title: Transitions of care in the management of acute bacterial skin and skin structure infections: a paradigm shift.
abstract: Acute bacterial skin and skin structure infections (ABSSSI) have evolved over a relatively short period of time to become one of the most challenging medical problems encountered in clinical practice. Notably the high incidence of methicillin-resistant S. aureus (MRSA) across the continuum of care has coincided with increased outpatient failures and higher rates of hospital admissions for parental antibiotic therapy. Consequently the management of ABSSSI constitutes a tremendous burden to the healthcare system in terms of cost of care and consumption of institutional and clinical resources. This perspective piece discusses current and new approaches to the management of ABSSSI in a hospital setting and the need for a multifaceted approach. Treatment strategies for the management through the utilization of observation units (OU), Outpatient Parental Antibiotic Therapy (OPAT), and newly developed antibiotics for the use against skin infections caused by Gram-positive bacteria will be discussed in the context of ABSSSI.
authors.affiliation: a Center for Anti-infective Research and Development , Hartford Hospital , Hartford , CT , USA.
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Verastegui
authors.affiliation: a Center for Anti-infective Research and Development , Hartford Hospital , Hartford , CT , USA.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: b Division of Infectious Diseases , Hartford Hospital , Hartford , CT , USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Nicolau
mesh_terms: D000208:Acute Disease; D000553:Ambulatory Care / Q000379:methods; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D017192:Skin Diseases, Bacterial / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: ABSSSI; Transitions of care; dalbavancin; observational units; oritavancin; tedizolid