Methods: An anonymous 35-item survey regarding knowledge, attitudes, and practices centered on the diagnosis and management of SSTIs was sent to medical students (n=48), residents (n=55), and attending physicians (n=18) in family and internal medicine at a university-based hospital.
Results: 103 surveys were completed out of 121 sent (85%) between the dates of July 2015 through March 2016. The most common SSTI encountered was cellulitis (95%) with 73% of the group managing at least 2-10 SSTIs per week. Hypotension, history of intravenous drug use, and fever >100.4F° were the most common reasons for admission to the hospital. The majority (66%) felt like the overall clinical picture, comorbidities of the patient, and history of multi-drug resistant organisms were the driving factors for choosing an initial treatment. Only 35% were familiar with the updated SSTI practice guidelines provided by the IDSA. 50% felt uncomfortable with their SSTI training and 85% felt the hospital staff would benefit from additional education. The majority (75%) agreed that more antibiotic stewardship training is needed and 61% felt like a consultation with a clinical pharmacists should be sought more often. When choosing an antibiotic 36% considered the cost of the drug when comparing analogous options. When asked for standard treatment modalities regarding non-purulent and purulent cellulitis 48% answered these knowledge questions correctly. Even though 75% of the group felt their colleagues knew when to request an appropriate surgical consult only 45% were able to recognize that this was the initial step in the management of suspected necrotizing fasciitis. 63% of the attending physicians as compared to 47% of the medical students and residents scored correctly on the knowledge section overall.
Conclusion: There are significant opportunities for development among physicians who encounter SSTIs. Antibiotic stewardship, SSTI education and training for junior trainees, and promoting the updated IDSA practice guidelines pertaining to the diagnosis of management of SSTIs are areas needing improvement.
J. A. Saenz, None
D. Nix, None
K. Matthias, None
M. Al Mohajer, None
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