Optimising cellulitis treatment at Thursday Island Hospital

Mr Robert Laidlaw, James Cook University Australia*
Ms Gabrielle Blanche, James Cook University, Australia

Background: Thursday Island is a small government and commercial hub for the Torres Strait islands and is located over 3,000km north of Brisbane. It shares a disproportionate amount of chronic diseases and their complications. One of these, cellulitis, an acute skin infection, constitutes a significant proportion of regional hospital admissions. Whilst the condition is largely responsive to antibiotic therapy, the challenge for clinicians lies in choosing the most appropriate antibiotic before timely pathology tests can isolate the organism.

Aims: To analyse the organisms isolated from cellulitis at the Thursday Island Hospital and to determine if the most appropriate antibiotic had been initiated on presentation.

Methods: An internal hospital record review was performed for all patients presenting to Thursday Island Hospital in 2009. Charts were reviewed and data analysed for significant trends and results were cross referenced with the AUSLAB pathology database.

Results: A total of 77 patients were identified with the average length of admission being 8.9 days. There was a higher usage of intravenous Timentin in the first half of the year although intravenous Flucloxacillin was the predominate choice in accordance with the current guidelines.

Conclusion: Intravenous Flucloxacillin should predominately be the first line agent, even in patients with co-morbidities such as Diabetes Mellitus.

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