Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM On Twitter
  • JABFM On YouTube
  • JABFM On Facebook
Research ArticleOriginal Research

Improving the Management of Skin and Soft Tissue Infections in Primary Care: A Report From State Networks of Colorado Ambulatory Practices and Partners (SNOCAP-USA) and the Distributed Ambulatory Research in Therapeutics Network (DARTNet)

Bennett Parnes, Douglas Fernald, Letoynia Coombs, Lauren DeAlleaume, Elias Brandt, Brian Webster, L. Miriam Dickinson, Wilson Pace and David West
The Journal of the American Board of Family Medicine September 2011, 24 (5) 534-542; DOI: https://doi.org/10.3122/jabfm.2011.05.110018
Bennett Parnes
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Douglas Fernald
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Letoynia Coombs
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lauren DeAlleaume
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elias Brandt
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brian Webster
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
L. Miriam Dickinson
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Wilson Pace
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David West
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1.
    • Download figure
    • Open in new tab
    Figure 1.

    Summary of Centers for Disease Control and Prevention (CDC) community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).

Tables

  • Figures
    • View popup
    Table 1.

    Characteristics of All Skin and Soft Tissue Infection Cases (680.x - 682.x) in Both Health Systems for the Preintervention and Intervention Periods

    Texas ClinicsNorth Carolina ClinicsCombined
    Pre n (%)Interv n (%)p value*Pre n (%)Interv n (%)p value*Pre n (%)Interv n (%)p value*
    Total number of cases1870643—1242763—31121406—
    Children/adolescents351 (18.77)81 (12.60).0003415 (33.41)258 (33.81).8539766 (24.61)339 (24.11).7155
    Mean age42.8346.84.000239.6540.57.485841.5643.44.0267
    Female1025 (54.81)346 (53.81).6596674 (54.27)419 (54.91).77741699 (54.6)765 (54.41).9077
    Clinician specialty†
        FM764 (40.86)264 (41.06).9284396 (31.88)213 (27.92).06071160 (37.28)477 (33.93).0301
        IM597 (31.93)185 (28.77).1362408 (32.85)293 (38.4).01141005 (32.29)478 (34).2591
        Peds153 (8.18)37 (5.75).0446314 (25.28)203 (26.61).5106467 (15.01)240 (17.07).0772
        IM and Peds81 (4.33)27 (4.2).88640 (0)0 (0)-81 (2.6)27 (1.92).1644
        Midlevel236 (12.62)108 (16.8).0079124 (9.98)54 (7.08).0263360 (11.57)162 (11.52).9642
    Clinical features
        Diabetes270 (14.44)123 (19.13).0047229 (18.44)145 (19).7521499 (16.03)268 (19.06).0121
        Fever2 (0.11)2 (0.31).26287 (0.56)3 (0.39).59899 (0.29)5 (0.36).7100
        Previous case SSTI321 (17.17)114 (17.73).7445123 (9.9)150 (19.66)<.0001444 (14.27)264 (18.78).0001
    • ↵* P values only calculated for proportions or mean values using Pearson χ2 tests, Fisher exact test for small cells, and t tests for continuous variables.

    • ↵† FM, family medicine; IM, internal medicine; Peds, pediatrics; IM and peds (double-boarded in internal medicine and pediatrics); Pre, preintervention period; Interv, intervention period; Midlevel, nurse practitioner or physician assistant; SSTI, skin and soft tissue infection.

    • View popup
    Table 2.

