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ARTICLE

Obesity & Heart Failure Increase Odds of Treatment Failure in SSTI Patients

MAR 20, 2017 | NICOLA M. PARRY, BVSC, MRCVS, MSC, DIPACVP ELS
Outpatients with uncomplicated skin and soft tissue infections (SSTIs) who have heart failure and obesity are at increased risk of failing oral antibiotic therapy, a new study suggests.
 
Researchers from Veterans Affairs Western New York Healthcare System published the results of their study online in Antimicrobial Agents and Chemotherapy.
 
“The incidence of skin and soft tissue infections in outpatients in the United States has increased from 8.6 million in 1997 to 14.2 million in 2005,” the authors write. “Hospitalization rates due to poorly managed or untreated skin infections have also continued to rise.”
 
Clinicians typically treat patients with SSTIs with oral antibiotics in the outpatient setting. The overall failure rate of oral antibiotic treatment is reported to range from 10% to 21%, and one study estimated that patients who fail therapy require additional medical interventions costing an estimated $1,934.
 
However, knowledge of risk factors for oral antibiotic failure for SSTIs in the outpatient setting is lacking. 
 
In an interview with Contagion®, Kari A. Mergenhagen, PharmD, BCPS AQ-ID, Veterans Affairs Western New York Healthcare System, Buffalo, New York, the study’s senior author, explained how the stewardship team had identified large numbers of patients admitted for SSTIs who had failed previous oral antibiotic therapy.  
 
The researcher conducted a study to investigate risk factors for failure of antibiotics in the outpatient setting. “Our goal was to identify these patients to prevent morbidity and effectively treat these patients at high risk for failure,” she said.

Using the Veterans Affairs Western New York Healthcare System electronic medical record, the researchers reviewed a total of 1,060 patient visits. They included 293 patients in the final analysis, 24% of whom failed antibiotic therapy within 30 days.



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