Complicated skin and soft tissue infections (cSSTIs) occur frequently, but limited data do not allow any consensus on an optimal treatment strategy. Lipsky, et al. designed a prospective, multicenter, observational study to explore the current epidemiology, treatment and resulting clinical outcomes of cSSTIs to help develop strategies to potentially improve outcomes.
From June 2008 to December 2009 the researchers enrolled a pre-specified number of adults treated in 62 U.S. hospitals with intravenous antibiotic(s) for any of the following cSSTIs: diabetic foot infection (DFI); surgical site infection (SSI); deep soft tissue abscess (DSTA); or cellulitis. Investigators treated all patients per their usual practice during the study and collected data on a standardized form.
The researchers enrolled 1,033 patients (DFI 27 percent; SSI 32 percent; DSTA 14 percent; cellulitis 27 percent; mean age 54 years; 54 percent male), of which 74 percent had healthcare-associated risk factors. At presentation, 89 percent of patients received initial empiric therapy with intravenous antibiotics; about 20 percent of these patients had this empiric regimen changed or discontinued based on culture and sensitivity results. Vancomycin was the most frequently used initial intravenous antibiotic, ordered in 61 percent of cases. During their stay 44 percent of patients underwent a surgical procedure related to the study infection, usually incision and drainage or debridement. The mean length of stay was 7.1 days, ranging from 5.8 (DSTA) to 8.1 (SSI).
The researchers say their findings from this large prospective observational study that characterized patients with cSSTIs from diverse U.S. inpatient populations provide useful information on the current epidemiology, clinical management practices and outcomes of this common infection. Their research was published in BMC Infectious Diseases.
Reference: Lipsky BA, et al. A Prospective, Multicenter, Observational Study of Complicated Skin and Soft Tissue Infections in Hospitalized Patients: Clinical Characteristics, Medical Treatment, and Outcomes. BMC Infectious Diseases 2012, 12:227 doi:10.1186/1471-2334-12-227