Table 5.
Medical management, culture results and pain control in children >2 years at three pediatric care settings.
| Medical management | Academic Pediatric Hospital ED (n=200) | General Academic Pediatric ED (n=100) | Community ED (n=92) | P-value* |
|---|---|---|---|---|
| Underwent incision and drainage in ED, n, % | 61, 46% | 62, 72% | 45, 59% | 0.001 |
| Infiltrated anesthetic (lidocaine) | 19 of 61, 31% | 20 of 62, 32% | 30 of 45, 67% | 0.0002 |
| Topical anesthetic cream | 37of 61, 61% | 43 of 62, 69% | 0 | < 0.0001 |
| Procedural sedation used | 18 of 61, 30% | 21 of 62, 34% | 5 of 45, 11% | 0.03 |
| Packing placed in abscess cavity | 13 of 61, 21% | 33 of 62, 53% | 22 of 45, 49% | < 0.0001 |
| Wound culture obtained† | 74 of 95, 78% | 61 of 74, 82% | 12 of 56, 21% | < 0.0001 |
| Organisms obtained at culture | ||||
| MRSA | 38 of 74, 51% | 42 of 61, 69% | 7 of 12, 58% | 0.12 |
| MSSA | 18 of 74, 24% | 14 of 61, 23% | 4 of 12, 33% | 0.75 |
| Other organism(s) | 18 of 74, 24% | 0 | 1 of 12, 8% | 0.0001 |
| Adjuvant antibiotics given at discharge | 111 of 113, 98% | 76 of 86, 88% | 64 of 70, 91% | 0.02 |
| Empiric coverage for MRSA | 103 of 113, 91% | 73 of 86, 85% | 49 of 70, 70% | 0.0008 |
| Pain assessed at triage | 134, 67% | 87, 87% | 67, 73% | 0.001 |
| Discharged with any pain medication | 28 of 113, 25% | 56 of 86, 65% | 30 of 70, 43% | <0.0001 |
| Discharged with a narcotic pain medication | 7 of 113, 6% | 9 of 86, 11% | 16 of 70, 23% | <0.0001 |
*
χ2 used to compare patient management and organism characteristics at the three settings.
†
Wound culture percentages reflect only those patients who had a spontaneously draining abscess or underwent incision and drainage of their abscess, including in the operating room
ED, emergency department; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive Staphylococcus aureus