Methods: A patient survey was conducted across 5 hospital EDs in the US. After providing informed consent, patients with ABSSSI completed a baseline survey assessing their ABSSSI history and preferences for antibiotic (ABX) therapy [intravenous (IV) versus oral] and treatment location. Patient characteristics and ensuing treatment details were collected from the medical record after the ED or hospitalization was completed. Descriptive statistics were used for analyses.
Results: Seventy one patients were enrolled and completed the baseline survey. The mean ± SD age was 50 ± 17 years, 22 (31%) had diabetes, and 47 (66.2%) had a previous ABSSSI. The median (25th-75th quartile) lesion size was 190 (53-613) cm2; 51 (71.8%) presented with cellulitis, an abscess, or both. Fifty-four (76.1%) were admitted to the hospital with a median (25th-75thquartile) length of stay of 4.5 (2-9) days. In the ED, vancomycin (39.4%) and beta-lactams (36.6%) were the most common ABX; IV was prescribed in 58/63 (92.1%) patients. Once admitted, 37 (68.5%) and 34 (63%) patients received vancomycin and beta-lactams, respectively. When surveyed, 26 (36.6%) patients preferred to receive ABX at home, while 22 (31.0%) chose hospital stay for one or more nights. The most common ABX preference was a single IV dose to complete treatment, selected by 29 (40.8%) patients. The most important ABX factors were efficacy and their doctor’s opinion, then convenience and route of administration; least important were treatment location, adverse events, and cost.
Conclusion: In these patients presenting to the ED with ABSSSI, the majority were admitted to the hospital and received IV ABX. Patient preferences for treatment location varied, but many valued therapies that could prevent admission. These data suggest opportunities for improving ABSSSI care by engaging the patient and offering treatment alternatives they may not be aware of.
S. Almarzoky Abuhussain,
S. Tart, None
G. Jacknin, None
K. Kohman, None
A. L. Hobbs, None
M. D. Nailor, None
K. R. Keyloun, Allergan: Employee , Salary
D. P. Nicolau, Allergan: Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium
J. L. Kuti, Allergan: Grant Investigator , Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium