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No benefit in longer treatment for SSTIs in patients with obesity, heart failure
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Longer courses of antibiotic therapy for skin and soft tissue infections are not associated with lower treatment failure rates in patients with obesity and heart failure, or both, study findings suggested.
“Although existing literature supports durations of 5 to 7 days for skin and soft tissue infections (SSTIs), longer durations are commonly used,” Claudia Ihm, MD, of the department of medicine at the University of Utah, and colleagues wrote. “Obesity and heart failure have been associated with increased risk for treatment failure of SSTIs; however, whether prolonged antibiotic durations reduce the risk of treatment failure is unknown.”
Ihm and colleagues conducted a single-center, retrospective cohort study between Jan. 1, 2006, and Dec. 30, 2016, involving 207 patients with obesity and/or heart failure to assess whether short antibiotic durations were associated with treatment failure. According to the study, they reviewed patient charts to collect demographic, clinical, treatment and outcome data.
Results showed that of the 207 patients included, 49 (23.7%) received a short course of antibiotics, with a median duration of 7 days, and 158 (76.3%) received a long course, with a median duration of 14 days. According to the study, five (10.2%) treatment failures occurred in the short-duration group compared with 28 (28.6%) in the long-duration group (P =.02). Additionally, Ihm and colleagues found that patients receiving a shorter course of antibiotics experienced a shorter length of stay than patients in the long-duration group, 2 days vs. 3 days.
“Our study suggests there is no benefit to longer antibiotic durations for SSTIs in patients with obesity or [heart failure]. Furthermore, longer antibiotic durations were associated with increased treatment failure, which may highlight patients who could benefit from more in-depth diagnostic evaluation,” the authors concluded.
“Our findings not only have implications for individual patient care and health care utilization but also importantly may inform much needed stewardship interventions aimed at minimizing unnecessary antibiotic durations of therapy and their untoward effects. Moreover, prospective studies evaluating duration of therapy for patients at high risk of SSTI relapse or recurrence are needed that utilize standard objective measures of treatment failure rather than rely on individual provider treatment decisions.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.
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