{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:45:16Z","timestamp":1792032316324,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Incision and drainage of subcutaneous abscesses is a common surgical procedure. It is the standard of treatment, with or without adjunctive antibiotics. Interestingly, there exists a lack of evidence regarding the role of intraoperative sampling of the purulent discharge from abscesses. This study aimed to demonstrate whether intraoperative swab results were used to tailor antibiotic management and the circumstances surrounding these decisions. This will guide local practice for judicious collection of swabs and empirical antibiotic management. This is needed in the Western Sydney population, who are often co\u2010morbid and experience recurrent abscesses.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study was performed of Westmead and Auburn Hospital's incision and drainage surgeries of subcutaneous abscesses from 2023 to 2025.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 2088 cases were identified and, in most cases (87%), an intraoperative swab was collected. The common causative organisms were\n staphylococcus<\/jats:italic>\n , followed by\n streptococcus<\/jats:italic>\n . Most organisms were pan\u2010sensitive; however, of the multi\u2010drug\u2010resistant organisms, methicillin\u2010resistant\n \n Staphylococcus aureus<\/jats:italic>\n <\/jats:styled-content>\n (MRSA) was most common. In 25% of cases where a causative organism was isolated, the bacteria were resistant to the antibiotic prescribed. However, the swab result only changed antibiotic management in 69 cases (3%). MRSA accounted for 62 of the 69 cases. Additionally, patients with causative organisms isolated were more often febrile (21%) than those without such swab results (16%) (\n p<\/jats:italic>\n \u2009<\u20090.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Overall, intraoperative swabs are recommended to be performed only in specific cases, not routinely. This includes patients who are febrile and patients with a history of or risk factors for multi\u2010drug\u2010resistant organisms such as MRSA.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.71003","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:05:11Z","timestamp":1792029911000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating the Use of Routine Swabs in Incision and Drainage of Abscesses: An Audit of Western Sydney Hospitals"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0117-6363","authenticated-orcid":false,"given":"Bethany Rachel","family":"O'Neill","sequence":"first","affiliation":[{"name":"Western Sydney Local Health District Sydney New South Wales Australia"},{"name":"The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2019-5979","authenticated-orcid":false,"given":"Amy","family":"Hort","sequence":"additional","affiliation":[{"name":"Western Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Mann","sequence":"additional","affiliation":[{"name":"Western Sydney Local Health District Sydney New South Wales Australia"},{"name":"The University of Notre Dame Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Incision and Drainage","author":"Pastorino A.","year":"2023"},{"issue":"3","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/cid\/ciy509","article-title":"Decreasing Incidence of Skin and Soft\u2010Tissue Infections in 86 US Emergency Departments, 2009\u20132014","volume":"68","author":"Morgan E.","year":"2019","journal-title":"Clinical Infectious Diseases"},{"issue":"1","key":"e_1_2_10_4_1","article-title":"Community\u2010Acquired Skin and Soft Tissue Infections: Epidemiology and Management in Patients Presenting to the Emergency Department of a Tertiary Care Hospital","volume":"15","author":"Alizai Q.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ebiom.2016.10.017","article-title":"Targeting Bacterial Abscess Formation","volume":"12","author":"Kolar S. L.","year":"2016","journal-title":"eBioMedicine"},{"issue":"1","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0052722","article-title":"Epidemics of Community\u2010Associated Methicillin\u2010Resistant \n Staphylococcus aureus\n in the United States: A Meta\u2010Analysis","volume":"8","author":"Dukic V. M.","year":"2013","journal-title":"PLoS One"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","DOI":"10.1093\/bjs\/znad241.328","article-title":"Microbiology Pus Swab Sampling in Incision and Drainage of Abscesses","volume":"110","author":"Paul M.","year":"2023","journal-title":"British Journal of Surgery"},{"issue":"1","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1093\/bjs\/znae318.049","article-title":"Is Routine Collection of Pus Swabs Necessary During Emergency Incision and Drainage of Abscesses?","volume":"112","author":"Sonoo P.","year":"2025","journal-title":"British Journal of Surgery"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.21037\/ajo-22-24","article-title":"Is There a Consensus on Peritonsillar Abscess Management?