RESUMEN
BACKGROUND: Dermatologic surgery is associated with low postoperative infection rates, averaging from approximately 1% to 4.25%. Often, postoperative infections are treated empirically based on clinical diagnosis of infection, given it can take 48 to 72 hours for a wound culture to identify a pathogen. OBJECTIVE: We aimed to evaluate the efficacy of empiric antibiotics in dermatologic surgery postoperative infections and if wound cultures change postoperative antibiotic therapy. METHODS: A 7-center, retrospective analysis of postoperative infections, with culture data, in dermatologic surgery patients was performed. RESULTS: Of 91 cases of clinically diagnosed postoperative infection, 82.4% (n = 75) were successfully treated with empiric oral antibiotics (95% confidence interval [0.73-0.89], p < .0001). In 16 (17.6%) cases, initial empiric antibiotics were unsuccessful, and wound culture results altered antibiotic therapy in 9 cases (9.9%) with 6 (6.6%) of these cases requiring additional coverage for methicillin-resistant Staphylococcus aureus (MRSA). CONCLUSION: Empiric antibiotic treatment is usually appropriate for patients with postoperative surgical-site infections with wound cultures altering antibiotic management in a minority of cases. When empiric antibiotics fail, lack of MRSA coverage is usually the cause; therefore, providers should be aware of local MRSA prevalence and susceptibilities.
Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica/métodos , Procedimientos Quirúrgicos Dermatologicos/efectos adversos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infección de la Herida Quirúrgica/tratamiento farmacológico , Adulto , Antibacterianos/farmacología , Técnicas Bacteriológicas , Farmacorresistencia Bacteriana , Femenino , Humanos , Masculino , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Prevalencia , Estudios Retrospectivos , Neoplasias Cutáneas/cirugía , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/microbiologíaAsunto(s)
Dermatología/educación , Lesiones por Pinchazo de Aguja/etiología , Salud Laboral , Encuestas y Cuestionarios , Heridas Penetrantes/etiología , Estudios Transversales , Educación de Postgrado en Medicina/métodos , Femenino , Humanos , Incidencia , Internado y Residencia , Masculino , Lesiones por Pinchazo de Aguja/epidemiología , Lesiones por Pinchazo de Aguja/microbiología , Medición de Riesgo , Infección de Heridas/epidemiología , Infección de Heridas/etiología , Infección de Heridas/fisiopatología , Heridas Penetrantes/epidemiología , Heridas Penetrantes/fisiopatología , Adulto JovenRESUMEN
Mites are arthropods of the subclass Acari (Acarina). Although Sarcoptes is the mite most commonly recognized as a cause of human skin disease in the United States, numerous other mite-associated dermatoses have been described, and merit familiarity on the part of physicians treating skin disease. This review discusses several non-scabies mites and their associated diseases, including Demodex, chiggers, Cheyletiella, bird mites, grain itch, oak leaf itch, grocer's itch, tropical rat mite, snake mite, and Psoroptes.