Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study
Autor(a) principal: | |
---|---|
Data de Publicação: | 2019 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494 |
Resumo: | Introduction: Skin and skin structure infections are an increasing cause of hospitalization. Although mortality is relatively low, skin and skin structure infections are associated with prolonged hospital length of stay and high costs. Oxazolidinones have been suggested as a tool to treat infected patients in the ambulatory setting in order to decrease hospital length of stay. We wanted to address the evidence associated with the use of oxazolidinones in the treatment of skin and skin structure infections.Material and Methods: In this observational retrospective study we analyzed the anonymized diagnosis related group coded information from the Portuguese database for hospital admissions, that included all adult patients with a diagnosis of oxazolidinone use and a SSSI, discharged between 2010 and 2015.Results: During the study period, a total of 5518 patients had a diagnosis of oxazolidinone treatment. We selected 483 of those who were also diagnosed with a skin and skin structure infections. Their mean age was 64.9 years and 62.7% were male. The median hospital length of stay was 27 days (Inter quartile range 13 – 56) and the mortality rate was 12.6%. The prevalence of secondary anemia and of thrombocytopenia in the whole group treated with oxazolidinones was 2.5% and 3%, respectively.Discussion: Despite the high bioavailability of oxazolidinones, we were not able to find evidence that its use was associated with a decrease of mortality or hospital length of stay (due to early discharge) of patients with skin and skin structure infections.Conclusion: In this study we were not able to find evidence that oxazolidinones had any clinically significant benefit. A structured approach, including antibiotics with favorable pharmacokinetic and safety profile as well as a carefully planned ambulatory follow up may be needed. |
id |
RCAP_27fa99970b4042c9bd0e254d31be0d5e |
---|---|
oai_identifier_str |
oai:ojs.www.actamedicaportuguesa.com:article/11494 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective StudyEvidência Associada ao Uso de Oxazolidinonas no Tratamento de Infeções da Pele e das Estruturas da Pele: Estudo RetrospectivoHospitalizationOxazolidinonesSkin DiseasesBacterial/drug therapySoft Tissue Infections/drug therapyDoenças Bacterianas da Pele/tratamentoHospitalizaçãoInfecções dos Tecidos Moles/tratamentoOxazolidinonasIntroduction: Skin and skin structure infections are an increasing cause of hospitalization. Although mortality is relatively low, skin and skin structure infections are associated with prolonged hospital length of stay and high costs. Oxazolidinones have been suggested as a tool to treat infected patients in the ambulatory setting in order to decrease hospital length of stay. We wanted to address the evidence associated with the use of oxazolidinones in the treatment of skin and skin structure infections.Material and Methods: In this observational retrospective study we analyzed the anonymized diagnosis related group coded information from the Portuguese database for hospital admissions, that included all adult patients with a diagnosis of oxazolidinone use and a SSSI, discharged between 2010 and 2015.Results: During the study period, a total of 5518 patients had a diagnosis of oxazolidinone treatment. We selected 483 of those who were also diagnosed with a skin and skin structure infections. Their mean age was 64.9 years and 62.7% were male. The median hospital length of stay was 27 days (Inter quartile range 13 – 56) and the mortality rate was 12.6%. The prevalence of secondary anemia and of thrombocytopenia in the whole group treated with oxazolidinones was 2.5% and 3%, respectively.Discussion: Despite the high bioavailability of oxazolidinones, we were not able to find evidence that its use was associated with a decrease of mortality or hospital length of stay (due to early discharge) of patients with skin and skin structure infections.Conclusion: In this study we were not able to find evidence that oxazolidinones had any clinically significant benefit. A structured approach, including antibiotics with favorable pharmacokinetic and safety profile as well as a carefully planned ambulatory follow up may be needed.Introdução: As infeções da pele e das estruturas da pele são uma causa crescente de hospitalização. Apesar da baixa mortalidade, as infeções da pele e das estruturas da pele estão associadas a internamentos prolongados e a custos elevados. O uso de oxazolidinonas foi proposto como estratégia para o tratamento ambulatório destes doentes como forma de reduzir a duração do internamento. Pretendeu-se avaliar a evidência associada ao uso de oxazolidinonas no tratamento de infeções da pele e das estruturas da pele.Material e Métodos: Neste estudo retrospectivo observacional analisámos a base de dados portuguesa anonimizada, codificada por grupos de diagnóstico homogéneos. Incluímos adultos com alta hospitalar entre 2010 a 2015 com diagnóstico de alta de utilização de oxazolidinonas. Nesse grupo selecionamos os que apresentavam diagnóstico concomitante de infeções da pele e das estruturas da pele.Resultados: Durante o período em estudo 5518 doentes receberam o diagnóstico de tratamento com oxazolidinona. Destes selecionámos 483 com diagnóstico concomitante de infeções da pele e das estruturas da pele. Destes, 62,7% eram homens e a idade média foi de 64,9 anos. A duração mediana do internamento hospitalar foi de 27 dias (intervalo interquartil 13 – 56) e a taxa de mortalidade foi 12,6%. A prevalência de anemia secundária, nos 5518 doentes tratados com oxazolidinonas, foi de 2,5% e a de trombocitopénia foi de 3%.Discussão: Apesar da elevada biodisponibilidade das oxazolidinonas, neste estudo não conseguimos identificar evidência que o seu uso estivesse associado a diminuição da mortalidade ou da demora média hospitalar (relacionado com alta precoce) dos doentes com infeções da pele e das estruturas da pele.Conclusão: Neste estudo não encontramos evidência de que a utilização de oxazolidinonas esteja associada a benefícios clínicos significativos. Estratégias integradas, incluindo antibióticos com bom perfil de segurança e de farmacocinética, bem como planeamento adequado para seguimento em ambulatório parecem ser necessários.Ordem dos Médicos2019-06-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494oai:ojs.www.actamedicaportuguesa.com:article/11494Acta Médica Portuguesa; Vol. 32 No. 6 (2019): June; 453-458Acta Médica Portuguesa; Vol. 32 N.