\u2014An Audit of a Tertiary Hospital in Australia","volume":"6","author":"Bigdeli R.","year":"2023","journal-title":"Australian Journal of Otolaryngology"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2025.112113","article-title":"Is the Burden of Diabetes in Australia Underestimated? Comparison of Diabetes Ascertainment Using Linked Administrative Health Data and an Australian Diabetes Registry","volume":"222","author":"Cox E.","year":"2025","journal-title":"Diabetes Research and Clinical Practice"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.5334\/ijic.ICIC20261","article-title":"Western Sydney Diabetes: An Integrated Program for Diabetes Prevention, Management, and Control in Sydney, Australia","volume":"21","author":"Maberly G.","year":"2021","journal-title":"International Journal of Integrated Care"},{"issue":"3","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.14740\/gr1279","article-title":"Auditing the Routine Microbiological Examination of Pus Swabs From Uncomplicated Perianal Abscesses: Clinical Necessity or Old Habit?","volume":"13","author":"Lalou L.","year":"2020","journal-title":"Gastroenterology Research"},{"issue":"7","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1007\/s10350-007-0221-x","article-title":"MRSA\u2010Related Perianal Abscesses: An Underrecognized Disease Entity","volume":"50","author":"Albright J. B.","year":"2007","journal-title":"Diseases of the Colon and Rectum"},{"issue":"3","key":"e_1_2_10_14_1","article-title":"Increased Incidence of Methicillin\u2010Resistant \n Staphylococcus aureus\n Skin and Soft Tissue Abscesses in Indigenous Children in North Queensland","volume":"18","author":"Aaron E.","year":"2026","journal-title":"Cureus"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-19123-6","article-title":"Drug Resistant Bacteria in Perianal Abscesses Are Frequent and Relevant","volume":"12","author":"Bender F.","year":"2022","journal-title":"Scientific Reports"},{"issue":"2","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/cid\/ciz818","article-title":"Frequent Methicillin\u2010Resistant \n Staphylococcus aureus\n Introductions Into an Inner\u2010City Jail: Indications of Community Transmission Networks","volume":"71","author":"Popovich K. J.","year":"2020","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.108732","article-title":"Diabetes and Acute Bacterial Skin and Skin Structure Infections","volume":"174","author":"Falcone M.","year":"2021","journal-title":"Diabetes Research and Clinical Practice"},{"issue":"7","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.4103\/jfmpc.jfmpc_1582_24","article-title":"Invasive Fungal Infections and the Management in Immunocompromised Conditions","volume":"14","author":"Anandani G.","year":"2025","journal-title":"Journal of Family Medicine and Primary Care"},{"issue":"3","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/cid\/ciq146","article-title":"Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin\u2010Resistant \n Staphylococcus aureus\n Infections in Adults and Children","volume":"52","author":"Liu C.","year":"2011","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_10_20_1","article-title":"A Prescription for Resistance: Management of Staphylococcal Skin Abscesses by General Practitioners in Australia","volume":"7","author":"Parrott C.","year":"2016","journal-title":"Frontiers in Microbiolology"},{"key":"e_1_2_10_21_1","unstructured":"Therapeutic Guidelines \u201cEmpirical Therapy for Boils and Carbuncles \u201d2025 https:\/\/app.tg.org.au.acs.hcn.com.au\/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=bartonella\u2010infections&guidelinename=auto§ionId=c_ABG_Boils\u2010and\u2010carbuncles_topic_2#c_ABG_Boils\u2010and\u2010carbuncles_topic_2."},{"issue":"4","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.annemergmed.2018.04.026","article-title":"Antibiotics Should Not be Routinely Prescribed After Incision and Drainage of Uncomplicated Abscesses","volume":"73","author":"Pulia M.","year":"2019","journal-title":"Annals of Emergency Medicine"},{"key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.annemergmed.2014.08.007","article-title":"Do Oral Antibiotics After Incision and Drainage of Simple Abscesses Improve Cure Rates?","volume":"65","author":"Ju N.","year":"2014","journal-title":"Annals of Emergency Medicine"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.71003","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.71003","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.71003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:05:15Z","timestamp":1792029915000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.71003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":22,"alternative-id":["10.1111\/ans.71003"],"URL":"https:\/\/doi.org\/10.1111\/ans.71003","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ans.71003"}}