Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations
نویسندگان
چکیده
INTRODUCTION Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians considered when prescribing antibiotics, and factors associated with patient satisfaction. METHODS Adults and children presenting to 10 academic EDs with acute lacerations were enrolled. Enrolled patients were interviewed before and after their physician encounter in the ED and 2 weeks later. Physicians were interviewed in the ED after the patient encounter about factors that influenced their management decisions, including their perceptions of patients' expectations. We included patients with uncomplicated lacerations (without contamination, infection, bone, tendon, or joint involvement) for analysis. RESULTS Of 436 patients enrolled, 260 had uncomplicated lacerations, and of these, 55 (21%) were treated with antibiotics in the ED or by prescription. Physicians were more likely to use antibiotics when the wound was more than 8 hours old, involved a puncture or amputation, and when the patient lacked medical insurance. A treatment course of 7 days or greater was given to 24 of 45 patients (53%) receiving outpatient prescriptions. Patient satisfaction was not associated with antibiotic use. CONCLUSION Antibiotics were used for about one fifth of ED patients with uncomplicated lacerations despite a lack of evidence for efficacy.
منابع مشابه
Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction.
STUDY OBJECTIVE Physicians often prescribe antibiotics to patients even when there is no clear indication for their use. Previous studies examining antibiotic use in acute bronchitis and upper respiratory infections have been conducted in primary care settings. We evaluate the factors that physicians in the emergency department (ED) consider when prescribing antibiotics (eg, patient expectation...
متن کاملRuling out the need for antibiotics: are we sending the right message?
OBJECTIVES To examine the relationships among physician-parent communication practices, physicians' perceptions of parental expectations for antibiotic treatment, and inappropriate antibiotic prescribing for viral upper respiratory tract infections. DESIGN Cross-sectional study of pediatric encounters motivated by cold symptoms between October 1, 2000, and June 30, 2001. Each encounter was vi...
متن کاملImpact of an antimicrobial stewardship intervention on antibiotic prescribing practices for community-acquired acute uncomplicated cystitis in the emergency department
متن کامل
Outpatient Antibiotic Prescribing Practices for Uncomplicated Urinary Tract Infection in Women in the United States, 2002–2011
Background. Urinary tract infection (UTI) is one of the most common diagnoses leading to an antibiotic prescription for women seeking ambulatory care. Understanding current national outpatient antibiotic prescribing practices will help ongoing stewardship efforts to optimize antibiotic use; however, information on recent national outpatient antibiotic prescribing trends for UTI is limited. Met...
متن کاملKnowledge, attitudes, and reported practices among obstetrician-gynecologists in the USA regarding antibiotic prescribing for upper respiratory tract infections.
BACKGROUND Knowledge, attitudes, and practices regarding antibiotic prescribing for upper respiratory tract infections (URIs) have not been well described among obstetrician-gynecologists (OB/GYNs). This information is useful for determining whether an OB/GYN-specific program promoting appropriate antibiotic use would significantly contribute to the efforts to decrease inappropriate antibiotic ...
متن کامل