297. The Impact of Initial Antibiotic Therapy (Linezolid, Vancomycin, Daptomycin) on Hospital Length of Stay for Skin and Soft Tissue Infections
Session: Poster Abstract Session: Antimicrobial Therapy: Clinical Studies
Friday, October 21, 2011
Room: Poster Hall B1
Background: 

Empiric therapy of inpatient skin and soft tissue infections (SSTIs) must include MRSA coverage.  Limited data are available to directly compare the initial antibiotic choice on treatment outcomes and length of stay (LOS).

Methods: A retrospective review of 219 patients diagnosed with acute SSTI and who received linezolid, vancomycin, or daptomycin for > 48 hours was performed.  Data collected included demographics, comorbidities, microbiologic/laboratory data, additional management (surgical, secondary antibiotics), hospital LOS, treatment outcome and morbidity/mortality.

Results: 

The three groups evaluated were linezolid (n=45), vancomycin (n=90) and daptomycin (n=84). Mean age in the linezolid, vancomycin, daptomycin was 48, 52, 49 years (SD±2.5), respectively. There was no difference between the three groups with respect to gender, comorbidities, leukocytosis, fever, antibiotics prior to admission, site of infection and surgical intervention. One death was recorded, not directly associated with diagnosis of SSTI. No significant difference in LOS was found (P= 0.525) between the three groups. The mean LOS in entire cohort was 4.5 days (SD±2.5); thirty patients had prolonged LOS for non SSTI reasons; reanalyzing the data without these patients did not produce any difference in the mean LOS results between the 3 groups.

Conclusion: 

We found that the initial antibiotic choice of linezolid, vancomycin, or daptomycin for SSTI did not impact hospital length of stay or treatment outcome. The three antibiotic regimens were equally effective in treating SSTIs, irrespective of age, gender, comorbidities or baseline severity of SSTI.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Ewa M. Szczypinska, MD1, Alexander Velazquez, MD1, Diana Salazar, MD2, Beata Raczynski, RN-BSN3, C. Andrew DeRyke, Pharm.D.1,4 and Mark R. Wallace, MD1, (1)Infectious Diseases, Orlando Health, Orlando, FL, (2)Medicine, Orlando Health, Orlando, FL, (3)Orlando Health, Orlando, FL, (4)Pharmacy, Orlando Health, Orlando, FL

Disclosures:

E. M. Szczypinska, None

A. Velazquez, None

D. Salazar, None

B. Raczynski, None

C. A. DeRyke, None

M. R. Wallace, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.