Athlete Develops Sepsis From Poorly Treated Skin Infection

The case involves a 17-year-old male swimmer in otherwise good health who presented to a dermatologist with a boil in his left groin area. The patient was given a cortisone shot and sent home. Several days later, the patient presented with a soft tissue infection. The patient went back to the dermatologist and was found to have cellulitis. The patient was placed on Amoxicillin for 2 weeks and was told to follow up at the end of the antibiotic course. When the patient presented for his follow up, the infection had not subsided, however, no culture was obtained. The dermatologist continued on the patient’s Amoxicillin treatment. Several weeks later, the patient began experiencing night sweats and high fever. He was taken to the hospital and diagnosed with viral sepsis. It was alleged that the proper steps were not taken to rule out complications of infections.

Question(s) For Expert Witness

1. Please explain your knowledge of proper care to prevent infectious in boils or similar skin issues?

Expert Witness Response E-005391

I direct the Pediatric Antimicrobial Stewardship Program at a prestigious university hospital, so routinely assist clinicians with the appropriate treatment of skin and soft tissue infections. I am also the director of the Pediatric Antimicrobial Stewardship Program at a medical school. As program director, I assist clinicians with optimizing the selection, route, dose, interval, and frequency of antibiotics, develop guidelines to guide the appropriate and judicious use of antibiotics and monitor patient outcomes after implementation of these practices. My research focuses on clinical outcomes related to antibiotic administration strategies in both children and adults and the incorporation of rapid diagnostics to assist with the early optimization of antibiotic therapy. I have a master's in epidemiology and have conducted a number of clinical outcomes studies which have incorporated sophisticated methods to analyze observational data. I am a member of the Society of Healthcare Epidemiology Antimicrobial Stewardship Committee and organize their annual stewardship workshop at ID Week as well as the Pediatric Infectious Diseases Society Antimicrobial Stewardship Committee. I also serve as an advisor to the Clinical Laboratory Standards Institute Antimicrobial Susceptibility Testing Committee and am closely involved with Centers for Diseases Control and Prevention efforts to improve inpatient antibiotic prescribing.