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Record W2790023498 · doi:10.1136/bmj.k243

Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline

2018· article· en· W2790023498 on OpenAlexaff
Mieke Vermandere, Bert Aertgeerts, Thomas Agoritsas, Catherine Liu, Jako Burgers, Arnaud Merglen, Patrick Okwen, Lyubov Lytvyn, Shunjie Chua, Per Olav Vandvik, Gordon Guyatt, Claudia Beltrán-Arroyave, Valéry Lavergne, Reinhart Speeckaert, Finn E Steen, Victoria Arteaga, Rachelle Sender, Shelley McLeod, Xin Sun, Wen Wang, Reed Siemieniuk

Bibliographic record

VenueBMJ · 2018
Typearticle
Languageen
FieldMedicine
TopicAntimicrobial Resistance in Staphylococcus
Canadian institutionsSchwartz/Reisman Emergency Medicine InstituteUniversité de MontréalUniversity of TorontoMcMaster UniversityImpact
Fundersnot available
KeywordsMedicineAntibioticsGuidelineIncision and drainageClindamycinIntensive care medicineDrainageSurgeryAbscess

Abstract

fetched live from OpenAlex

What role do antibiotics have in the treatment of uncomplicated skin abscesses after incision and drainage? A recent study suggested that, for small uncomplicated skin abscesses, antibiotics after incision and drainage improve the chance of short term cure compared with placebo. Triggered by this trial, the Rapid Recommendation team produced a new systematic review. Relying on this review and using the GRADE framework according to the BMJ Rapid Recommendation process, an expert panel makes a weak recommendation in favour of trimethoprim-sulfamethoxazole (TMP-SMX, co-trimoxazole) or clindamycin in addition to incision and drainage over incision and drainage alone. For patients who have chosen to initiate antibiotics, the panel issues a strong recommendation for TMP-SMX or clindamycin rather than a cephalosporin and a weak recommendation for TMP-SMX rather than clindamycin. Box 1 shows the articles and evidence linked to this Rapid Recommendation. The infographic presents the recommendations together with other pertinent information, including an overview of the absolute benefits and harms of candidate antibiotics in the standard GRADE format. The panel emphasises shared decision making in the choice of whether to initiate antibiotics and in which antibiotic to use, because the desirable and undesirable consequences are closely balanced: clinicians using MAGICapp ( http://magicapp.org/goto/guideline/jlRvQn/section/ER5RAn ) will find decision aids to support the discussion with patients. Table 2 below shows any evidence that has emerged since the publication of this article. ### What you need to know

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.005
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.054
Threshold uncertainty score0.620

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.038
GPT teacher head0.436
Teacher spread0.398 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations50
Published2018
Admission routes1
Has abstractyes

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Same venueBMJSame topicAntimicrobial Resistance in StaphylococcusFrench-language works237,207