Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections: A south Texas ambulatory research network (STARNet) study

Matthew J. Labreche, Grace C. Lee, Russell T. Attridge, Eric M. Mortensen, Jim Koeller, Liem C. Du, Natalie R. Nyren, Lucina B. Treviño, Sylvia B. Treviño, Joel Peña, Michael W. Mann, Abilio Muñoz, Yolanda Marcos, Guillermo Rocha, Stella Koretsky, Sandra Esparza, Mitchell Finnie, Steven D. Dallas, Michael L. Parchman, Christopher R. Frei

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus skin and soft tissue infections (SSTIs). Methods: This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have "moderate or complicated" SSTIs if they had a lesion ≥5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. Results: Overall, treatment failure occurred in 21% of patients (21 of 98) at a mean additional cost of $1,933.71 per patient. In a subgroup analysis of patients who received incision and drainage, those with moderate or complicated SSTIs had higher rates of treatment failure than those with mild or uncomplicated SSTIs (36% vs. 10%; P = .04). Conclusions: One in 5 patients presenting to a primary care clinic for a methicillin-resistant S. aureus SSTI will likely require additional interventions at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting.

Original languageEnglish (US)
Pages (from-to)508-517
Number of pages10
JournalJournal of the American Board of Family Medicine
Volume26
Issue number5
DOIs
StatePublished - Sep 2013

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Soft Tissue Infections
Methicillin-Resistant Staphylococcus aureus
Treatment Failure
Health Care Costs
Skin
Research
Primary Health Care
Costs and Cost Analysis
Observational Studies
Drainage
Diabetes Mellitus
Prospective Studies
Incidence
Wounds and Injuries

Keywords

  • Antibiotics
  • Cost of illness
  • Epidemiology
  • Infectious diseases
  • Practice-based research
  • Primary health care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

Cite this

Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections : A south Texas ambulatory research network (STARNet) study. / Labreche, Matthew J.; Lee, Grace C.; Attridge, Russell T.; Mortensen, Eric M.; Koeller, Jim; Du, Liem C.; Nyren, Natalie R.; Treviño, Lucina B.; Treviño, Sylvia B.; Peña, Joel; Mann, Michael W.; Muñoz, Abilio; Marcos, Yolanda; Rocha, Guillermo; Koretsky, Stella; Esparza, Sandra; Finnie, Mitchell; Dallas, Steven D.; Parchman, Michael L.; Frei, Christopher R.

In: Journal of the American Board of Family Medicine, Vol. 26, No. 5, 09.2013, p. 508-517.

Research output: Contribution to journalArticle

Labreche, MJ, Lee, GC, Attridge, RT, Mortensen, EM, Koeller, J, Du, LC, Nyren, NR, Treviño, LB, Treviño, SB, Peña, J, Mann, MW, Muñoz, A, Marcos, Y, Rocha, G, Koretsky, S, Esparza, S, Finnie, M, Dallas, SD, Parchman, ML & Frei, CR 2013, 'Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections: A south Texas ambulatory research network (STARNet) study', Journal of the American Board of Family Medicine, vol. 26, no. 5, pp. 508-517. https://doi.org/10.3122/jabfm.2013.05.120247
Labreche, Matthew J. ; Lee, Grace C. ; Attridge, Russell T. ; Mortensen, Eric M. ; Koeller, Jim ; Du, Liem C. ; Nyren, Natalie R. ; Treviño, Lucina B. ; Treviño, Sylvia B. ; Peña, Joel ; Mann, Michael W. ; Muñoz, Abilio ; Marcos, Yolanda ; Rocha, Guillermo ; Koretsky, Stella ; Esparza, Sandra ; Finnie, Mitchell ; Dallas, Steven D. ; Parchman, Michael L. ; Frei, Christopher R. / Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections : A south Texas ambulatory research network (STARNet) study. In: Journal of the American Board of Family Medicine. 2013 ; Vol. 26, No. 5. pp. 508-517.
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abstract = "Objective: To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus skin and soft tissue infections (SSTIs). Methods: This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have {"}moderate or complicated{"} SSTIs if they had a lesion ≥5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. Results: Overall, treatment failure occurred in 21{\%} of patients (21 of 98) at a mean additional cost of $1,933.71 per patient. In a subgroup analysis of patients who received incision and drainage, those with moderate or complicated SSTIs had higher rates of treatment failure than those with mild or uncomplicated SSTIs (36{\%} vs. 10{\%}; P = .04). Conclusions: One in 5 patients presenting to a primary care clinic for a methicillin-resistant S. aureus SSTI will likely require additional interventions at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting.",
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T1 - Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections

T2 - A south Texas ambulatory research network (STARNet) study

AU - Labreche, Matthew J.

AU - Lee, Grace C.

AU - Attridge, Russell T.

AU - Mortensen, Eric M.

AU - Koeller, Jim

AU - Du, Liem C.

AU - Nyren, Natalie R.

AU - Treviño, Lucina B.

AU - Treviño, Sylvia B.

AU - Peña, Joel

AU - Mann, Michael W.

AU - Muñoz, Abilio

AU - Marcos, Yolanda

AU - Rocha, Guillermo

AU - Koretsky, Stella

AU - Esparza, Sandra

AU - Finnie, Mitchell

AU - Dallas, Steven D.

AU - Parchman, Michael L.

AU - Frei, Christopher R.

PY - 2013/9

Y1 - 2013/9

N2 - Objective: To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus skin and soft tissue infections (SSTIs). Methods: This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have "moderate or complicated" SSTIs if they had a lesion ≥5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. Results: Overall, treatment failure occurred in 21% of patients (21 of 98) at a mean additional cost of $1,933.71 per patient. In a subgroup analysis of patients who received incision and drainage, those with moderate or complicated SSTIs had higher rates of treatment failure than those with mild or uncomplicated SSTIs (36% vs. 10%; P = .04). Conclusions: One in 5 patients presenting to a primary care clinic for a methicillin-resistant S. aureus SSTI will likely require additional interventions at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting.

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