Tiseo Giusy, Falcone Marco
Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
Curr Opin Infect Dis. 2025 Apr 1;38(2):128-135. doi: 10.1097/QCO.0000000000001092. Epub 2025 Jan 15.
To discuss the new available options for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and how to implement in the clinical practice innovative approaches for their management.
The availability of long-acting antibiotics, including dalbavancin and oritavancin, changed the approach to patients with ABSSSI. Direct discharge from the emergency department and early discharge from the hospital should be considered in patients with ABSSSI. Despite limited data about different bactericidal properties, the choice between dalbavancin and oritavacin is usually based on patients' characteristics and comorbidities. Delafloxacin and omadacycline are other options and have the advantage to be available for both intravenous and oral formulations, allowing a sequential therapy and switch from intravenous to oral treatment in clinically stable patients. Further studies should elucidate the profile of patients who may beneficiate from these drugs.
Early discharge from the hospital should be considered in patients with ABSSSI at a high risk of methicillin-resistant Staphylococcus aureus and in vulnerable patients for which hospitalization may have detrimental consequences. In elderly individuals, patients with diabetes mellitus, oncological people who need for continuing their healthcare pathway, this approach may reduce complications and costs related to hospitalization.
探讨治疗急性细菌性皮肤和皮肤结构感染（ABSSSI）的新可用选择，以及如何在临床实践中实施其管理的创新方法。
长效抗生素（包括达巴万星和奥利万星）的出现改变了ABSSSI患者的治疗方法。对于ABSSSI患者，应考虑从急诊科直接出院和早期出院。尽管关于不同杀菌特性的数据有限，但达巴万星和奥利万星之间的选择通常基于患者的特征和合并症。德拉氟沙星和奥玛环素是其他选择，其优势在于有静脉和口服制剂，可在临床稳定的患者中进行序贯治疗并从静脉治疗转换为口服治疗。进一步的研究应阐明可能从这些药物中获益的患者特征。
对于耐甲氧西林金黄色葡萄球菌感染风险高的ABSSSI患者以及住院可能产生不利后果的脆弱患者，应考虑早期出院。在老年人、糖尿病患者、需要继续其医疗保健途径的肿瘤患者中，这种方法可能会减少与住院相关的并发症和费用。
