Community antibiotic management of skin infections in the Torres Strait

Hempenstall, Allison, Pilot, Pelista, McDonald, Malcolm, Smith, Simon, and Hanson, Joshua (2022) Community antibiotic management of skin infections in the Torres Strait. Australian Journal of Primary Health, 29 (1). pp. 91-98.

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DOI: 10.1071/PY22142

View at Publisher Website: https://doi.org/10.1071/PY22142

Abstract

Background: There is a high burden of skin and soft tissue infections (SSTI) – including cellulitis – among Aboriginal and Torres Strait Islander peoples living in remote communities. In tropical environments, such as the Torres Strait, cellulitis accounts for 37% of potentially preventable hospitalisations. This study aimed to evaluate the safety, effectiveness and community acceptance of outpatient antibiotic treatment for the management of skin infections in the Torres Strait.

Methods: This was a 12-month prospective, observational study commencing in January 2019 involving 295 adults with a skin infection across the Torres Strait.

Results: Most (276/295 (94%)) participants were treated successfully in the community. Of 295 enrolled patients, 151 of 295 (51%) had cellulitis, 59 of 295 (20%) had a skin abscess and 85 of 295 (28%) had a wound infection. Of the 77 of 278 (27%) infections accompanied by systemic features, 63 of 77 (82%) were managed in the community. Staphylococcus aureus was the most frequent isolate, at 165 of 261 (63%); 56 of 165 (33%) were methicillin resistant. In the 276 community-managed cases, oral trimethoprim/sulfamethoxazole was initially used in 159 (57%), oral flucloxacillin in 75 (27%) and intravenous cefazolin plus oral probenecid in 32 (13%). The clinical course was complicated in eight of 232 (3%) patients who had complete follow-up data: seven patients required hospitalisation after initial treatment in the community and one had an antibiotic side-effect. All 232 patients with complete follow-up data were content with the care they received.

Conclusions: Outpatient management of skin infection in the Torres Strait is effective, safe and appreciated by patients.


Item ID:	76743
Item Type:	Article (Research - C1)
ISSN:	1836-7399
Keywords:	Aboriginal and Torres Strait Islander, antibiotics, infectious disease, outpatient management, public health, rural health, skin and soft tissue infections, skin disease
Copyright Information:	© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University.
Date Deposited:	09 Nov 2022 08:05
FoR Codes:	45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450402 Aboriginal and Torres Strait Islander biomedical and clinical sciences @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 50%
SEO Codes:	21 INDIGENOUS > 2103 Aboriginal and Torres Strait Islander health > 210302 Aboriginal and Torres Strait Islander health status and outcomes @ 50% 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50%
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