Inappropriate Initial Antibiotic Treatment May Extend Stays for Patients with Healthcare-Associated Skin Infections

Inappropriate Initial Antibiotic Treatment May Extend Stays for Patients with
Healthcare-Associated Skin Infections

PHILADELPHIA, Oct. 30 /PRNewswire/ -- Patients who acquire skin and soft
tissue infections (SSTIs) in a hospital or other healthcare setting may be
more likely to receive inappropriate antibiotic therapy at the beginning of
their treatment. As a result, they also may have significantly longer hospital
stays to control the infection. Preliminary results from a new study by the
Henry Ford Health System evaluated records from patients who acquired SSTIs in
hospital and healthcare settings and those who acquired similar infections in
the community. Results from the study, which were presented today at the 47th
Annual Meeting of the Infectious Diseases Society of America (IDSA), also shed
new light on baseline risk factors that are associated with inappropriate
initial therapy (Abstract #053). This information may help guide clinicians in
the appropriate treatment of SSTIs.

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Complicated skin and skin structure infections (cSSTIs) account for almost 10
percent of all hospital admissions in the U.S.(1) According to the Centers
for Disease Control and Prevention (CDC), approximately 25-30% of the U.S.
population has some form of Staphylococcus aureus on their skin, and an
increasing number of those individuals carry the more resistant form known as
methicillin-resistant Staphylococcus aureus (MRSA).(2)(3)(4)

"Up to this point, the importance of initiating appropriate empiric* therapy
has been well documented in other infections such as pneumonia, but not in
skin infections," said study author Marcus Zervos, M.D. Division Head,
Infectious Diseases, Director Infection Control at the Henry Ford Health
System, in Detroit, MI. "These results show that a more comprehensive
evaluation of hospital patient risk factors may help physicians determine the
optimal initial antibiotic treatment, sparing patients unnecessary treatment
and time in the hospital."

Risk Factors for Inappropriate Treatment
In the hospitalized patient population, three risk factors were identified as
being associated with receiving inappropriate antibiotic treatment:

-- Healthcare-associated infection status (i.e., recent exposure within
nursing homes, or medical clinics)
-- Presence of a "gram-negative" pathogen

-- Presence of a pathogen other than a Streptococcus species

Study Methods and Key Results
The study, conducted by the Henry Ford Health System with a grant from
Ortho-McNeil Janssen Scientific Affairs, LLC, is an analysis of administrative
and medical records of 368 patients hospitalized between late 2005 and 2008
with an admission diagnosis of a cSSTI. Patients were classified as having
healthcare associated infections (HCAI) if they were: 1) recently
hospitalized; 2) immunocompromised; 3) on hemodialysis; or 4) admitted from
nursing home. All others were classified as having community-acquired
infections (CAI). Initial empiric therapy (IET) was considered appropriate if
antibiotics active against the infecting pathogen(s) were administered within
24 hours of admission.

Among patients with SSTIs whose infection was confirmed by culture
("culture-positive"), those who acquired an infection in a hospital or
healthcare setting were more likely to be treated inappropriately than those
who acquired an infection in a community setting (35.2% vs. 20.5%, p<0.01).
Additionally, when other risk factors were adjusted, patients who received
inappropriate initial therapy stayed in the hospital an average of nearly six
days longer than patients who received appropriate initial therapy.

Moreover, the study showed that S. aureus was the most common pathogen in
patients with both HCAI (55.6%) as well as CAI (58.2%), and the majority of
these were methicillin-resistant S. aureus, commonly referred to as MRSA
(73.4% in HCAI and 64.8% in CAI). MRSA represents a growing healthcare concern
and has become an increasingly common cause of SSTIs, as evidenced by the
prevalence of MRSA in this study.

Dr. Zervos is a principal investigator for the study and a paid consultant
retained by Ortho-McNeil Janssen Scientific Affairs, LLC.

*Empiric treatment is defined as antibiotics prescribed prior to the
identification of the causative pathogen(s) by culture results.

About Ortho-McNeil
Ortho-McNeil, Inc. is committed to providing innovative, high-quality
prescription medicines, education and resources for patients, healthcare
providers, and other members of the healthcare community in primary care,
specialty and hospital settings. Based in Raritan, NJ, the company specializes
in the areas of gastrointestinal and infectious diseases, pain management,
women's health and urology, and has broad interest in other therapeutic
categories. For more information, visit www.ortho-mcneil.com.

(1) DiNubile MJ, Lipsky BA. Complicated Infections of skin and skin
structures: when the infection is more than skin deep. JAC. 2004;53

(2) Halem M., et al. 2006. Community-acquired methicillin resistant
Staphylococcus aureus skin infections. Semin. Cutan. Med. Surg. 25:68-71

(3) Kluytmans-Vandenbergh M.F., et al. 2006. Community-acquired methicillin
resistant Staphylococcus aureus: current perspectives. Clin. Microbiol.
Infect. 12 Suppl 1:9-15

(4) Kollef M.H., and S.T. Micek. 2006. Methicillin resistant Staphylococcus
aureus: a new community acquired pathogen? Curr. Opin. Infect. Dis. 19:161-168

Media Contact: Amy Firsching, 908-218-7583

SOURCE Ortho-McNeil, Inc.

Amy Firsching, +1-908-218-7583