Percorso diagnostico-terapeutico e assistenziale di infezioni di cute

e strutture cutanee (Acute Bacterial Skin and Skin Structure Infections - ABSSSI) nell’Azienda Ospedaliero-Universitaria Careggi di Firenze

DOI 10.23753/htafocus2019.02.008

Filippo Lagi, Letizia Ottino, Elisabetta Mantengoli, Giampaolo Corti, Alberto Farese, Bassam Dannaoui, Alessandra Ipponi, Tiziana Falai, Gian Maria Rossolini, Alessandro Bartoloni, Filippo Bartalesi


Introduction The acute bacterial skin and skin structure infections (ABSSSI) are the most common cause of Emergency Departments admission among skin diseases.  Their clinical management may be challenging and is associated with a high cost that weighs on the health care system and on the community. A multi-professional patient-oriented diagnostic and treatment protocol (DTP) has been defined to meet the need of individuals with ABSSSIs.

Methods The ABSSSI DTP has been developed basing on available evidence in the literature, on local epidemiology and a retrospective research conducted at Azienda Ospedaliero-Universitaria Careggi, a tertiary hospital in Florence, Italy.

Results The DTP is summarized in the following flowcharts describing two different scenarios:

• from the first assessment of a patient with ABSSSI to the empiric treatment choice;

• evaluation of early discharge criteria after 72 hours of hospitalization.

Conclusions Raising awareness among clinicians about well-defined early discharge criteria is crucial. Shorter hospitalization for patients with ABSSSIs would improve the quality of care, decrease the risk for health care-associated infections, and reduce costs. New antimicrobial agents with longer half-life can encourage the early discharge and improve, in certain patients, the compliance to the home treatment.

Key words: ABSSSI, DPT, early disclosure, home therapy, long acting antibiotics