Acute Bacterial Skin and Skin Structure Infections (ABSSSI): Practice Guidelines for Management and Care Transitions in the Emergency Department and Hospital

Background Hospital admissions for non-purulent lower extremity cellulitis (NLEC) are common and can be prolonged and costly. Newer treatment options and preventive strategies are expected to result in cost savings before implementation, but few studies have quantified the cost of conventional treatment. Methods Using the Rochester Epidemiology Project, the incidence of NLEC in Olmsted County, MN in 2013 was 176.6 per 100,000 persons. The subset of patients who required hospitalization for NLEC in 2013 was determined. Hospital admissions were analyzed retrospectively using standardized cost analysis within several relevant categories. Results Thirty-four patients had an average hospital length of stay of 4.7 days. The median total inpatient cost was $7,341. The median cost per day was $2,087, with 49% due to room and board. Antibiotics administered for treatment of NLEC contributed a median cost of $75 per day of hospitalization, and laboratory and imaging test costs were $73 and $44, respectively, per day of hospitalization. Conclusions Hospitalizations for NLEC can be costly and prolonged with room and board accounting for much of the cost. Therefore, newer management strategies should seek to reduce hospital length of stay and/or avoid inpatient admission to reduce cost.

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“…[5] The presence of other comorbidities and other active medical problems may also impact the decision to admit to the hospital. [6]…”

Section: Introductionmentioning

confidence: 99%

Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

et al. 2017

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“…The Eron classification, developed in February 2003 by an expert panel of clinicians and researchers from the US, Canada and the UK, was one of the first attempts to categorize severity as a mechanism to guide initial site of care decisions for patients with SSTIs [12]. However, application of Eron and other similar site of care recommendations in clinical practice has been inconsistent as hospital admission decisions still appear to be heavily influenced by clinical judgment [12][13][14][15]. Data, albeit limited, indicate that SSTI patients without major complications or comorbidities are frequently admitted [7,13,16].…”

Section: Introductionmentioning

confidence: 99%

Hospital admission patterns in adult patients with skin and soft tissue infections: Identification of potentially avoidable hospital admissions through a retrospective database analysis

2015

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“…Acute bacterial skin and skin structure infections (AB-SSSIs) are associated with high mortality and morbidity and a substantial financial burden on health-care systems. 1 The incidence and severity of disease has increased in recent years, in parallel with the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections. 2,3 Community-acquired MRSA is of global concern and has contributed to substantial health-care resource utilization in the United States, where approximately half (46%) of all ABSS-SIs caused by S. aureus were found to be the result of methicillin-resistant isolates.…”

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confidence: 99%

Dalbavancin Population Pharmacokinetic Modeling and Target Attainment Analysis

Carrothers

Chittenden

Critchley

2019

Clinical Pharm in Drug Dev

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Dalbavancin is indicated for the treatment of acute bacterial skin and skin structure infections caused by susceptible gram-positive microorganisms. This analysis represents the update of the population pharmacokinetics (popPK) modeling and target attainment simulations performed with data from the single-dose safety and efficacy study and an unrelated but substantial revision of the preclinical pharmacokinetic/pharmacodynamic target (fAUC/MIC, free area under concentration-time curve/minimum inhibitory concentration ratio). A 3-compartment distribution model with first-order elimination provided an appropriate fit, with typical dalbavancin clearance of 0.05 L/h and total volume of distribution of ß15 L. Impact of intrinsic factors was modest, although statistically significant (P < .05) relationships with total clearance were found for the following covariates: creatinine clearance, weight, and albumin -dose adjustment was only indicated for severe renal impairment. Under the new nonclinical target, simulations of the popPK model projected that >99% of subjects would achieve the nonclinical target at MIC values up to and including 2 mg/L. Keywordsacute bacterial skin and skin structure infection, dalbavancin, long-acting intravenous antibiotic, pharmacokinetics, target attainment 1 Allergan plc,

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Acute Bacterial Skin and Skin Structure Infections (ABSSSI): Practice Guidelines for Management and Care Transitions in the Emergency Department and Hospital

Cited by 95 publications

References 34 publications

Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

Hospital admission patterns in adult patients with skin and soft tissue infections: Identification of potentially avoidable hospital admissions through a retrospective database analysis

Dalbavancin Population Pharmacokinetic Modeling and Target Attainment Analysis

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