Table 2.

Effect of Inappropriate or Inadequate Antibiotic Therapy on Resource Utilization and Outcomes in Patients With Skin and Soft Tissue Infections [19, 25, 27, 28]

Study	Population	% Patients Receiving Inappropriate/Inadequate Therapy	Additional Burden and Outcomes
Zilberberg 2010	Hospitalized HCA cSSTI	23a (N = 717)	• 1.8 additional hospital days • 4.6 additional hospital days in subgroup with cSSTI and bacteremia
Eagye 2009	Hospitalized cSSI	30b (N = 130)	• 4 additional hospital days • 3 additional days of therapy • $7667 additional inpatient costs
Zervos 2012	Hospitalized cSSTI	18.5 (N = 1096)	• 12-times higher mortality and readmission rate within 30 days in subgroup of patients with ulcers
Lipsky 2014b	Hospitalized cSSTI	23.1 (N = 494)	• 1 additional hospital day • 2.43 additional hospital days in MRSA+HCA cohort • 9% more patients with at least 1 composite economic outcomec • 22% more patients with at least 1 composite economic outcome in the MRSA+HCA cohort

Abbreviations: cSSI, complicated surgical site infection; cSSTI, complicated skin and soft tissue infections; HCA, healthcare associated; MRSA, methicillin resistant S. aureus.

^aInappropriate empiric antibiotic therapy defined as patient did not receive treatment within 24 hours of the time the culture was obtained with an agent exhibiting in vitro activity against the isolated pathogen.

^bInadequate antibiotic therapy was deemed to have been given if the patient did not receive an antibiotic to which the causative organism(s) was susceptible within 24 hours of identification of infection.

^cComposite economic outcome = hospital admission, emergency department visit, or unscheduled visits to a healthcare provider due to study infection after hospital discharge.