    Preintervention and Intervention Rates for Procedures, Cultures, Prescribed Antibiotics, and Methicillin-resistant Staphylococcus aureus (MRSA) Covering Antibiotics of Purulent Skin and Soft Tissue Infections (680.x)

    Texas ClinicsNorth Carolina ClinicsCombined
    Pre n (%)Interv n (%)p value*Pre n (%)Interv n (%)p value*Pre n (%)Interv n (%)p value*
    Total 680.x cases11846175102293148
    Procedures†2 (1.69)2 (4.35).322528 (16.00)5 (4.90).006030 (10.24)7 (4.73).0488
    Culture21 (17.8)3 (6.52).066529 (16.57)18 (17.65).818150 (17.06)21 (14.19).4378
    Antibiotics prescribed63 (53.39)32 (69.57).059444 (25.14)37 (36.27).0495107 (36.52)69 (46.62).0408
    MRSA-covering antibiotics‡34 (53.97)18 (56.25).83289 (20.45)14 (37.84).083943 (40.19)32 (46.38).4175
    • ↵* P values from Pearson χ2 tests, Fisher exact test for small cells, and t tests for continuous variables.

    • ↵† Procedures, incision and drainage only.

    • ↵‡ Trimethoprim-sulfamethoxazole, doxycycline or minocycline, clindamycin, Linezolid.

    • View popup
    Table 3.

    Prescribed Antibiotics and Methicillin-resistant Staphylococcus aureus (MRSA) Covering Antibiotics for Cellulitis and Abscess Skin and Soft Tissue Infections (681.x - 682.x)

    Texas ClinicsNorth Carolina ClinicsCombined
    Pre n (%)Interv n (%)p value*Pre n (%)Interv n (%)p value*Pre n (%)Interv n (%)p value*
    Total number of 681.x - 682.x cases1752597106766128191258
    Antibiotics prescribed738 (42.12)368 (61.64)<.0001265 (24.84)202 (30.56).00921003 (35.58)570 (45.31)<.0001
    MRSA-covering antibiotics†289 (39.16)166 (45.11).058249 (18.49)56 (27.72).0179338 (33.7)222 (38.95).0366
    • ↵* P values from Pearson χ2 tests, Fisher exact test for small cells, and t tests for continuous variables.

    • ↵† Trimethoprim-sulfamethoxazole, doxycycline or minocycline, clindamycin, Linezolid.

    • View popup
    Table 4.

    Among 680.x Cases, Odds Ratios for Procedure, Culture, Prescribed Antibiotics, and Prescribed Methicillin-resistant Staphylococcus aureus (MRSA) Covering Antibiotics (n = 441)

    VariableProceduresCulturesAll AntibioticsMRSA-Covering Antibiotics*
    Odds Ratio95% Confidence Limitsp valueOdds Ratio95% Confidence Limitsp valueOdds Ratio95% Confidence Limitsp valueOdds Ratio95% Confidence Limitsp value
    Intervention0.36420.11241.1796.09210.93540.52551.665.82042.1831.44293.3026.00022.62411.49554.6044.0008
    Child or adolescent (age < 18)3.17411.007110.0035.04861.94680.71965.2672.18960.36280.14880.8846.02581.14170.58032.2462.701
    Male2.23391.28973.8692.00411.84851.10973.0793.01831.03330.68211.5651.87731.27340.72522.236.4002
    Previous case of MRSA0.72310.34651.509.38770.56920.32351.0015.05060.80140.43271.484.48121.1650.46932.8921.742
    Texas clinics patient0.38780.0951.5836.1870.55630.23731.304.17722.73451.56674.7726.00044.29182.28368.0662<.0001
    Diabetes2.38390.77377.3455.13031.24380.57562.688.57890.55320.3230.9477.03110.92620.44551.9255.8373
    Specialty: IM vs. FM0.71220.17032.9785.6422.2060.55358.7918.26210.65850.37861.1451.13892.7620.98847.7178.0527
    Specialty: Midlevel vs. FM0.23230.04511.1957.08088.98552.163237.3245.00251.60380.6963.6957.26746.68242.081821.450.0014
    Specialty: Peds vs. FM0.6150.15312.4702.49322.42390.57510.2187.22782.56670.90517.2788.07632.40390.8326.7726.0970
    • ↵* Trimethoprim-sulfamethoxazole, doxycycline or minocycline, clindamycin, Linezolid.

    • IM, internal medicine; FM, family medicine; Peds, pediatrics.

    • View popup
    Table 5.

