How complicated skin and soft tissue infections are treated in Italy: economic evaluation of inpatient intravenous antibiotic treatment in seven hospitals.
OBJECTIVE
Complicated skin and soft tissue infections (cSSTIs) are a common cause of morbidity at hospital level. This study aimed to evaluate the costs and outcomes of inpatient intravenous antibiotic therapy for the treatment of cSSTI in seven Italian hospitals.


METHODS
A total of 307 patients were enrolled in a retrospective, multicentre, incidence-based, observational study. The target population consisted of hospitalised patients eligible to receive intravenous antibiotic therapy for cSSTI. Direct hospital costs were measured through a microcosting approach.


RESULTS
Failure of initial antibiotic therapy occurred in 23% of patients. Average antibiotic treatment lasted 12.2 days; the average full cost of admission totalled euro5,530. If the initial antibiotic regimen fails to eradicate the infectious organism, the length of stay extends for 7 days and costs increase by euro2,850 per patient. Nevertheless, when taking into account the lower intensity of care during the last days of treatment, savings reduce costs to euro671 per patient. These could be increased by euro74 for each hospital day avoided because of faster antibiotic action.


CONCLUSIONS
Efforts should be made to minimise the risk of selecting wrong antibiotics and to identify the quickest antibiotic in eradicating the infection.
Tarricone
Rosanna
R
CERGAS, IPAS, SDA , Bocconi University, Milan, Italy.
Aguzzi
Giovanni
G
Capone
Alessandro
A
Caravaggi
Carlo Maria
CM
Esposito
Silvano
S
Franzetti
Fabio
F
Muzzi
Alba
A
Ricci
Lucia
L
Bassetti
Matteo
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous / Q000191:economics*; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000188:drug therapy*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy*; D055815:Young Adult
D000900:Anti-Bacterial Agents