Patients with Skin Infections Fail to Complete Antibiotics, Leading to Poor Outcomes

In the first study of its kind, researchers found patients with S. aureus skin and soft tissue infections took, on average, just 57% of their prescribed antibiotic doses after leaving the hospital, resulting in nearly half of them getting a new infection or needing additional treatment for the existing skin infection.

The study, published in the peer-reviewed journal, Antimicrobial Agents and Chemotherapy, measured antibiotic dosing by using medication containers fitted with electronic caps that reported when the patient opened the antibiotic container. By using this measurement system, the researchers found a large discrepancy in patient reports and the electronic measurement. Patients reported taking, on average, 96% of their medication, or nearly twice the 57% reported by the electronic caps. 

“We have seen similar differences and similar failures to take all the prescribed medications in many other conditions, including hypertension, diabetes and HIV,” said Loren G. Miller, MD, MPH, an LA BioMed lead researcher and corresponding author of the study. “But these failures have never been studied in skin infections or linked with clinical outcomes. These findings suggest that we need better methods to have patients receive antibiotics for skin infections, such as counseling them on the importance of adhering to the medication dosing or by using newer antibiotics that require only once-weekly dosing.”

Researchers followed 188 patients who had been hospitalized and suffered S. aureus associated skin and soft tissue infections. Of those, the researchers were able to obtain complete records on 87. Of the 87 patients, 40 needed additional treatment within 30 days of leaving the hospital: They had a new skin infection, required incision and drainage of their infections or new antibiotics.

The researchers also found higher rates of non-adherence to antibiotic regimens among patients who were prescribed more than one antibiotic after leaving the hospital, didn’t see the same healthcare provider for follow-up visits or felt they didn’t have a regular healthcare provider. 

Also participating in the study were: Samantha J. Eells, MPH; Megan Nguyen, PharmD4; Jina Jung, PharmD4; Raul Macias-Gil, MD, and Larissa May, MD, MSPH. Funding was provided by the National Operating Committee on Standards for Athletic Equipment and the National Center for Research Resources, USA (Grant No. M01 RR 19975). Funding was provided by Pfizer, Inc.