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Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms

 

Table 15. Time to resolution according to various characteristics, retrospective, prospective, and all cases

 

Retrospective (N = 263)

Prospective (N = 114)

Total (N = 377)

 

N

Time to Resolution
(Days)

ANOVA
P-Value

N

Time to Resolution
(Days)

Anova P-Value

N

Time to Resolution
(Days)


ANOVA P-Value

Demographics
Gender
   Female
   Male


131
132


10.8 ± 6.3
10.8 ± 6.3


0.028


66
48


14.7 ± 8.6
15.9 ± 11.5


0.529


197
180


12.1 ± 7.4
13.7 ± 9.5


0.079

Age group (years)
   < 20
   20 to < 40
   40 to < 65
   65 to 96


60
66
88
48


10.8 ± 4.5
11.4 ± 6.2
12.6 ± 10.1
12.4 ± 7.1


0.467


27
34
38
14


18.1 ± 14.9
13.4 ± 8.5
14.4 ± 7.2
16.3 ± 6.7


0.280


87
100
126
62


13.1 ± 9.7
12.1 ± 7.1
13.2 ± 9.3
13.3 ± 7.1


0.768

Age group (years)
   < 40
   ≥40


126
136


11.2 ± 5.5
12.6 ± 9.1


0.129


61
52


15.5 ± 12.0
14.9 ± 7.0


0.733


187
188


12.6 ± 8.4
13.2 ± 8.6


0.465

Rurality
   Non-rural
   Rural


183
80


10.7 ± 6.3
14.6 ± 9.0


< 0.001


82
31


14.9 ± 9.3
16.3 ± 11.4


0.520


265
111


12.0 ± 7.6
15.1 ± 10.0


0.004

Insurance
   Private
   Medicaid
   Medicare
   Uninsured


152
44
44
18


11.7 ± 7.8
11.3 ± 8.0
12.8 ± 7.7
11.6 ± 5.6


0.824


76
20
10
2


14.5 ± 10.7
14.9 ± 8.2
20.1 ± 8.2
15.0 ± 1.4


0.433


228
64
54
20


12.7 ± 8.9
12.4 ± 8.2
14.1 ± 8.2
12.8 ± 8.5


0.641

Race
   Caucasian
   Non-Caucasian


191
8


12.5 ± 8.0
8.5 ± 1.6


0.163


107
7


15.4 ± 10.1
12.9 ± 6.8


0.515


298
15


13.5 ± 8.9
10.5 ± 5.1


0.198

Ethnicity
   Hispanic
   Non-Hispanic


10
178


13.4 ± 10.8
12.6 ± 8.2


0.773


2
112


8.5 ± 7.8
15.3 ± 9.9


0.334


12
290


12.6 ± 10.2
13.7 ± 9.0


0.682

Patient Presenting Characteristics
Site of Infection
   Face/neck
   Groin/pubic/ lower extremities
   Thorax/upper  extremities


