Treatment Failure and Costs in Patients With Methicillin-Resistant Staphylococcus aureus (MRSA) Skin and Soft Tissue Infections: A South Texas Ambulatory Research Network (STARNet) Study

Journal Name: 
J Am Board Fam Med
Authors: 
Labreche,M.J.
Lee,G.C.
Attridge,R.T.
Mortensen,E.M.
Koeller,J.
Du,L.C.
Nyren,N.R.
Trevino,L.B.
Trevino,S.B.
Pena,J.
Mann,M.W.
Munoz,A.
Marcos,Y.
Rocha,G.
Koretsky,S.
Esparza,S.
Finnie,M.
Dallas,S.D.
Parchman,M.L.
Frei,C.R.
Abstract: 
Objective: To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus skin and soft tissue infections (SSTIs). METHODS: This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have "moderate or complicated" SSTIs if they had a lesion >/=5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. RESULTS: Overall, treatment failure occurred in 21% of patients (21 of 98) at a mean additional cost of $1,933.71 per patient. In a subgroup analysis of patients who received incision and drainage, those with moderate or complicated SSTIs had higher rates of treatment failure than those with mild or uncomplicated SSTIs (36% vs. 10%; P=.04). CONCLUSIONS: One in 5 patients presenting to a primary care clinic for a methicillin-resistant S. aureus SSTI will likely require additional interventions at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting
9
2013
Volume: 
26
Pages: 
508-517
Keywords: 
90, Ambulatory, analysis, clinical, cost, data, Diabetes, Diabetes Mellitus, education, electronic, Health, health care, Incidence, Infection, information, Internal Medicine, intervention, Laboratories, laboratory, medical, Medicine, Methicillin-Resistant Staphylococcus aureus, Methods, patient, Patients, Pharmacies, Pharmacy, primary care, provider, Research, Risk, Skin, Staphylococcus aureus, STARNET, system, Texas, Treatment Failure, Universities