Related Experiment Video
Updated: May 1, 2026
A Novel High-Throughput Ex Vivo Ovine Skin Wound Model for Testing Emerging Antibiotics
Published on: September 16, 2022
Economic outcomes of inappropriate initial antibiotic treatment for complicated skin and soft tissue infections: a
B A Lipsky1, L M Napolitano2, G J Moran3
1University of Oxford, Oxford, UK.
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).
Insights
Inappropriate initial antibiotic treatment for complicated skin infections led to longer hospital stays and increased healthcare costs. This highlights the economic impact of selecting the right antibiotics upfront.
Area of Science:
- Infectious Diseases
- Health Economics
- Pharmacoeconomics
Background:
- Complicated skin and soft tissue infections (cSSTIs) pose significant treatment challenges.
- Inappropriate initial antibiotic treatment (IIAT) is a concern in managing cSSTIs.
- Economic consequences of IIAT require thorough investigation.
Purpose of the Study:
- To evaluate the economic outcomes of IIAT in hospitalized adult patients with cSSTIs.
- To analyze economic impacts specifically in patients with methicillin-resistant Staphylococcus aureus (MRSA) and healthcare-associated (HCA) infections.
Main Methods:
- Retrospective analysis of 494 adult patients treated with intravenous antibiotics for cSSTIs.
- Data collection on length of stay (LOS) and composite economic outcomes (subsequent admissions/visits).
- Statistical analysis to compare outcomes between patients with and without IIAT, adjusting for relevant factors.
Main Results:
- Overall mean LOS was 7.4 days; 15.0% experienced composite economic outcomes.
- 23.1% of patients received IIAT.
- IIAT was associated with significantly longer LOS in HCA and MRSA+HCA cohorts and increased likelihood of composite economic outcomes across all cohorts.
Conclusions:
- IIAT for cSSTIs significantly increases length of hospital stay and healthcare utilization.
- Targeted antibiotic selection is crucial for improving patient outcomes and reducing economic burden.
- Findings emphasize the importance of appropriate antibiotic stewardship in managing cSSTIs, particularly those caused by MRSA and HCA pathogens.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:25Clinical Significance of Antibiotic Resistance
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:29Staphylococcal Skin Infections