Bite wounds and antibiotic prescription among patients presenting to an Australian emergency department

International Emergency Nursing
Matthew BirdseyBiswadev Mitra

Abstract

Emergency department presentations after mammalian bites may be associated with injection of bacteria into broken skin and may require prophylactic antibiotics to prevent subsequent infection. We aim to describe the epidemiology of patients presenting with a mammalian bite injury and antibiotic choice to an Australian adult tertiary centre. A retrospective cohort study was performed capturing all presentations after mammalian bite wounds between 01 Jan 2014 and 31 Dec 2014. An explicit chart review was conducted to determine management of each case. Cases were subgrouped into high- and low-risk groups as defined by the Australian Therapeutic Guidelines for animal bites. There were 160 cases of mammalian bite wounds included, with 143 (89.4%) patients grouped as high-risk and 17 (10.6%) patients identified as low-risk. High-risk features were delayed presentation > 8 hours (57 patients, 35.6%), bites to the head, hand or face (113 patients, 70.6%), and puncture wounds unable to be adequately debrided (74 patients, 46.3%). There was a significant association with delayed presentation of more than eight hours and clinically established infection [OR 36.2; 95% CI: 12.6-103.6; P < 0.001]. Prescriptions for antibiotics that adhered t...Continue Reading

References

Jun 10, 2000·Journal of Clinical Pharmacy and Therapeutics·P F SmithD B May
Jan 8, 2009·Emergency Medicine Australasia : EMA·Claire Dendle, David Looke
Jul 25, 2013·Journal of Community Hospital Internal Medicine Perspectives·Andrew CrockerKris Levingood
Feb 1, 2014·The Journal of Hand Surgery·Nikola BabovicBrian T Carlsen
Aug 7, 2014·The Open Orthopaedics Journal·Pradyumna RavalAnant Narayan Mahapatra

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