RT Journal Article SR Electronic T1 Treatment Failure and Costs in Patients With Methicillin-Resistant Staphylococcus aureus (MRSA) Skin and Soft Tissue Infections: A South Texas Ambulatory Research Network (STARNet) Study JF The Journal of the American Board of Family Medicine JO J Am Board Fam Med FD American Board of Family Medicine SP 508 OP 517 DO 10.3122/jabfm.2013.05.120247 VO 26 IS 5 A1 Labreche, Matthew J. A1 Lee, Grace C. A1 Attridge, Russell T. A1 Mortensen, Eric M. A1 Koeller, Jim A1 Du, Liem C. A1 Nyren, Natalie R. A1 Treviño, Lucina B. A1 Treviño, Sylvia B. A1 Peña, Joel A1 Mann, Michael W. A1 Muñoz, Abilio A1 Marcos, Yolanda A1 Rocha, Guillermo A1 Koretsky, Stella A1 Esparza, Sandra A1 Finnie, Mitchell A1 Dallas, Steven D. A1 Parchman, Michael L. A1 Frei, Christopher R. YR 2013 UL http://www.jabfm.org/content/26/5/508.abstract 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.