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.