title: Acute bacterial skin and skin structure infections (ABSSSI): practice guidelines for management and care transitions in the emergency department and hospital.
abstract: BACKGROUND
  Acute bacterial skin and skin structure infections (ABSSSI), formally referred to as complicated skin and soft tissue infections, include infections with resistance to previously effective antimicrobials. Increasing dramatically in incidence, they have become a challenging medical problem associated with high direct and indirect costs to both the medical system and society.
  
  
  OBJECTIVE
  To describe the burden of ABSSSI and to explore multidisciplinary approaches to its management and new treatments that can be initiated in the emergency department.
  
  
  CONCLUSIONS
  We offer a best practice model aimed at providing risk-stratified and convenient care for ABSSSI at the lowest possible cost, while minimizing complications, readmissions, and inappropriate antibiotic use. In doing so, we focus on the care provided by emergency physicians and hospitalists and the transition of management between them for inpatient care, as well as the facilitation of observation or direct-to-outpatient care for suitable patients.
  
  
  CONCLUSIONS
  A standard, consistent, and multidisciplinary approach to ABSSSI can streamline care, reduce admissions, support antimicrobial stewardship, and improve clinical and resource consumption outcomes.
authors.affiliation: Department of Emergency Medicine, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Charles V
authors.initials: CV
authors.lastname: Pollack
authors.affiliation: Hospital Medicine, University of California-Irvine, Orange, California.
authors.forename: Alpesh
authors.initials: A
authors.lastname: Amin
authors.affiliation: Hospital Medicine, Abington Health, Abington, Pennsylvania.
authors.forename: William T
authors.initials: WT
authors.lastname: Ford
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Richard
authors.initials: R
authors.lastname: Finley
authors.affiliation: Department of Medicine, Wayne State University, Detroit, Michigan; Department of Quality and Patient Safety, Department of Infection Prevention, Hospital Epidemiology and Antibiotic Stewardship, Detroit Medical Center, Detroit, Michigan.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Section of Hospital Medicine, Acute Infections Management Service, UC Davis Medical Center, Sacramento, California.
authors.forename: Hien H
authors.initials: HH
authors.lastname: Nguyen
authors.affiliation: Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Detroit, Michigan; (Adjunct) Division of Infectious Diseases, Department of Medicine, Wayne State University, Detroit, Michigan.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rybak
authors.affiliation: Department of Emergency Medicine and Division of Infectious Diseases, Olive View-UCLA Medical Center, Sylmar, California.
authors.forename: David
authors.initials: D
authors.lastname: Talan
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003266:Continuity of Patient Care; D017281:Cost of Illness; D019468:Disease Management; D004636:Emergency Service, Hospital; D006801:Humans; D017410:Practice Guidelines as Topic; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: ABSSSI; antibiotics; best practice; processes of care; skin infections