J Acute Care Surg.  2020 Mar;10(1):5-9. 10.17479/jacs.2020.10.1.5.

The Role of Wound Swab Microbial Cultures and Antibiotic Sensitivity Results in the Management of Sacrococcygeal Pilonidal Abscess

• Cheng C
• Lai JM
• Mori K

• KMID: 2512813
• DOI: http://doi.org/10.17479/jacs.2020.10.1.5

Abstract

Purpose
Current practice for patients who present to hospitals with acute sacrococcygeal pilonidal abscess is operative management. Wound swabs are routinely taken peri-operatively and antibiotics are initiated empirically pending culture and sensitivity results. The aim of our study was to evaluate whether the results of wound swabs change post-operative antibiotic therapy for these patients, and to identify the common microorganisms.
Methods
This was a retrospective analysis which included patients who presented to the Northern Hospital, Victoria, with acute sacrococcygeal pilonidal abscess between 1^st January 2013 to 30^th June 2016. Data was collected using hospital electronic medical records. Patients who had wound swabs taken were identified and their post-operative management analyzed.
Results
There were 297 presentations identified within the study period, of which, 224 cases (224/297, 75.4%) had wound swabs taken, out of which 130 (130/297, 43.8%) cases were followed up in outpatient clinic and 1 case (1/130, 0.8%) had a subsequent change in antibiotics based on the wound swab result. Common microorganisms grown were mixed anaerobes (138/224, 61.6%) and skin flora (45/224, 20.1%).
Conclusion
Wound swabs could be omitted during peri-operative care for patients with acute sacrococcygeal pilonidal abscess. The because the results of wound swabs did not change the management of these patients. Additionally, omitting wound swabs could save money for the health care. Pre-operative antibiotic therapy should have anaerobic coverage as it is the most common type of micro-organism cultured from pilonidal abscesses.

Keyword

abscess; anti-bacterial agents; microbial sensitivity tests; operative surgical procedures; pilonidal sinus