Antimicrobial stewardship in the treatment of skin and soft tissue infections

Abstract

Background: Research on treating skin and soft tissue infections (SSTI) has shown improved patient outcomes with effective pharmaceutic prescribing. Antimicrobial stewardship programs can reduce consequences of broad-spectrum antimicrobial administration in SSTI treatment.

Methods: Prospective and historic control data were collected during two 7-month periods. Intervention consisted of implementing a new SSTI evidence-based treatment algorithm and provider education, including calls and medical record notes targeted at physicians.

Results: Of 412 patients, 76 and 86 were found eligible from the historic and intervention groups, respectively. The intervention group had a higher prevalence of appropriate antibiotic usage (33% vs 19%, respectively; P = .04). There was a lower median number of days from intravenous antibiotic therapy to oral conversion (3 vs 5; P < .0001) and a lower median number of days of antipseudomonal antibiotic use (3 vs 5; P = .03) in the intervention group, respectively. The intervention group also had fewer documented SSTI treatment complications (1% vs 8%, respectively; P = .04). The positive outcomes outlined demonstrate potential impacts made from the use of multidisciplinary antibiotic stewardship initiatives.

Conclusions: Appropriate use of antimicrobial agents under the direction of an antimicrobial stewardship program can lead to improved outcomes for patients being treated for SSTIs.

Keywords: Antibiotic; Antimicrobial; Cellulitis; Infection; Skin; Stewardship.