Skin And Soft Tissue Infections Pdf

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The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population.

What Are Skin and Soft Tissue Infections?

The objective of this analysis was to describe in real-life settings the clinical outcomes and safety associated with daptomycin treatment in a cohort of patients with complicated skin and soft tissues infection cSSTI. The most frequent underlying diseases were cardiovascular disease The most frequent cSSTIs included surgical site infections A total of The majority of hospitalized patients Among patients with positive cultures, Staphylococcus aureus The overall clinical success rate was Adverse events possibly related to daptomycin treatment were reported in 2.

Daptomycin treatment resulted in high clinical success rates in patients with different cSSTI subtypes, the majority of whom having failed previous antibiotic therapy. Daptomycin was well tolerated and there were no new or unexpected safety findings. Skin and soft tissue infections SSTIs are the consequence of a microbial invasion of the layers of the skin and underlying soft tissues [ 1 ].

Moreover, associated comorbidities and microbial factors, particularly drug resistance, make the treatment of cSSTI more challenging [ 3 ]. Staphylococcus aureus is the main causative pathogen of cSSTIs [ 3 ]. Further, methicillin-resistant S. The glycopeptide vancomycin has been widely used for the treatment of MRSA infections, and its overuse has resulted in the emergence of vancomycin-intermediate and vancomycin-resistant S.

As a consequence, the increase of the minimum inhibitory concentrations MICs of vancomycin for MRSA is now a major challenge [ 7 , 8 ]. Therefore, the initial antibiotic treatment of cSSTI is frequently empirical before identification of the causative pathogen. Empirical coverage of both methicillin-susceptible S.

Daptomycin, a cyclic lipopeptide, displays rapid bactericidal activity against a wide range of Gram-positive pathogens including pathogens resistant to methicillin and vancomycin [ 13 ].

In two pivotal trials, the clinical success rate in patients with cSSTI was Of interest, daptomycin required a shorter duration of treatment than comparator antibiotics chosen by the study investigators [ 15 ]. The results from this registry during the first 2.

The data were collected by local investigators using standardized case report forms. Patients who might have received daptomycin as part of a controlled clinical trial were excluded from the study.

For the present study, patients with cSSTI were selected and analyzed for treatment outcome and safety. Clinical success was defined as patients who were cured or improved. The time to improvement was also recorded. The reasons for stopping daptomycin therapy and other antibiotics prescribed following daptomycin were also collected.

All AEs, regardless of seriousness or severity, were recorded. The safety population included all eligible patients with at least one safety assessment and the efficacy population included all eligible patients for whom clinical outcome was assessed.

Owing to the nature of the trial, inferential analyses were not performed and no formal statistical methodology other than simple descriptive statistics was used. Continuous variables were summarized as arithmetic mean, standard deviation, median and range; categorical variables were summarized by absolute and relative frequencies.

Daptomycin therapy was completed without further antibiotic treatment for The majority of patients were male Culture results were available for MRSA was reported in Antibiotics prior to daptomycin therapy were received by Treatment failure Concomitant antibiotics were given more frequently to hospitalized patients The most common concomitant antibiotics were carbapenems Daptomycin was prescribed as a first-line therapy in Of the patients with MRSA infection, Clinical success rates were high for all doses.

The overall clinical success rate cured or improved was High clinical success rates were observed in all subtypes of cSSTI. The clinical success rates for cSSTI subtypes were highest for diabetic ulcer infections Overall, clinical success rates by primary pathogen were comparable as detailed in Fig.

Clinical outcome by cSSTI subtype. Clinical outcome by predominant primary pathogen. Overall, Daptomycin was discontinued due to an AE for 2. Increased blood creatine phosphokinase CPK was reported for 1. SAEs were reported for 5. EU-CORE was a retrospective, multicenter registry, designed to collect real-world data on the use of daptomycin for Gram-positive infections.

The results of the current analysis provide greater insights into the prescribing patterns of daptomycin and outcomes in cSSTI patients. Nevertheless, daptomycin treatment resulted in high clinical success rates in patients with different types of cSSTI, the majority of whom not responding to prior antibiotic therapies. As expected, the most frequently reported causative agent was S. These high doses could reflect treatment of patients with serious or deep-seated cSSTIs e.

