The Management of Skin and Soft Tissue Infections: Outpatient Parenteral Antibiotic Therapy in the United Kingdom

Abstract

In a study in Scotland, skin and soft tissue infections (SSTIs) accounted for 10% of hospitalizations, with mean stays of approximately 5 days, and were the second most common reason for hospital-based intravenous antibiotic therapy lasting more than 48 h. A total of 125 patients with SSTIs were recently treated using an outpatient parenteral antibiotic therapy (OPAT) service. The patients received intravenous antibiotic therapy for a mean duration of 5.32 days. The two primary agents administered were once-daily ceftriaxone and teicoplanin. Of the 125 patients, 123 (98.4%) were cured or improved; 2 worsened and required surgery. Patient satisfaction was very high. OPAT saved the inpatient facility 665 bed days. Economic benefits were realized despite use of more expensive agents. Data indicate that if the hospital stay of patients with SSTIs were reduced by only 1 day, savings would amount to £½–1 million per year. OPAT is a feasible alternative to inpatient management of SSTIs and may safely, effectively and cost-effectively reduce the number of hospital days for these infections.