Management failure in treating skin and soft tissue infections

Risk factors, such as a fever, are associated with failures in the management of skin and soft tissue infections (SSTIs) in emergency department observation units (EDOUs), a review has found.

A management failure in SSTIs is recorded if a patient overstays in the EDOU for more than 28 hours or dies.

Ten studies were included in this review. Of these, six identified risk factors or pre-existing variables present on arrival at the EDOU that were associated with management failure.

The risk factors identified were: high body temperature, an initial high white blood cell count and known exposure to meticillin-resistant Staphylococcus aureus .

Management failure rates ranged from 15%-38% – all as high or higher than the generally accepted EDOU failure rate of 15% – with most being higher than 21.8%. None of the studies reported death.

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