of the most common sources of methicillin-resistant Staphylococcus aureus reduction of unnecessary prescribing for injuries could have […]
An acute Charcot process within a neuropathic foot (often a diabetic patient) arises silently over some months and is often misdiagnosed as cellulitis due to the presence of skin warmth and redness. The process is usually unilateral.
The Infectious Diseases Society of America also has started a Choosing wisely campaign. This advice is valuable. In the recent District-wide wound surveillance survey across Hunter New England Health hospitals and community nursing services, there were over 900 patients with active wounds identified (including many venous ulcers related to stasis dermatitis). Of these 28% had received antibiotics in […]