Epidemiology, treatment, and economics of patients presenting to the emergency department for skin and soft tissue infections

Linder, Kristin E; Nicolau, David P.; Nailor, Michael D

doi:10.1080/21548331.2017.1279519

Cited by 23 publications

(20 citation statements)

References 19 publications

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“…As described earlier, a published national average from 2011 showed a LOS of 4.95 days in patients with similar diagnoses . For the secondary outcomes, mean total direct cost per case was $2989 and 5 patients (11.4%) were readmitted within 30 days for any cause, below a published 30‐day overall readmission rate of 16% in patients with skin and soft tissue infections treated as inpatients at a single center . When compared against internal data from the year prior, 945 patients met the same inclusion/exclusion criteria and had a hospital LOS of 8 days, a total direct cost per case of $7863, and a 30‐day all‐cause readmission rate of 8.6%.…”

Section: Resultsmentioning

confidence: 95%

“…4 For the secondary outcomes, mean total direct cost per case was $2989 and 5 patients (11.4%) were readmitted within 30 days for any cause, below a published 30-day overall readmission rate of 16% in patients with skin and soft tissue infections treated as inpatients at a single center. 5 When compared against internal data from the year prior, 945 patients met the same inclusion/exclusion criteria and had a hospital LOS of 8 days, a total direct cost per case of $7863, and a 30-day all-cause readmission rate of 8.6%. 17 Our institution has been able to demonstrate that partnering among disciplines to facilitate early discharge can be a safe and effective way to treat patients with ABSSSI.…”

Section: Methodsmentioning

confidence: 99%

“…There is also concern that discharging these patients too early could lead to readmission. There are few studies looking at readmission rates in these patients, but one single center retrospective study reported a 30‐day overall readmission rate of 16% in 2015 for patients with skin and soft tissue infections treated as inpatients …”

Section: Introductionmentioning

confidence: 99%

“…There are few studies looking at readmission rates in these patients, but one single center retrospective study reported a 30-day overall readmission rate of 16% in 2015 for patients with skin and soft tissue infections treated as inpatients. 5 Considering the FDA criteria for ABSSSI, agents covering solely gram-positive bacteria should be used in most cases, especially for cellulitis and abscesses. 1 For patients seeking treatment for cSSSI at emergency departments, data have shown that 59% of these are due to community-associated methicillin-resistant Staphylococcus aureus (MRSA).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of dalbavancin on length of stay in acute bacterial skin and skin structure infections

Jones

Hersey

Taylor

et al. 2019

J Am Coll Clin Pharm

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Purpose Acute bacterial skin and skin structure infections (ABSSSI) are common reasons for hospital admission. A pathway to shift care to the outpatient setting sooner could decrease length of stay (LOS). Our not‐for‐profit community health system has developed a novel practice of partnering with hospitalists as part of a multidisciplinary early discharge of hospitalized patients with dalbavancin for ABSSSI. The primary purpose of this study was to evaluate outcomes associated with this process. Methods This was a retrospective evaluation of an ongoing, prospective process between March 2016 and March 2017. The process involves the hospitalist or infectious diseases pharmacist evaluating patients as possible candidates for dalbavancin therapy. Patients were included if their infection was consistent with cellulitis, abscess, or post‐operative wound infection and they received dalbavancin immediately after discharge from the hospital. The primary outcome was hospital LOS with secondary outcomes of direct cost per case and 30‐day readmission rate. Hospital LOS and 30‐day readmission rate were benchmarked to national averages and internal data from the same time frame the year prior. Results Forty four patients were identified who had received dalbavancin during the time period and met criteria for study inclusion. For the primary outcome of hospital LOS, patients discharged to receive dalbavancin had a mean LOS of 4.3 days similar to published national average (4.95 days in 2011) and lower than internal data (8 days). For secondary outcomes, mean total direct cost per case was $2989 and five patients (11.4%) were readmitted within 30 days similar to published national (16%) and internal data (8.6%). Conclusion Patients discharged to receive dalbavancin had a LOS and overall 30‐day readmission rate below published national data for ABSSSI. Further study is needed to evaluate this process as an effective means to shorten LOS in the management of ABSSSI.

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Section: Resultsmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of dalbavancin on length of stay in acute bacterial skin and skin structure infections

Jones

Hersey

Taylor

et al. 2019

J Am Coll Clin Pharm

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“…SSTI of the forefoot ranges from superficial to deep infections to necrotising fasciitis. SSTI cause annually about 850 000 hospitalizations in the US [ 1 ][ 2 ][ 3 ][ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Forefoot Phlegmon – A Complication of Intravenous Heroin-Addiction

Wollina¹,

Lotti²,

Tchernev³

2018

Open Access Maced J Med Sci

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Infections of the skin and soft tissues (SSTI) are clinical entities with variable presentations, causes, and levels of clinical severity. They are frequent in emergency departments. The most common pathogen in the Western World is Staphylococcus aureus. SSTI may provide a hint to underlying pathologies such as diabetes and other states of immune compromise. Here we present a 41-year-old non-diabetic male patient with pain and swelling of the left forefoot but not any recent trauma. Microbiology identified streptococci. The medical history was positive for intravenous heroin abuse. The diagnosis of forefoot phlegm due to drug addition was confirmed. Treatment was realised by a combination of intravenous antibiosis and drainage. Intravenous drug addiction is a significant risk factor for SSTI.

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Antibiotic Stewardship in the Emergency Department

Goodlet

Nailor

May

2023

Antimicrobial Stewardship in Non-Traditional Settings

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Epidemiology, treatment, and economics of patients presenting to the emergency department for skin and soft tissue infections

Abstract: This analysis identifies opportunities to improve processes of care for SSTIs with the aim of decreasing LOS, reducing readmissions, and ultimately decreasing burden on the healthcare system.

Cited by 23 publications

References 19 publications

Evaluation of dalbavancin on length of stay in acute bacterial skin and skin structure infections

Evaluation of dalbavancin on length of stay in acute bacterial skin and skin structure infections

Acute Forefoot Phlegmon – A Complication of Intravenous Heroin-Addiction

Antibiotic Stewardship in the Emergency Department

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