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Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs

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Abstract

Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed.

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Authors and Affiliations

  1. Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I, Viale Dell’Università 37, 00161, Rome, Italy

    Marco Falcone

  2. Department of Pathology, University of Verona, Verona, Italy

    Ercole Concia

  3. Hospital San Giovanni Bosco, Turin, Italy

    Massimo Giusti

  4. Hospital of Legnano, Milan, Italy

    Antonino Mazzone

  5. Hospital Vannini, Rome, Italy

    Claudio Santini

  6. Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Catania, Italy

    Stefania Stefani

  7. Department of Internal Medicine and Medical Specialties, “Sapienza” University of Rome, Rome, Italy

    Francesco Violi

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  1. Marco Falcone
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  2. Ercole Concia
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  3. Massimo Giusti
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  4. Antonino Mazzone
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  7. Francesco Violi
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Correspondence to Marco Falcone.

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Falcone, M., Concia, E., Giusti, M. et al. Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs. Intern Emerg Med 11, 637–648 (2016). https://doi.org/10.1007/s11739-016-1450-6

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  • DOI: https://doi.org/10.1007/s11739-016-1450-6

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