Lane et al identified factors influencing the decision on how and where a patient with an acute bacterial skin and skin structure infection (ABSSSI) is treated. The authors are from ICON plc Epidemiology, The Medicines Company, Thomas Jefferson University, Duke University and Ninewells Hospital in Dundee.
Patient selection: acute bacterial skin and skin structure infection (ABSSSI)
Parameters:
(1) age in years
(2) severity of comorbidities
(3) severity of the infection
(4) concerns about adherence
The ideal patient for outpatient therapy for ABSSSI:
(1) age < 75
(2) absence of severe comorbidities
(3) mild to moderate severity of ABSSSI
(4) no concerns about adherence
Inpatient therapy was usually provided if one or both of the following is present:
(1) severe comorbidity (poorly controlled diabetes, cancer with immunosuppression, steroid therapy for COPD, etc)
(2) severe ABSSSI (toxic with organ failure, 2 or 3 SIRS criteria, severe sepsis)
Age and adherence concerns may be relative concerns provided an effective solution is found.
Other factors that may influence decision:
(1) cost of inpatient therapy
(2) cost of outpatient therapy
(3) disability