34
122
104


13.5 ± 10.7
13.4 ± 8.5
9.6 ± 4.1


<0.001


15
47
45


18.3 ± 10.7
15.8 ± 11.5
13.2 ± 7.3


0.184


49
169
149


15.0 ± 10.8
14.0 ± 9.4
10.7 ± 5.5


< 0.001

Temperature (°F)
   < 99°
   ≥99°


206
24


11.5 ± 7.3
15.1 ± 10.0


0.031


101
10


14.6 ± 9.2
20.8 ± 16.0


0.256


307
34


12.5 ± 8.1
16.8 ± 12.1


0.053

Duration of infection prior to being seen
   < 5 days
   ≥5 days


132
89


11.4 ± 6.7
13.1 ± 8.9


0.099


65
41


15.0 ± 11.3
15.4 ± 8.3


0.851


197
130


12.6 ± 8.6
13.9 ± 8.8


0.199

Patient hospitalized
   Yes
   No


11
252


21.6 ± 14.9
11.4 ± 6.8


<0.001


3
109


31.0 ± 26.3
14.6 ± 8.8


0.392


14
361


23.6 ± 17.1
12.4 ± 7.6


0.029

Patient had at least 1 risk factor
   Yes
   No


69
194


13.8 ± 8.9
11.2± 6.9


0.016


39
75


15.6 ± 9.2
15.0 ± 10.3


0765


108
269


14.4 ± 9.0
12.3 ± 8.2


0.025

Patient had diabetes
   Yes
   No


35
228


15.4 ± 10.4
11.3 ± 6.9


0.032


19
95


15.1 ± 4.4
15.3 ± 10.7


0.888


54
323


15.3 ± 8.7
12.5 ± 8.4


0.026

Wound type
   Abscess only
   Cellulitis only
   Abscess and cellulitis


93
143
27


10.5 ± 6.1
12.3 ± 8.1
14.0 ± 8.6


0.059


18
66
24


18.4 ± 13.8
15.1 ± 9.7
14.0 ± 7.2


0.347


111
209
51


11.8 ± 8.3
13.2 ± 8.7
14.0 ± 7.9


0.224

Treatment at Office
Incision and drainage done
   Yes
   No


85
178


10.2 ± 5.6
12.7 ± 8.3


0.014


32
82


14.4 ± 8.4
15.5 ± 10.4


0.582


117
260


11.4 ± 6.7
13.6 ± 9.1


0.019

Culture done
   Yes
   No


92
171


13.4 ± 8.7
11.1 ± 6.8


0.029


50
64


13.4 ± 7.3
16.7 ± 11.4


0.088


142
235


13.4 ± 8.2
12.6 ± 8.7


0.368

Wound packed
   Wound packed
   Wound not packed
   Incision and drainage not done


30
55
178


9.8 ± 6.9
10.5 ± 4.8
12.7 ± 8.3


0.046


8
22
82


19.6 ± 11.2
12.5 ± 7.0
15.5 ± 10.4


0.200


38
77
260


11.8 ± 8.8
11.1 ± 5.5
13.6 ± 9.1


0.054

For those who had incision and
   Wound packed
   Wound not packed


30
55


9.8 ± 6.9
10.5 ± 4.8


0.592


8
22


19.6 ± 11.2
12.5 ± 7.0


0.046


38
77


11.8 ± 8.8
11.1 ± 5.5


0.615

Antibiotics Prescribed
Antibiotic prescribed at first visit
   Yes
   No


246
17


12.1 ± 7.7
9.1 ± 6.0


0.123


111
3


15.3 ± 10.0
13.7 ± 5.5


0.783


357
20


13.1 ± 8.6
9.8 ± 6.0


0.095

Initial antibiotics covered MRSA
   Yes
   No


70
176


11.4 ± 6.6
12.3 ± 8.0


0.421


58
56


15.1 ± 8.7
15.4 ± 11.1


0.862


128
232


13.1 ± 7.8
13.0 ± 8.9


0.974

Antibiotics covered MRSA at some time during infection
   Yes
   No



91
157



13.3 ± 8.3
11.4 ± 7.1


0.064



68
46



16.0 ± 10.0
14.0 ± 9.7


0.286



159
203



14.4 ± 9.2
12.0 ± 7.8


0.006

Total number of antibiotics used over the course of the infection
   ≤ 2
   > 2



241
22



10.9 ± 6.4
22.6 ±10.9


< 0.001



103
11



14.1 ± 7.8
26.1 ± 18.4


0.056



344
33



11.8 ± 7.0
23.8 ± 13.6


< 0.001

Total number of antibiotics used over course of infection
   0
   1
   2
   3
   4
   5
   6



15
176
50
16
3
3
0



8.3 ± 5.9
9.6 ± 3.7
16.0 ± 10.3
21.1 ± 10.0
22.7 ± 12.6
22.7 ± 12.6


< 0.001



1
77
25
8
2
0
1



8.0
13.9 ± 8.1
14.9 ± 7.2
25.3 ± 17.6
31.0 ± 34.0
---
23.0


0.005



16
253
75
24
5
3
1



8.3 ± 5.7
11.0 ± 5.8
15.7 ± 9.3
22.5 ± 12.8
26.0 ± 19.7
30.7 ± 14.6
23.0


< 0.001

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Figure 1. Map of offices participating in CA-MRSA study

This map of Iowa shows counties that participated in the IRENE CA_MRSA study. Participating cities include: Bloomfield, Guttenberg, Davenport, Blue Grass, Manchester, Le Mars, Riverside, Sigourney, Iowa City, and Urbandale

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Figure 2. Antibiotics prescribed at initial visit

This graph titled Antiobiotics Prescribed at Initial Visit shows the types and number of antibiotics that were prescribed at the initial visit for a skin or soft tissue infection. The most commonly prescribed antibiotics were cephalosporins, with 127 prescriptions written. The second most common were TMP-sulfas, with 48 prescriptions written.

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Figure 3. Antibiotics prescribed at first follow-up visit

This graph, titled Antibiotics Prescribed at First Follow-Up Visit, shows that 210 patients out of 261 patients received no prescription for antibiotics during a first follow-up visit.

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Figure 4. Antibiotics prescribed at initial prospective visit
N=114 individuals

This graph titled Antibiotics Prescribed at Initial Prospective Visit shows the types and number of antibiotics that were prescribed at the initial visit for a skin or soft tissue infection. The most commonly prescribed antibiotics were TMP-sulfas, with 33 prescriptions written, and cephalosporins, with 32 prescriptions written.

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Current as of March 2011
Internet Citation: Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms. March 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/mrsa/iowa_mrsatabfigs.html