Should we make less fuss about pus?

Abstract

### The study. This study measured 2 known types of unnecessary antibiotic use for inpatient skin and soft tissue infections (SSTIs): (1) use of antibiotics with a broad spectrum of activity against aerobic Gram-negative pathogens; and (2) total treatment duration >10 days. The study was a planned secondary analysis of pediatric patients in a larger retrospective cohort of patients with SSTIs managed at hospitals in Colorado (84 of the 102 pediatric patients were treated at Children’s Hospital Colorado). ### The key findings. Two-thirds of children were exposed to either unnecessary broad-spectrum antibiotics, prolonged duration of antibiotic therapy, or both. This figure is probably a conservative estimate of inappropriate antibiotic therapy in the setting of an SSTI, as 40% of children in the current study had cutaneous abscesses, a proportion of whom received antibiotics. Other authors have shown that most adequately drained abscesses do not benefit from antibiotic therapy.1 #### Why do we care? Management of the estimated 70 000 children hospitalized annually with SSTIs represents a tremendous antibiotic stewardship opportunity for pediatric hospitalists. The authors of this study have previously demonstrated the …