Economic outcomes of inappropriate initial antibiotic treatment for complicated skin and soft tissue infections: a multicenter prospective observational study

Diagn Microbiol Infect Dis. 2014 Jun;79(2):266-72. doi: 10.1016/j.diagmicrobio.2014.02.013. Epub 2014 Feb 24.

Abstract

This study examined economic outcomes associated with inappropriate initial antibiotic treatment (IIAT) in complicated skin and soft tissue infections using data from adults hospitalized and treated with intravenous antibiotic therapy. We specifically analyzed for the subsets of patients infected with methicillin-resistant Staphylococcus aureus (MRSA), with healthcare-associated (HCA) infections, or both. Data from 494 patients (HCA: 360; MRSA:175; MRSA + HCA: 129) showed the overall mean length of stay (LOS) was 7.4 days and 15.0% had the composite economic outcome of any subsequent hospital admissions, emergency department visits, or unscheduled visits related to the study infection. A total of 23.1% of patients had IIAT; after adjustments, these patients had longer LOS than patients without IIAT in the HCA cohort (marginal LOS = 1.39 days, P = 0.03) and the MRSA + HCA cohort (marginal LOS = 2.43 days, P = 0.01) and were significantly more likely to have the composite economic outcome in all study cohorts (odds ratio: overall = 1.79; HCA = 3.09; MRSA = 3.66; MRSA + HCA = 6.92; all P < 0.05).

Keywords: Complicated skin and soft tissue infections; Economic outcomes; Inappropriate antibiotics treatment.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Anti-Bacterial Agents / economics*
  • Anti-Bacterial Agents / therapeutic use*
  • Cross Infection / drug therapy
  • Cross Infection / economics
  • Emergency Medical Services
  • Female
  • Health Care Costs*
  • Humans
  • Inappropriate Prescribing / economics*
  • Length of Stay
  • Male
  • Middle Aged
  • Prospective Studies
  • Skin Diseases, Bacterial / drug therapy*
  • Skin Diseases, Bacterial / economics
  • Soft Tissue Infections / drug therapy*
  • Soft Tissue Infections / economics
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / economics
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents