Article Figures & Data
Figures
- Figure 1.
Iowa Research Network (IRENE), intervention office study sites.
- Figure 2.
Outpatient† management of skin and soft tissue infections in the era of community-associated Staphylococcus aureus (MRSA)‡.
Tables
IRENE Office No. City City Population No. of Usable and Returned Preintervention Forms No. of Usable and Returned Postintervention Forms (1) Davenport 98,359 25/31 8/10 (2) Guttenberg 1987 26/30 24/25 (3) Manchester 5257 26/30 9/9 (4) Le Mars 9237 29/30 11/11 (5) Riverside 928 25/30 5/7 (6) Sigourney 2209 25/33 12/14 (7) Iowa City 62,220 30/30 30/30 (8) Urbandale 29,072 30/30 19/19 Total 216/244 118/124 - Table 2.
Demographic Characteristics, Clinical Aspects, Management, and Treatment of Skin Infections*
Preintervention Group N = 216 N (%) Postintervention Group N = 118 N (%) P Value Demographic characteristics Age (years) <20 44 (21) 28 (24) 0.34 20 to 39 54 (25) 35 (30) 40 to 64 74 (34) 39 (33) ≥65 43 (20) 15 (13) Male 108 (50) 50 (42) 0.18 Caucasian 161 (95) 111 (94) 0.65 Hispanic 10 (6) 5 (4) 0.53 Insurance coverage Private 122 (57) 78 (70) 0.03 Medicaid 36 (17) 20 (18) Medicare 40 (19) 12 (11) Uninsured 15 (7) 2 (2) Lives rural county 60 (28) 34 (29) 0.80 Patient presenting characteristics Site of infection Face/neck 26 (12) 15 (14) 0.73 Groin/pubic/lower extremities 102 (48) 48 (43) Thorax/upper extremities 85 (40) 48 (43) Initial temperature (°F) <99° 170 (90) 104 (90) 0.99 ≥99° 18 (10) 11 (10) Duration of infection prior to being seen <5 days 101 (55) 61 (56) 0.94 ≥5 days 81 (45) 48 (44) Has ≥1 MRSA risk factor 85 (39) 54 (46) 0.26 Hospitalized with infection 10 (5) 3 (3) 0.36 Diabetic wound type 32 (15) 20 (17) 0.61 Abscess only 74 (34) 18 (15) <0.0001 Cellulitis only 119 (55) 69 (58) Abscess and cellulitis 23 (11) 25 (21) Management and treatment Incision and drainage done 68 (32) 33 (28) 0.50 Culture done 79 (37) 52 (44) 0.18 MRSA cultured (of those cultured) only for those who had an incision and drainage done 40 (51) 16 (31) 0.03 Wound packed 28 (41) 8 (24) 0.10 Verbal wound care instructions provided (n = 65 preintervention and n = 110 post intervention) 56 (86) 88 (80) 0.30 Follow-up visit scheduled 110 (51) 70 (61) 0.08 Antibiotics prescribed Antibiotic prescribed at initial visit 201 (93) 115 (98) 0.09 Antibiotic(s) prescribed at initial visit covered MRSA 60 (30) 60 (52) <0.0001 Second antibiotic was prescribed with first 17 (8) 17 (14) 0.06 Antibiotics prescribed that covered MRSA at some time during infection 75 (37) 72 (62) <0.0001 Total number of antibiotics used over the course of the infection ≤2 197 (91) 106 (90) 0.68 >2 19 (9) 12 (10) Total number of different antibiotics used over course of infection 0 14 (6) 1 (1) 0.14 1 145 (67) 79 (67) 2 38 (18) 26 (22) 3 14 (6) 10 (8) 4 3 (1) 1 (1) 5 2 (1) 0 6 0 1 (1) Cephalosporins 52 (18) 20 (12) <0.0001 Trimethoprim-sulfamethoxazole 40 (14) 50 (29) 0.006 -
↵* If a cell does not total the N, then there were missing data.
-
MRSA, Staphylococcus aureus
-
Initial Antibiotic Covered MRSA N = 308 Odds Ratio (CI), P Value MRSA Antibiotic Coverage at Any Time N = 313 Odds Ratio (CI), P Value Postintervention vs. preintervention group 2.67 (1.54, 4.62), 0.0005 2.70 (1.68, 4.32), <0.0001 Abscess or abscess plus cellulitis vs. cellulitis alone 2.81 (1.62, 4.87), <0.0001 2.61 (1.63, 4.18), <0.0001 Culture sent vs. not sent 3.03 (1.72, 5.35), 0.0003 2.54 (1.62, 3.99), <0.0001 Prescribed ≤ 2 antibiotics vs. > 2 7.67 (2.19, 26.88), <0.0001 Antibiotics Patient not hospitalized vs. hospitalized 10.55 (1.35, 82.60), 0.0186 Age between 20 and 60 vs. other ages 1.69 (1.17, 2.57), 0.0112 -
↵* Multivariate logistic regression.
-
