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. 2011 Nov;12(4):375-80.
doi: 10.5811/westjem.2011.2.2115.

Antibiotic prescribing practices of emergency physicians and patient expectations for uncomplicated lacerations

Samuel Ong  1 , Gregory J Moran, Anusha Krishnadasan, David A Talan; EMERGEncy ID NET Study Group
Affiliations

Antibiotic prescribing practices of emergency physicians and patient expectations for uncomplicated lacerations

Samuel Ong et al. West J Emerg Med. 2011 Nov.

Abstract

Introduction: Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians considered when prescribing antibiotics, and factors associated with patient satisfaction.

Methods: Adults and children presenting to 10 academic EDs with acute lacerations were enrolled. Enrolled patients were interviewed before and after their physician encounter in the ED and 2 weeks later. Physicians were interviewed in the ED after the patient encounter about factors that influenced their management decisions, including their perceptions of patients' expectations. We included patients with uncomplicated lacerations (without contamination, infection, bone, tendon, or joint involvement) for analysis.

Results: Of 436 patients enrolled, 260 had uncomplicated lacerations, and of these, 55 (21%) were treated with antibiotics in the ED or by prescription. Physicians were more likely to use antibiotics when the wound was more than 8 hours old, involved a puncture or amputation, and when the patient lacked medical insurance. A treatment course of 7 days or greater was given to 24 of 45 patients (53%) receiving outpatient prescriptions. Patient satisfaction was not associated with antibiotic use.

Conclusion: Antibiotics were used for about one fifth of ED patients with uncomplicated lacerations despite a lack of evidence for efficacy.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources, and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

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Figure
Patient flow diagram.
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