º 6 (2019): Junho; 453-4581646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/5713https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/10883https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/11061https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/11247Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessGonçalves-Pereira, JoãoFroes, FilipeSantos, Fernanda PaulaAntão, Helena SofiaGuimarães, João Paulo2022-12-20T11:06:16Zoai:ojs.www.actamedicaportuguesa.com:article/11494Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:02.789591Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study Evidência Associada ao Uso de Oxazolidinonas no Tratamento de Infeções da Pele e das Estruturas da Pele: Estudo Retrospectivo |
title |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study |
spellingShingle |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study Gonçalves-Pereira, João Hospitalization Oxazolidinones Skin Diseases Bacterial/drug therapy Soft Tissue Infections/drug therapy Doenças Bacterianas da Pele/tratamento Hospitalização Infecções dos Tecidos Moles/tratamento Oxazolidinonas |
title_short |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study |
title_full |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study |
title_fullStr |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study |
title_full_unstemmed |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study |
title_sort |
Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study |
author |
Gonçalves-Pereira, João |
author_facet |
Gonçalves-Pereira, João Froes, Filipe Santos, Fernanda Paula Antão, Helena Sofia Guimarães, João Paulo |
author_role |
author |
author2 |
Froes, Filipe Santos, Fernanda Paula Antão, Helena Sofia Guimarães, João Paulo |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Gonçalves-Pereira, João Froes, Filipe Santos, Fernanda Paula Antão, Helena Sofia Guimarães, João Paulo |
dc.subject.por.fl_str_mv |
Hospitalization Oxazolidinones Skin Diseases Bacterial/drug therapy Soft Tissue Infections/drug therapy Doenças Bacterianas da Pele/tratamento Hospitalização Infecções dos Tecidos Moles/tratamento Oxazolidinonas |
topic |
Hospitalization Oxazolidinones Skin Diseases Bacterial/drug therapy Soft Tissue Infections/drug therapy Doenças Bacterianas da Pele/tratamento Hospitalização Infecções dos Tecidos Moles/tratamento Oxazolidinonas |
description |
Introduction: Skin and skin structure infections are an increasing cause of hospitalization. Although mortality is relatively low, skin and skin structure infections are associated with prolonged hospital length of stay and high costs. Oxazolidinones have been suggested as a tool to treat infected patients in the ambulatory setting in order to decrease hospital length of stay. We wanted to address the evidence associated with the use of oxazolidinones in the treatment of skin and skin structure infections.Material and Methods: In this observational retrospective study we analyzed the anonymized diagnosis related group coded information from the Portuguese database for hospital admissions, that included all adult patients with a diagnosis of oxazolidinone use and a SSSI, discharged between 2010 and 2015.Results: During the study period, a total of 5518 patients had a diagnosis of oxazolidinone treatment. We selected 483 of those who were also diagnosed with a skin and skin structure infections. Their mean age was 64.9 years and 62.7% were male. The median hospital length of stay was 27 days (Inter quartile range 13 – 56) and the mortality rate was 12.6%. The prevalence of secondary anemia and of thrombocytopenia in the whole group treated with oxazolidinones was 2.5% and 3%, respectively.Discussion: Despite the high bioavailability of oxazolidinones, we were not able to find evidence that its use was associated with a decrease of mortality or hospital length of stay (due to early discharge) of patients with skin and skin structure infections.Conclusion: In this study we were not able to find evidence that oxazolidinones had any clinically significant benefit. A structured approach, including antibiotics with favorable pharmacokinetic and safety profile as well as a carefully planned ambulatory follow up may be needed. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-06-28 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494 oai:ojs.www.actamedicaportuguesa.com:article/11494 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/11494 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/5713 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/10883 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/11061 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11494/11247 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2019 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 32 No. 6 (2019): June; 453-458 Acta Médica Portuguesa; Vol. 32 N.º 6 (2019): Junho; 453-458 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799130649416695808 |