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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Saturday, December 12, 2015

Infecciones de piel y tejidos blandos

EMOttawa - December 11, 2015 - Guest post by Dr. Krishan Yadav
Take Home Points
  • Necrotizing Fasciitis is a clinical diagnosis
  • The sensitivity of the LRINEC score is unacceptable for use in the ED. 
  • Consider adjuncts if you have a high clinical suspicion: CT, MRI or ultrasound
  • There are MRSA Risk Factors you should consider for your patients: 
  • Hepatitis C, substance abuse, previous MRSA infection/colonization, antibiotics in past year, homelessness in past year, communal living, incarceration. 
  • Novel Once-Weekly Antibiotics are Non-Inferior to Conventional Therapy against MRSA: 
  • Dalbavancin and Oritavancin are FDA approved (could be in Canada soon!). 
  • Once-weekly antibiotics have the potential to revolutionize the way SSTIs are managed. 
Which patients require hospital admission? Who Should Get IV versus Oral Antibiotic Therapy for SSTIs? It is still UNCLEAR! 
  • There is a significant evidence gap: we do not know who actually requires admission versus inpatient stay. 
  • There is even less guidance for optimal route of antibiotic therapy. 
  • This is a big deal: the treatment failure rate for SSTIs in Canadian EDs is 20%. 
    • This suggests that there is LOTS of research still to be done!