Patients who acquire skin and soft tissue infections (SSTIs) in a hospital or other healthcare setting may be more likely to receive inappropriate antibiotic therapy at the beginning of their treatment. As a result, they also may have significantly longer hospital stays to control the infection.
Preliminary results from a new study by the Henry Ford Health System evaluated records from patients who acquired SSTIs in hospital and healthcare settings and those who acquired similar infections in the community. Results from the study, which were presented at the 47th annual meeting of the Infectious Diseases Society of America (IDSA), also shed new light on baseline risk factors that are associated with inappropriate initial therapy. This information may help guide clinicians in the appropriate treatment of SSTIs.
Complicated skin and skin structure infections (cSSTIs) account for almost 10 percent of all hospital admissions in the U.S. According to the Centers for Disease Control and Prevention (CDC), approximately 25 percent to 30 percent of the U.S. population has some form of Staphylococcus aureus on their skin, and an increasing number of those individuals carry the more resistant form known as methicillin-resistant Staphylococcus aureus (MRSA).
“Up to this point, the importance of initiating appropriate empiric* therapy has been well documented in other infections such as pneumonia, but not in skin infections,” said study author Marcus Zervos, MD, head of infectious diseases and director of infection control at the Henry Ford Health System in Detroit. “These results show that a more comprehensive evaluation of hospital patient risk factors may help physicians determine the optimal initial antibiotic treatment, sparing patients unnecessary treatment and time in the hospital.”
Risk Factors for Inappropriate Treatment
In the hospitalized patient population, three risk factors were identified as being associated with receiving inappropriate antibiotic treatment:
-- Healthcare-associated infection status (i.e., recent exposure within nursing homes, or medical clinics)
-- Presence of a Gram-negative pathogen
-- Presence of a pathogen other than a Streptococcus species
