Healthcare Pathways and Burden of Disease of Patients with Skin and Soft Tissue Infections (Sstis)


      SSTIs are an emerging cause of outpatient visits and hospitalizations, due to the dramatic rising of antimicrobial resistance and severity of the infection. This study aimed to analyze the healthcare profile of patients with SSTIs in the real clinical practice and to determine the total cost of the disease.


      Starting from ARNO Observatory database (13 million citizens), a cohort of patients with SSTIs, with available, complete and good quality data on pharmaceutical prescriptions, diagnostic procedures and hospital discharges, was selected. The accrual period lasted from the January 1st to December 31st 2012. Every single patient was followed for 1 year, to identify events, healthcare services associated to SSTIs and their costs. A focus on Linezolid was made to evaluate the proper length of treatment, both in hospital (assuming hospitalization days equivalent to prescriptions) and in community care (pharmaceutical prescriptions).


      Of 2.216 patients with SSTIs (67% men, mostly aged ≤ 25), 1.771 (79,9%) received at least one drug prescription: “Beta-lactam antibacterials” the most prescribed (40%) and “Other antibiotics” the most expensive (1.340€), where Linezolid resulted the most used (106 patients). According to requirements, its therapy length is appropriate if it lasts 10 to 14 days (600mg twice daily). The outpatient oral cycle therapy lasted on average for 17,8 days and the IV formulation for 9,8 days, while hospitalization days were on average 7. Ordinary and daily hospitalizations were the most expensive healthcare services (on average 4.718€/patient). Linezolid widely contributes to pharmaceutical costs (622€/patient), both for IV and for oral formulation, respectively mean expenditure 914€ and 686€ during the one-year follow-up.


      The community use of Linezolid is bordering on authorized dosages and raises costs of patients with SSTIs. This must be considered by LHUs and Physicians when assessing healthcare profiles of SSTIs disease, estimating costs of illness and improving clinical governance.