Nathwani et al reported criteria for evaluating the clinical response to antibiotic therapy for a patient with an acute bacterial skin and skin structure infection (ABSSSI). The authors are from Ninewells Hospital (Dundee), Duke University, InClin and Merck Research Laboratories.

Patient: acute bacterial skin and skin structure infection (ABSSSI)


Timings of evaluation:

(1) early (48 to 72 hours after starting therapy)

(2) late (7 to 14 days after end of therapy)


Criteria for early treatment success:

(1) >= 20% reduction in area of physical findings from baseline

(2) clinical assessment as improving or stable



Physical findings may be erythema alone (used in ESTALISH-1 trial) or maximal extent of erythema, induration or edema (used in ESTABLISH-2).

Area is based on multiplying maximal dimension by widest perpendicular measure (an ellipse might be more accurate).


Criteria for late clinical cure:

(1) clinical assessment as resolved or nearly resolved

(2) no further antibiotic therapy required

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