부산대학교 도서관

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. Outpatient management of skin infections is a safe and cost-effective alternative to inpatient care in temperate Australia; however, skin infections account for 37% of preventable hospitalisations in the remote Torres Strait region of tropical Australia. This study highlights that outpatient management of skin infections in the Torres Strait is safe, effective and well-accepted by patients. Outpatient management of skin infections in remote, tropical Australia can reduce unnecessary transfers and hospitalisations, optimising the use of finite local health resources. [ABSTRACT FROM AUTHOR]