TY - JOUR
T1 - Current and future trends in antibiotic therapy of acute bacterial skin and skin-structure infections
AU - Russo, A.
AU - Concia, E.
AU - Cristini, F.
AU - De Rosa, F. G.
AU - Esposito, S.
AU - Menichetti, F.
AU - Petrosillo, N.
AU - Tumbarello, Mario
AU - Venditti, M.
AU - Viale, P.
AU - Viscoli, C.
AU - Bassetti, M.
PY - 2016
Y1 - 2016
N2 - In 2013 the US Food and Drug Administration (FDA) issued recommendations and guidance on developing drugs for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections. The main goal of the FDA was to better identify specific infections where the advantages of a new antibiotic could be precisely estimated through quantifiable parameters, such as improvement of the lesion size and of systemic signs of infection. Before the spread and diffusion of methicillin-resistant Staphylococcus aureus (MRSA) in skin infections, antibiotic therapy was relatively straightforward. Using an empiric approach, a β-lactam was the preferred therapy and cultures from patients were rarely obtained. With the emergence of MRSA in the community setting, initial ABSSSI management has been changed and readdressed. Dalbavancin, oritavancin and tedizolid are new drugs, approved or in development for ABSSSI treatment, that also proved to be efficient against MRSA. Dalbavancin and oritavancin have a long half-life and can be dosed less frequently. This in turn makes it possible to treat patients with ABSSSI in an outpatient setting, avoiding hospitalization or potentially allowing earlier discharge, without compromising efficacy. In conclusion, characteristics of long-acting antibiotics could represent an opportunity for the management of ABSSSI and could profoundly modify the management of these infections by reducing or in some cases eliminating both costs and risks of hospitalization.
AB - In 2013 the US Food and Drug Administration (FDA) issued recommendations and guidance on developing drugs for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections. The main goal of the FDA was to better identify specific infections where the advantages of a new antibiotic could be precisely estimated through quantifiable parameters, such as improvement of the lesion size and of systemic signs of infection. Before the spread and diffusion of methicillin-resistant Staphylococcus aureus (MRSA) in skin infections, antibiotic therapy was relatively straightforward. Using an empiric approach, a β-lactam was the preferred therapy and cultures from patients were rarely obtained. With the emergence of MRSA in the community setting, initial ABSSSI management has been changed and readdressed. Dalbavancin, oritavancin and tedizolid are new drugs, approved or in development for ABSSSI treatment, that also proved to be efficient against MRSA. Dalbavancin and oritavancin have a long half-life and can be dosed less frequently. This in turn makes it possible to treat patients with ABSSSI in an outpatient setting, avoiding hospitalization or potentially allowing earlier discharge, without compromising efficacy. In conclusion, characteristics of long-acting antibiotics could represent an opportunity for the management of ABSSSI and could profoundly modify the management of these infections by reducing or in some cases eliminating both costs and risks of hospitalization.
KW - Acute bacterial skin and skin-structure infection
KW - Ambulatory Care
KW - Anti-Bacterial Agents
KW - Complicated forms of skin and soft-tissue infections
KW - Drug Resistance, Multiple, Bacterial
KW - Early discharge
KW - Glycopeptides
KW - Humans
KW - Infectious Diseases
KW - Long-acting antibiotics
KW - Methicillin-resistant Staphylococcus aureus
KW - Microbiology (medical)
KW - Organophosphates
KW - Oxazoles
KW - Skin Diseases, Bacterial
KW - Staphylococcal Skin Infections
KW - Teicoplanin
KW - United States
KW - United States Food and Drug Administration
KW - Acute bacterial skin and skin-structure infection
KW - Ambulatory Care
KW - Anti-Bacterial Agents
KW - Complicated forms of skin and soft-tissue infections
KW - Drug Resistance, Multiple, Bacterial
KW - Early discharge
KW - Glycopeptides
KW - Humans
KW - Infectious Diseases
KW - Long-acting antibiotics
KW - Methicillin-resistant Staphylococcus aureus
KW - Microbiology (medical)
KW - Organophosphates
KW - Oxazoles
KW - Skin Diseases, Bacterial
KW - Staphylococcal Skin Infections
KW - Teicoplanin
KW - United States
KW - United States Food and Drug Administration
UR - http://hdl.handle.net/10807/92373
UR - http://onlinelibrary.wiley.com/journal/10.1111/(issn)1469-0691
U2 - 10.1016/S1198-743X(16)30095-7
DO - 10.1016/S1198-743X(16)30095-7
M3 - Article
SN - 1198-743X
SP - S27-S36
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
ER -