PT - JOURNAL ARTICLE AU - Labreche, Matthew J. AU - Lee, Grace C. AU - Attridge, Russell T. AU - Mortensen, Eric M. AU - Koeller, Jim AU - Du, Liem C. AU - Nyren, Natalie R. AU - Treviño, Lucina B. AU - Treviño, Sylvia B. AU - Peña, Joel AU - Mann, Michael W. AU - Muñoz, Abilio AU - Marcos, Yolanda AU - Rocha, Guillermo AU - Koretsky, Stella AU - Esparza, Sandra AU - Finnie, Mitchell AU - Dallas, Steven D. AU - Parchman, Michael L. AU - Frei, Christopher R. TI - Treatment Failure and Costs in Patients With Methicillin-Resistant <em>Staphylococcus aureus</em> (MRSA) Skin and Soft Tissue Infections: A South Texas Ambulatory Research Network (STARNet) Study AID - 10.3122/jabfm.2013.05.120247 DP - 2013 Sep 01 TA - The Journal of the American Board of Family Medicine PG - 508--517 VI - 26 IP - 5 4099 - http://www.jabfm.org/content/26/5/508.short 4100 - http://www.jabfm.org/content/26/5/508.full SO - J Am Board Fam Med2013 Sep 01; 26 AB - Objective: To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus skin and soft tissue infections (SSTIs). Methods: This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have “moderate or complicated” SSTIs if they had a lesion ≥5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. Results: Overall, treatment failure occurred in 21% of patients (21 of 98) at a mean additional cost of $1,933.71 per patient. In a subgroup analysis of patients who received incision and drainage, those with moderate or complicated SSTIs had higher rates of treatment failure than those with mild or uncomplicated SSTIs (36% vs. 10%; P=.04). Conclusions: One in 5 patients presenting to a primary care clinic for a methicillin-resistant S. aureus SSTI will likely require additional interventions at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting.