PURPOSE: Many pediatric centers admit patients following incision and drainage (I&D) of soft-tissue abscesses. The purpose of this study is to assess the safety and efficacy of the same-day discharge following I&D. METHODS: Retrospective review was performed of children aged 3 months-4 years who underwent operative I&D of an abscess followed by same-day discharge. Patients receiving antibiotics within 2 weeks of presentation were excluded. Treatment failure was defined as readmission or repeat procedure related to the initial abscess. Statistical analysis was performed using Wilcoxon Rank-Sum and Fisher's Exact tests. RESULTS: There were 442 procedures performed in 408 patients. Mean age was 1.8 years. Fever was noted in 25.8%. Of those who had a white blood cell (WBC) count drawn, 59.7% had leukocytosis. Mean time from procedure to discharge was 2.3 h, and 85.0% were discharged with oral antibiotics. Treatment failure occurred in four (0.9%) and ten (2.3%) patients at 14 and 30 days, respectively. Mean WBC count was higher in the 14-day treatment failure group (24.1 versus 16.3; p = 0.10). In patients with leukocytosis, there were 2 (1.4%) treatment failures compared to none in those without leukocytosis. CONCLUSION: Same-day discharge after I&D of abscess in diaper-age children is safe and effective.
PURPOSE: Many pediatric centers admit patients following incision and drainage (I&D) of soft-tissue abscesses. The purpose of this study is to assess the safety and efficacy of the same-day discharge following I&D. METHODS: Retrospective review was performed of children aged 3 months-4 years who underwent operative I&D of an abscess followed by same-day discharge. Patients receiving antibiotics within 2 weeks of presentation were excluded. Treatment failure was defined as readmission or repeat procedure related to the initial abscess. Statistical analysis was performed using Wilcoxon Rank-Sum and Fisher's Exact tests. RESULTS: There were 442 procedures performed in 408 patients. Mean age was 1.8 years. Fever was noted in 25.8%. Of those who had a white blood cell (WBC) count drawn, 59.7% had leukocytosis. Mean time from procedure to discharge was 2.3 h, and 85.0% were discharged with oral antibiotics. Treatment failure occurred in four (0.9%) and ten (2.3%) patients at 14 and 30 days, respectively. Mean WBC count was higher in the 14-day treatment failure group (24.1 versus 16.3; p = 0.10). In patients with leukocytosis, there were 2 (1.4%) treatment failures compared to none in those without leukocytosis. CONCLUSION: Same-day discharge after I&D of abscess in diaper-age children is safe and effective.
Entities:
Keywords:
Abscess; Antibiotic stewardship; Antibiotics; Skin and soft-tissue infection
Authors: David A Talan; William R Mower; Anusha Krishnadasan; Fredrick M Abrahamian; Frank Lovecchio; David J Karras; Mark T Steele; Richard E Rothman; Rebecca Hoagland; Gregory J Moran Journal: N Engl J Med Date: 2016-03-03 Impact factor: 91.245
Authors: Steven S Tsoraides; Richard H Pearl; Amy B Stanfill; Lizabeth J Wallace; Ravindra K Vegunta Journal: J Pediatr Surg Date: 2010-03 Impact factor: 2.545
Authors: Neeraja Kairam; Michael E Silverman; David F Salo; Elizabeth Baorto; Ben Lee; Christopher S Amato Journal: J Emerg Med Date: 2009-07-10 Impact factor: 1.484
Authors: Daniel J Pallin; William D Binder; Matthew B Allen; Molly Lederman; Siddharth Parmar; Michael R Filbin; David C Hooper; Carlos A Camargo Journal: Clin Infect Dis Date: 2013-03-01 Impact factor: 9.079
Authors: Brigitte M Baumann; Christopher J Russo; Daniel Pavlik; Tara Cassidy-Smith; Naomi Brown; Alfred Sacchetti; Lisa M Capano-Wehrle; Rakesh D Mistry Journal: West J Emerg Med Date: 2011-05