title: Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs.
abstract: Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed.
authors.affiliation: Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I, Viale Dell'Università 37, 00161, Rome, Italy. marco.falcone@uniroma1.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Falcone
authors.affiliation: Department of Pathology, University of Verona, Verona, Italy.
authors.forename: Ercole
authors.initials: E
authors.lastname: Concia
authors.affiliation: Hospital San Giovanni Bosco, Turin, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Giusti
authors.affiliation: Hospital of Legnano, Milan, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Mazzone
authors.affiliation: Hospital Vannini, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Santini
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Catania, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Stefani
authors.affiliation: Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000009:adverse effects / Q000493:pharmacokinetics; D002511:Cephalosporins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D017576:Daptomycin / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects / Q000493:pharmacokinetics; D006020:Glycopeptides / Q000494:pharmacology / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007049:Iatrogenic Disease; D007388:Internal Medicine / Q000379:methods* / Q000592:standards; D000069349:Linezolid / Q000494:pharmacology / Q000627:therapeutic use; D000077427:Lipoglycopeptides; D008297:Male; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D023303:Oxazolidinones / Q000494:pharmacology / Q000627:therapeutic use; D012874:Skin Diseases, Infectious / Q000188:drug therapy* / Q000503:physiopathology; D018461:Soft Tissue Infections / Q000188:drug therapy* / Q000503:physiopathology; D017334:Teicoplanin / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D000078304:Tigecycline; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use / Q000031:analogs & derivatives; D000097583:Ceftaroline
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D017576:Daptomycin; D024841:Fluoroquinolones; D006020:Glycopeptides; D000069349:Linezolid; D000077427:Lipoglycopeptides; D008911:Minocycline; D023303:Oxazolidinones; D017334:Teicoplanin; D000078304:Tigecycline; D014640:Vancomycin; D000097583:Ceftaroline; C469289:dalbavancin; C100708:oritavancin
keywords: Acute bacterial skin and skin structure infections; Elderly patients; Internal medicine wards; New drugs