Skin infections in Europe: a retrospective study of incidence, patient characteristics and practice patterns

Grossi, Antonio Paolo; Vecchio, A. Del; Comandini, Alessandro; Corio, Luciana; Calisti, Fabrizio; Loreto, Giorgio Di; Almirante, Benito

doi:10.1016/j.ijantimicag.2022.106637

Cited by 7 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median age of the patients was lower than that found in other studies (38.0 vs. 41.1–61.6 years) [ 4 , 13 , 14 , 15 , 16 , 17 ], with a predominance of men, similar to previous studies (52.3% vs. 50.7–63.0%) [ 4 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. The clinical manifestations of patients with skin and soft tissue infections, as well as the location of infections predominantly in the lower limbs, were consistent with those reported in the literature [ 13 , 15 , 16 , 19 , 20 ].…”

Section: Discussionsupporting

confidence: 85%

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Valladales-Restrepo,

Aristizábal-Carmona,

Giraldo-Correa

et al. 2023

Microorganisms

View full text Add to dashboard Cite

Background: Skin and soft tissue infections are one of the main causes of consultations worldwide. The objective was to determine the treatment of a group of patients with uncomplicated skin and soft tissue infections in Colombia. Methods: Follow-up study of a cohort of patients with skin infections who were treated in the Colombian Health System. Sociodemographic, clinical and pharmacological variables were identified. Treatments were evaluated using clinical practice guidelines for skin infections. Results: A total of 400 patients were analyzed. They had a median age of 38.0 years and 52.3% were men. The most commonly used antibiotics were cephalexin (39.0%), dicloxacillin (28.0%) and clindamycin (18.0%). A total of 49.8% of the subjects received inappropriate antibiotics, especially those with purulent infections (82.0%). Being cared for in an outpatient clinic (OR: 2.09; 95% CI: 1.06–4.12), presenting pain (OR: 3.72; 95% CI: 1.41–9.78) and having a purulent infection (OR: 25.71; 95% CI: 14.52–45.52) were associated with a higher probability of receiving inappropriate antibiotics. Conclusions: Half of patients with uncomplicated skin and soft tissue infections were treated with antibiotics that were not recommended by clinical practice guidelines. This inappropriate use of antibiotics occurred in the vast majority of patients with purulent infections because the antimicrobials used had no effect on methicillin-resistant Staphylococcus aureus.

show abstract

Section: Discussionsupporting

confidence: 85%

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Valladales-Restrepo,

Aristizábal-Carmona,

Giraldo-Correa

et al. 2023

Microorganisms

View full text Add to dashboard Cite

show abstract

“…Langat and colleagues identified flucloxacillin and metronidazole as the most frequently prescribed drugs for SSTIs at a major referral facility in Kenya [9]. In Europe, up to 98% of SSTI patients were treated empirically, mainly with beta lactams [23]. It is encouraging that both gram-positive and gram-negative isolates identified in this study were generally susceptible to first line drugs and that second line drugs such as cefepime, carbapenems, amikacin and vancomycin were not prescribed.…”

Section: Empiric Antimicrobial Therapy For Suspected Sstismentioning

confidence: 78%

Low-Level Antibiotic Resistance among <i>Staphylococcus aureus</i> and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya

Nyasinga,

Munshi,

Musila

et al. 2024

OJMM

View full text Add to dashboard Cite

Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% -100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% -100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally How to cite this paper:

show abstract

“…ABSSSIs are a frequent reason of hospital admission and nearly 10% of all hospital antibiotic therapy is attributed to ABSSSIs, with a consequent relevant healthcare system burden. 40 Indeed, the management of ABSSSIs is complex given the frequent association with comorbidities such as obesity, diabetes mellitus and peripheral vascular disease, which may complicate the choice of the appropriate empirical antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…This MRSA prevalence could be responsible for the high rate of clinical failure of conventional first-line therapy of ABSSSIs, often characterized by suboptimal coverage of MRSA with the empirical treatment that was in fact modified in more than 60% of patients, as reported in a recent European survey. 40 In this setting, dalbavancin is active against most MDR Gram-positive bacteria, including MRSA. However, we suggest that the use of dalbavancin, also in the outpatient setting, may be evaluated in a coordinated antimicrobial stewardship programme to improve the appropriate use of empirical treatments, reserving anti-MRSA antibiotics for in the presence of known MRSA risk factors or local epidemiological issues.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

Bai

Mazzitelli

Silvola

et al. 2023

JAC-Antimicrobial Resistance

View full text Add to dashboard Cite

Objectives Thanks to its long half-life, dalbavancin qualifies as an optimal drug for saving costs. We aimed to assess the cost and effectiveness of dalbavancin versus the standard of care (SoC). Patients and methods We conducted a multicentre retrospective study, including all hospitalized or outpatients diagnosed with ABSSSIs at Padua University Hospital, Padua and San Paolo Hospital, Milan (1 January 2016 to 31 July 2020). We compared patients according to antibiotic treatment (dalbavancin versus SoC), the number of lines of dalbavancin treatment, and monotherapy or combination (dalbavancin in association with other antibiotics). Primary endpoints were direct medical costs and length of hospital stay (LOS) associated with ABSSSI management; Student’s t-test, chi-squared test and one-way ANOVA were used. Results One hundred and twenty-six of 228 (55.3%) patients received SoC, while 102/228 (44.7%) received dalbavancin. Twenty-seven of the 102 (26.5%) patients received dalbavancin as first-line treatment, 46 (45.1%) as second-line, and 29 (28.4%) as third- or higher-line treatment. Most patients received dalbavancin as monotherapy (62/102; 60.8%). Compared with SoC, dalbavancin was associated with a significant reduction of LOS (5 ± 7.47 days for dalbavancin, 9.2 ± 5.59 days for SoC; P < 0.00001) and with lower mean direct medical costs (3470 ± 2768€ for dalbavancin; 3493 ± 1901€ for SoC; P = 0.9401). LOS was also reduced for first-line dalbavancin, in comparison with second-, third- or higher-line groups, and for dalbavancin monotherapy versus combination therapy. Mean direct medical costs were significantly lower in first-line dalbavancin compared with higher lines, but no cost difference was observed between monotherapy and combination therapy. Conclusions Monotherapy with first-line dalbavancin was confirmed as a promising strategy for ABSSSIs in real-life settings, thanks to its property in reducing LOS and saving direct medical costs.

show abstract

Skin infections in Europe: a retrospective study of incidence, patient characteristics and practice patterns

Cited by 7 publications

References 22 publications

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Low-Level Antibiotic Resistance among <i>Staphylococcus aureus</i> and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

Contact Info

Product

Resources

About

Skin infections in Europe: a retrospective study of incidence, patient characteristics and practice patterns

Cited by 7 publications

References 22 publications

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Low-Level Antibiotic Resistance among &lt;i&gt;Staphylococcus aureus&lt;/i&gt; and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

Contact Info

Product

Resources

About

Low-Level Antibiotic Resistance among <i>Staphylococcus aureus</i> and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya