SKIN AND SOFT-TISSUE INFECTIONS - DEVELOPMENT OF A COLLABORATIVE MANAGEMENT PLAN BETWEEN COMMUNITY AND HOSPITAL-CARE

The commonest indication in the US for referral to an outpatient/home i.v, antibiotic therapy programme is the management of skin and soft t issue infections. In the UK, however, these infections account for 10% or more of admissions to infection units. The main indication for hos pitalisation is to receive parenteral antibiotics. A retrospective aud it of one year of admissions to a regional infection unit revealed tha t, although most of these patients do not progress to complications (' low risk'), they occupy a mean time of five days in hospital and for n early half of that time they receive parenteral antibiotics. This peri od in hospital reflected 11.4% of the unit's bed occupancy, Even if 75 % of these patients were treated in the community with parenteral ther apy, this would result in bed savings of 8.55%, nearly one-tenth of th e unit's occupied capacity. This type of audit should help key decisio n makers thinking of developing similar services in their region. Outp atient or home parenteral antimicrobial therapy (OHPAT) should be deli vered as part of a complete disease management programme in collaborat ion with primary care.