Outcomes and management costs in patients hospitalized for skin and skin-structure infections

Itani, Kamal M.F.; Merchant, Sanjay; Lin, Swu–Jane; Akhras, Kasem; Alandete, Juan Carlos; Hatoum, Hind T.

doi:10.1016/j.ajic.2010.03.018

Cited by 43 publications

(42 citation statements)

References 15 publications

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“…Skin and soft tissue infections (SSTIs) are common reasons for seeking medical care, and can have significant morbidity including hospitalization [1,2]. In patients hospitalized due to SSTI, Staphylococcus aureus ( S. aureus ) is the most common bacterial pathogen identified [3-5].…”

Section: Introductionmentioning

confidence: 99%

“…Menzin, et al, studied over 13,000 S. aureus -SSTI inpatient episodes from 2005 to 2006 and found that the mean associated hospitalization costs were $6,800 per patient [12]. Itani, et al, studied 5,156 patients hospitalized with SSTIs and found that the median charge among the 3,079 with gram positive-associated SSTIs (which includes S. aureus ) was $19,894 with a mean of $40,046 [2]. …”

Section: Introductionmentioning

confidence: 99%

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Incidence and cost of hospitalizations associated with Staphylococcus aureusskin and soft tissue infections in the United States from 2001 through 2009

et al. 2014

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BackgroundThe emergence of community-associated methicillin-resistant Staphylococcus aureus (SA) and its role in skin and soft tissue infections (SSTIs) accentuated the role of SA-SSTIs in hospitalizations.MethodsWe used the Nationwide Inpatient Sample and Census Bureau data to quantify population-based incidence and associated cost for SA-SSTI hospitalizations.ResultsSA-SSTI associated hospitalizations increased 123% from 160,811 to 358,212 between 2001 and 2009, and they represented an increasing share of SA- hospitalizations (39% to 51%). SA-SSTI incidence (per 100,000 people) doubled from 57 in 2001 to 117 in 2009 (p < 0.01). A significant increase was observed in all age groups. Adults aged 75+ years and children 0–17 years experienced the lowest (27%) and highest (305%) incidence increase, respectively. However, the oldest age group still had the highest SA-SSTI hospitalization incidence across all study years. Total annual cost of SA-SSTI hospitalizations also increased and peaked in 2008 at $4.84 billion, a 44% increase from 2001. In 2009, the average associated cost of a SA-SSTI hospitalization was $11,622 (SE = $200).ConclusionThere has been an increase in the incidence and associated cost of SA-SSTI hospitalizations in U.S.A. between 2001 and 2009, with the highest incidence increase seen in children 0–17 years. However, the greatest burden was still seen in the population over 75 years. By 2009, SSTI diagnoses were present in about half of all SA-hospitalizations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and cost of hospitalizations associated with Staphylococcus aureusskin and soft tissue infections in the United States from 2001 through 2009

et al. 2014

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“…33 Mixed infections can increase mortality, length of stay, and hospital charges compared with gram-positive or gram-negative infections alone. 8 Methicillin-Resistant S aureus Initially, CA-MRSA was reported in specific populations (eg, intravenous [IV] drug users and athletes) 34,35 but currently is so common in the community that historically high-risk groups are no longer clinically useful. Epidemiologically, CA-MRSA infections occur in individuals in the outpatient setting or within 2 days of hospitalization and without the presence of health careeassociated risk factors, whereas hospitalacquired MRSA is traditionally associated with recent hospitalization.…”

Section: Health Careeassociated Infectionsmentioning

confidence: 99%

“…5,6 Methicillin-resistant S aureus (MRSA) is a predominant pathogen that causes SSTIs, is associated with increased length of hospitalization, and is an independent risk factor for increased mortality and hospital charges compared with methicillin-susceptible S aureus (MSSA). 7,8 The increasing incidence of SSTIs in both ambulatory and hospital settings, coupled with the increase of MRSA as a causative pathogen, demands optimal management of these infections to improve outcomes.…”

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confidence: 99%

Hospitalist Perspective on the Treatment of Skin and Soft Tissue Infections

Amin

Cerceo

Deitelzweig

et al. 2014

Mayo Clinic Proceedings

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The prevalence of skin and soft tissue infections (SSTIs) has been increasing in the United States. These infections are associated with an increase in hospital admissions. Hospitalists play an increasingly important role in the management of these infections and need to use hospital resources efficiently and effectively. When available, observation units are useful for treating low-risk patients who do not require hospital admission. Imaging tools may help to exclude abscesses and necrotizing soft tissue infections; however, surgical exploration remains the principal means of diagnosing necrotizing soft tissue infections. The most common pathogens that cause SSTIs are streptococci and Staphylococcus aureus. Methicillin-resistant S aureus (MRSA) is a prevalent pathogen, and concerns are increasing regarding the unclear distinctions between community-acquired and hospital-acquired MRSA. Other less frequent pathogens that cause SSTIs include Enterococcus species, Escherichia coli, Klebsiella species, Enterobacter species, and Pseudomonas aeruginosa. Cephalexin and clindamycin are suitable options for infections caused by streptococcal species and methicillin-susceptible S aureus. The increasing resistance of S aureus and Streptococcus pyogenes to erythromycin limits its use in these infections, and better alternatives are available. Parenteral cefazolin, nafcillin, or oxacillin can be used in hospitalized patients with nonpurulent cellulitis caused by streptococci and methicillin-susceptible S aureus. When oral MRSA therapy is indicated, clindamycin, doxycycline, trimethoprim-sulfamethoxazole, or linezolid is appropriate. Vancomycin, linezolid, daptomycin, tigecycline, telavancin, and ceftaroline fosamil are intravenous options that should be used in MRSA infections that require patient hospitalization. In the treatment of patients with SSTIs, hospitalists are at the forefront of providing proper patient care that reduces hospital costs, duration of therapy, and therapeutic failures. This review updates guidelines on the management of SSTIs with a focus on infections caused by S aureus, particularly MRSA, and outlines the role of the hospitalist in the effective management of SSTIs.

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“…Several studies have shown an increase in ambulatory and hospital visits related to these infections, and an increase in length of stay in hospital, mortality risk and health costs 1–3. In North American hospitals, an increase of 29% was detected in hospital admissions because of SSTIs between 2000 and 2004 4.…”

Section: Introductionmentioning

confidence: 99%

Delafloxacin: design, development and potential place in therapy

Candel¹,

Peñuelas²

2017

DDDT

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Delafloxacin (DLX) is a new fluoroquinolone pending approval, which has shown a good in vitro and in vivo activity against major pathogens associated with skin and soft tissue infections and community-acquired respiratory tract infections. DLX also shows good activity against a broad spectrum of microorganisms, including those resistant to other fluoroquinolones, as methicillin-resistant Staphylococcus aureus. Its pharmacokinetic properties and excellent activity in acidic environments make DLX an alternative in the treatment of these and other infections. In this manuscript, a detailed analysis of this new fluoroquinolone is performed, from its chemical structure to its in vivo activity in recently published clinical trials. Its possible place in the current antimicrobial outlook and in other infectious models is also discussed.

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Outcomes and management costs in patients hospitalized for skin and skin-structure infections

Cited by 43 publications

References 15 publications

Incidence and cost of hospitalizations associated with Staphylococcus aureusskin and soft tissue infections in the United States from 2001 through 2009

Incidence and cost of hospitalizations associated with Staphylococcus aureusskin and soft tissue infections in the United States from 2001 through 2009

Hospitalist Perspective on the Treatment of Skin and Soft Tissue Infections

Delafloxacin: design, development and potential place in therapy

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