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 language | English (US) |
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Pages (from-to) | 508-517 |
Number of pages | 10 |
Journal | Journal of the American Board of Family Medicine |
Volume | 26 |
Issue number | 5 |
DOIs | |
State | Published - Sep 2013 |
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