Among 98 patients seen with bites over the course of a year, only 63 (64%) were discharged [from the ED] on the appropriate antibiotic.
So, a study presented in a poster session at the midyear clinical meeting of the American Society of Health-System Pharmacists somehow got top billing on ACEP’s daily email alert. Think about that. The big finding is quoted above.
I’m reading a summary of a poster, so it’s hard to find enough meat to chew on. But even without really knowing their methods, I’m glad they took a stab at outcomes. So of all these ED patients getting the wrong meds, how many did poorly? The authors reveal: just three.
“Despite the large number of patients who received inappropriate or inadequate treatment, there were only three treatment failures. One was in a 69-year-old woman with lupus and coronary artery disease who was bitten on the hand and face, and received amoxicillin-clavulanate.
A second was a 64-year-old man bitten on the hand who also received amoxicillin-clavulanate, and the third was a 46-year-old man with sarcoidosis and uncontrolled diabetes who was on long-term prednisone.”
So I could rewrite the headline as, “Old folks, often with comorbidities and immunosupression, really might require more than oral antibiotics after an animal bite. As for the rest, maybe antibiotic selection doesn’t matter so much.”
But that wouldn’t make headlines, now, would it?
Maybe it would, but only in an ACEP email.
I’ve got to ask, again: how is the research chosen for inclusion in ACEP’s daily newsletters? Can’t they work with the folks at JournalWatch or EMEDhome or Ryan Radecki or the LifeIntheFastLane guys to highlight clinically relevant news?