ABSTRACT
The impact of infectious diseases (ID) specialist consultation in the management of many types of bacterial infections has been fully demonstrated but not for bone and joint infections (BJIs). Nineteen ID Italian centres collected of data from June 2009 to May 2012. Italian guidelines (2009) were used to determine the appropriateness of the diagnostic and therapeutic process of BJIs before and after consulting an ID specialist. Data on 311 patients were collected: 111 cases of prosthetic joint infection, 99 osteomyelitis, 64 spondylodiscitis and 37 fixation device infection. A significant increase of microbiological investigations, imaging techniques and blood inflammation markers were noted after consulting the ID specialist. Moreover, inappropriateness of treatment duration, dosage, and number of administrations significantly decreased after consultation. Infectious disease specialist intervention in the management of BJIs significantly increases the appropriateness both in performing instrumental and laboratory analysis, but especially in determining the correct therapy.
Subject(s)
Bacterial Infections/diagnosis , Bone Diseases/diagnosis , Joint Diseases/diagnosis , Referral and Consultation , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/etiology , Bone Diseases/etiology , Bone Diseases/therapy , Communicable Diseases , Female , Humans , Italy , Joint Diseases/etiology , Joint Diseases/therapy , Male , Middle Aged , Orthopedic Procedures , Surveys and Questionnaires , Young AdultABSTRACT
Although meticillin-resistant Staphylococcus aureus (MRSA) is recognized as a significant cause of nosocomial infections, it is also becoming an increasingly common cause of infections in the community. Overall, the most common infections caused by MRSA are those involving the skin and skin structures. These infections are difficult to treat and are associated with high morbidity and substantial cost. This article summarizes the current oral and parenteral therapeutic options, of which there are several, and the optimal site of care for the management of these infections. Defining the severity of the illness is central to improving the decision-making process about the route of administration and site of care.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Soft Tissue Infections/drug therapy , Soft Tissue Infections/microbiology , Staphylococcal Skin Infections/drug therapy , Staphylococcal Skin Infections/microbiology , Administration, Oral , Hospitalization , Humans , Infusions, IntravenousABSTRACT
In the present review, authors take into consideration the classification and the epidemiology of the skin and soft tissue infections (SSTIs), a set of commonly observed pathologies, which can present different features, relatively to site and localization, clinical characteristics, and aetiological agent, their severity being related to the depth of the interested sites. Given the variable presentation of SSTIs, an assessment of their incidence and prevalence is difficult. In general, the incidence of SSTIs has increased due to the ageing of the general population, the increased number of critically ill patients, the increased number of immunocompromised patients (HIV, cancer and organ transplant patients) and the recent emergence of multi-drug resistant pathogens.
