Rethinking IV Antibiotics for Cellulitis Key point: Oral antibiotics are noninferior to parenteral antibiotics for uncomplicated cellulitis. Erythema of cellulitis commonly expands somewhat, even if treated with appropriate antibiotics, for the first 1-2 days after starting treatment. Citation: Aboltins CA, Hutchinson AF, Sinnappu RN, et al. Oral versus parenteral antimicrobials for the treatment of cellulitis: a randomized non-inferiority trial, J Antimicrob Chemother. 2015;70(2):581-586. Patients with cellulitis are often referred from urgent care to the emergency …
Read MoreAbstracts in Urgent Care-March 2019
Practice of Urgent Care: More Patients, More Decisions, More Fatigue Key point: We should be aware, as clinicians, that as we progress through our shifts, decision fatigue mounts. One manifestation of decision fatigue is an incremental decline in antibiotic stewardship. It is also important to understand that taking breaks seems to combat the harmful effects of decision fatigue. Citations: Linder JA, Doctor JN, Friedberg MW, et al. Time of day and the decision to prescribe …
Read MoreAbstracts In Urgent Care – February 2019
Check the Temps: A Timely Throwback Key points: Peripheral temperatures (ie, temporal, tympanic, oral, and axillary) are inaccurate and cannot reliably exclude the presence of fever. If absolute certainty regarding febrile status is critical (eg, neonates, immunosuppressed patients), a (gentle) rectal temperature is the preferred method of temperature acquisition in the urgent care setting. For all others, a tympanic temperature reading <37.5°C appears to best exclude true fever with reasonable certainty. Finally, all this comes …
Read MoreAbstracts In Urgent Care – January 2019
A Brief Introduction Happy New Year! 2018 is now behind us and it was another great year for urgent care. We are fortunate to work in one of the most dynamic and rapidly growing fields in medicine. I find it thrilling that the future of urgent care is ours to define and design. According to data from the UCA, last year nearly 150 million patients received care in U.S. urgent care centers (UCCs). These patients …
Read MoreAbstracts In Urgent Care – December 2018
The Year in Abstracts: Top Papers of 2018 for the Urgent Care Clinician Reviewed by Andy S. Barnett, MD This has been an eventful year in the urgent care marketplace. Then again, you could say that at the end of most years in our dynamic, ever-growing industry. That begs the question, what did set 2018 apart from other years? Mergers and acquisitions, evolving technologies, and workplace trends certainly impact what you do every day. But …
Read MoreAbstracts In Urgent Care – November 2018
From ID Week: Outbreak-Related Hep A Infections Are on the Rise Key point: Hepatitis A infection may be evolving from common-source exposure to outbreak exposure. Urgent care clinicians can influence this phenomenon by recommending that at-risk adults receive immunization. Citation: Foster M, Hofmeister M, Yin S, et al. Changing epidemiology of hepatitis A virus infections—United States, 2009–2017. Oral Abstract Session. ID Week 2018. Available at: https://idsa.confex.com/idsa/2018/webprogram/Paper74176.html. Accessed October 8, 2018. Between 2007 and 2017, the …
Read MoreAbstracts In Urgent Care – October 2018
New Data Show ‘Steep and Sustained’ Increase in STD Occurrence—Especially Syphilis Key point: Over the past 5 years, rates of syphilis, gonorrhea, and chlamydia have all increased in the United States, with syphilis cases almost doubling and cases of antibiotic-reistant gonorrhea rising. Citation: Centers for Disease Control and Prevention. 2018 STD Prevention Conference. New CDC Analysis Shows Steep and Sustained Increases in STDs. August 28, 2018. Available at: https://www.cdc.gov/nchhstp/newsroom/2018/2018-std-prevention-conference.html#Graphics. Accessed September 7, 2018. Every other …
Read MoreAbstracts in Urgent Care – September 2018
WHO Announces ICD-11, Coming Next Year Key point: New set will reflect current terminologies and classifications, integrate more smoothly with new technologies. Citation: World Health Organization. WHO Releases New International Classification of Diseases (ICD 11). June 18, 2018. Available at: http://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11). Accessed August 14, 2018. ICD-10 was released in 2015, but according to the World Health Organization (WHO) we can already expect the next revision, ICD-11, sometime early in the next decade. ICD-11 is supposed …
Read MoreAbstracts in Urgent Care – July 2018
CDC Attributes 200+ Cases of Coagulopathy to Synthetic Cannaboids Key point: “Marijuana alternatives” are widely available—and being blamed for multiple deaths. Citation: Moritz E, Austin C, Wahl M, et al. Notes from the field: outbreak of severe illness linked to the vitamin K antagonist brodifacoum and use of synthetic cannabinoids—Illinois, March–April 2018. MMWR Morb Mortal Wkly Rep. 2018;67:607–608. The Centers for Disease Control and Prevention revealed that they have received more than 200 reported cases …
Read MoreAbstracts in Urgent Care – June 2018
Some Oral Antibiotics Up Risk for Kidney Stones Key point: Oral antibiotics are associated with an increased risk for nephrolithiasis in adults and children, with the risk highest in those exposed at a younger age. Citation: Tasian GE, et al. Oral antibiotic exposure and kidney stone disease. J Am Soc Nephrol. 2018; May 10. [Epub ahead of print] The prevalence of kidney stones has increased 70% during the last 30 years, with the most disproportionate …
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