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What is new in the management of skin and soft tissue infections in 2016?

Poulakou, Garyphallia; Giannitsioti, Efthymia; Tsiodras, Sotirios

Current Opinion in Infectious Diseases: April 2017 - Volume 30 - Issue 2 - p 158–171
doi: 10.1097/QCO.0000000000000360
SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti

Purpose of review: Skin and soft tissue infections (SSTIs) are the most frequent infectious cause of referrals to emergency departments and hospital admissions in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology and management of SSTIs.

Recent findings: Incidence trends of SSTIs were increasing worldwide with Staphylococcus aureus and streptococci predominating and methicillin-resistant S. aureus (MRSA) posing additional challenges, because of high rates of treatment failure and relapse. Development of new antimicrobials was associated with an appraisal of regulatory definitions and endpoints. Prediction of clinical response can be very tricky, because of variable risk factors for recurrence or treatment failure, depending mostly on the host. Precise indications for new antimicrobials should be established; their integration into clinical practice algorithms may serve reduction of unnecessary admissions, overtreatment and total costs.

Summary: New antimicrobials with activity against MRSA have been recently launched. Long-acting agents, mainly oritavancin and dalbavancin, provide the opportunity of single-dose treatment and early discharge. Further outpatient treatment options include new per os antibiotics such as oxazolidinones. Validated assessment tools are urgently needed to support decision-making toward rational resource utilization and delivery of optimal treatment.

Fourth Department of Internal Medicine, Athens National and Kapodistrian University, School of Medicine, Attikon University General Hospital, Athens, Greece

Correspondence to Garyphallia Poulakou, Fourth Department of Internal Medicine, Athens National and Kapodistrian University, School of Medicine, Attikon University General Hospital, 1 Rimini st 12462, Athens, Greece. Tel: +302105831990; e-mail: gpoulakou@gmail.com

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