The high clinical success rate These results are also consistent with previously reported randomized clinical trials which assessed the efficacy of daptomycin in patients with cSSTI [ 15 , 20 ]. In the two pivotal studies of Arbeit et al.

Quist et al. In the meta-analysis of Wang et al. Therefore, these results further support the use of daptomycin as a first-line treatment option for cSSTI. Our results confirmed in real-world settings a comparable high effectiveness across infections caused by various pathogens, in particular MRSA.

These results support the use of daptomycin as empiric treatment for cSSTI. Indeed, S. Early treatment of cSSTI caused by MRSA was associated with lower in-hospital mortality rates, shorter length of hospital stay and lower total costs [ 10 ]. The current analysis displayed high clinical success rates in different types of cSSTI including diabetic foot infection, which is a serious, difficult-to-treat infection [ 18 ].

These results support previous results from Joseph et al. In the exploratory study of Knapp et al. Daptomycin showed a favorable safety profile in this patient population without any new or unexpected safety findings.

Study drug discontinuations due to AEs were infrequent. The blood CPK elevations were minimal. The limitations of the present analysis were first related to the non-randomized and retrospective design of the study. Moreover, the treatment outcome was judged by the local investigators who were not blinded.

No central laboratory was used and results of primary pathogens and their susceptibility could be different across the different centers.

Daptomycin being specific for Gram-positive bacteria, the mixed cSSTI might not be cured completely, thus affecting the clinical success rate, and also increasing the need for concomitant antibiotic therapy. There was also no restriction on the use of concomitant antibiotics. Although the use of concomitant antibiotics complicated the data interpretation for both clinical outcome and safety of daptomycin, the treatment outcome associated with daptomycin reflected its use in real life.

Despite these limitations, high levels of success were reported in the different centers that included patients in the registry with no stringent criteria.

Indeed, the only criterion was daptomycin treatment for cSSTI. Therefore, patients with poor conditions who would have been excluded in a randomized trial were included in the registry. Daptomycin treatment resulted in high clinical success rates in patients with different types of cSSTI, the majority of whom failed previous antibiotic therapy.

Ki V, Rotstein C. Bacterial skin and soft tissue infections in adults: a review of their epidemiology, pathogenesis, diagnosis, treatment and site of care.

Dryden MS. Complicated skin and soft tissue infection. J Antimicrob Chemother. Clin Microbiol Infect. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe Stockholm: ECDC; Google Scholar.

Antibacterial treatment of meticillin-resistant Staphylococcus aureus complicated skin and soft tissue infections: a cost and budget impact analysis in Greek hospitals. Infect Dis Ther.

Methicillin and vancomycin resistant S. J Glob Infect Dis. Vancomycin-resistant Staphylococcus aureus in the United States, —

What Are Skin and Soft Tissue Infections?

Nicholas Black, Jon W. Skin and soft tissue infections are common presenting complaints for Emergency Department ED patients. Although they are common, there remain no definitive guidelines on decisions of admission for these patients. To determine the influence of demographic and clinical information of those presenting with skin and soft tissue infection s SSTI on both disposition and treatment failure. Secondary outcome was treatment failure.

Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections SSTIs is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Incidence was 1. Overall case fatality rate was 3.

What Are Skin and Soft Tissue Infections?

The objective of this analysis was to describe in real-life settings the clinical outcomes and safety associated with daptomycin treatment in a cohort of patients with complicated skin and soft tissues infection cSSTI. The most frequent underlying diseases were cardiovascular disease The most frequent cSSTIs included surgical site infections A total of The majority of hospitalized patients

Metrics details.

5 Response
  1. Lea S.

    Zulu shaman dreams prophecies and mysteries pdf download for the beauty of the earth john rutter free pdf

  2. Kieran W.

    Skin and soft-tissue infections SSTIs are common and are linked to a wide variety of clinical conditions.

  3. Vanina V.

    Skin and soft tissue infections SSTIs can affect the outer skin, fascia sheaths of connective tissue , muscle and other tissue of the body.

  4. Hassan M.

    Skin and soft tissue infections result from microbial invasion of the skin and for treatment. sicm1.org

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