    Among 681.x-682.x Cases, Odds Ratios for Prescribed Antibiotics and Prescribed Methicillin-resistant Staphylococcus aureus (MRSA) Covering Antibiotics (n = 4077)

    VariableAll AntibioticsMRSA-Covering Antibiotics†
    Odds Ratio95% Wald Confidence LimitsP ValueOdds Ratio95% Wald Confidence LimitsP Value
    Intervention period monthly change1.12211.07141.1752<.00011.12681.05651.2019.0003
    Historical period monthly change1.05011.02411.0767.00011.04381.00891.0799.0136
    Child or adolescent (age < 18)1.13380.90471.4210.27550.78450.55111.1167.1779
    Male1.09920.97671.2371.11671.14350.97371.3429.1021
    Previous case of MRSA0.87640.69871.0993.25390.83550.61471.1354.2508
    Texas clinics patient2.97262.27453.8848<.00014.03432.73505.9507<.0001
    Diabetes0.89550.73601.0896.27040.88650.69131.1368.3425
    Specialty: IM vs. FM0.86600.60981.2300.42170.69320.44151.0883.1113
    Specialty: Midlevel vs. FM1.05960.63241.7753.82600.93620.54641.6040.8103
    Specialty: Peds vs. FM1.17120.82831.6559.37131.76981.09552.8589.0197
    • ↵† Trimethoprim-sulfamethoxazole, doxycycline or minocycline, clindamycin, linezolid.

    • * IM, internal medicine; FM, family medicine; Peds, pediatrics; Midlevel, nurse practitioner or physician assistant; SSTI, skin and soft tissue infection.

PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 24 (5)
The Journal of the American Board of Family Medicine
Vol. 24, Issue 5
September-October 2011
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Improving the Management of Skin and Soft Tissue Infections in Primary Care: A Report From State Networks of Colorado Ambulatory Practices and Partners (SNOCAP-USA) and the Distributed Ambulatory Research in Therapeutics Network (DARTNet)
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
9 + 5 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Improving the Management of Skin and Soft Tissue Infections in Primary Care: A Report From State Networks of Colorado Ambulatory Practices and Partners (SNOCAP-USA) and the Distributed Ambulatory Research in Therapeutics Network (DARTNet)
Bennett Parnes, Douglas Fernald, Letoynia Coombs, Lauren DeAlleaume, Elias Brandt, Brian Webster, L. Miriam Dickinson, Wilson Pace, David West
The Journal of the American Board of Family Medicine Sep 2011, 24 (5) 534-542; DOI: 10.3122/jabfm.2011.05.110018

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Improving the Management of Skin and Soft Tissue Infections in Primary Care: A Report From State Networks of Colorado Ambulatory Practices and Partners (SNOCAP-USA) and the Distributed Ambulatory Research in Therapeutics Network (DARTNet)
Bennett Parnes, Douglas Fernald, Letoynia Coombs, Lauren DeAlleaume, Elias Brandt, Brian Webster, L. Miriam Dickinson, Wilson Pace, David West
The Journal of the American Board of Family Medicine Sep 2011, 24 (5) 534-542; DOI: 10.3122/jabfm.2011.05.110018
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgments
    • Notes
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Do Professional Development Programs for Maintenance of Certification (MOC) Affect Quality of Patient Care?
  • An Assessment of the Hawthorne Effect in Practice-based Research
  • Journal of the American Board of Family Medicine Sixth Annual Practice-based Research Network Theme Issue -They Just Keep Getting Better and Better
  • Google Scholar

More in this TOC Section

  • Priorities for Artificial Intelligence Applications in Primary Care: A Canadian Deliberative Dialogue with Patients, Providers, and Health System Leaders
  • Increasing Primary Care Utilization of Medication-Assisted Treatment (MAT) for Opioid Use Disorder
  • Perceptions of Artificial Intelligence Use in Primary Care: A Qualitative Study with Providers and Staff of Ontario Community Health Centres
Show more Original Research

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2023 American Board of Family Medicine

Powered by HighWire