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Inappropriate Initial Antibiotic Treatment May Extend Stays for Patients with Healthcare-Associated Skin Infections
Date:10/30/2009

ic treatment, sparing patients unnecessary treatment and time in the hospital."

Risk Factors for Inappropriate Treatment

In the hospitalized patient population, three risk factors were identified as being associated with receiving inappropriate antibiotic treatment:

  • Healthcare-associated infection status (i.e., recent exposure within nursing homes, or medical clinics)
  • Presence of a "gram-negative" pathogen
  • Presence of a pathogen other than a Streptococcus species

Study Methods and Key Results

The study, conducted by the Henry Ford Health System with a grant from Ortho-McNeil Janssen Scientific Affairs, LLC, is an analysis of administrative and medical records of 368 patients hospitalized between late 2005 and 2008 with an admission diagnosis of a cSSTI. Patients were classified as having healthcare associated infections (HCAI) if they were: 1) recently hospitalized; 2) immunocompromised; 3) on hemodialysis; or 4) admitted from nursing home. All others were classified as having community-acquired infections (CAI). Initial empiric therapy (IET) was considered appropriate if antibiotics active against the infecting pathogen(s) were administered within 24 hours of admission.

Among patients with SSTIs whose infection was confirmed by culture ("culture-positive"), those who acquired an infection in a hospital or healthcare setting were more likely to be treated inappropriately than those who acquired an infection in a community setting (35.2% vs. 20.5%, p<0.01). Additionally, when other risk factors were adjusted, patients who received inappropriate initial therapy stayed in the hospital an average of nearly six days longer than patients who received appropriate initial therapy.

Moreover, the study showed that S. aureus was the most common pathogen in patients with both HCAI (55.6%) as well as CAI (58.2%), and the majority of these
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SOURCE Ortho-McNeil, Inc.
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