Becker's Clinical Quality & Infection Control

7 Preventing HAIs MRSA-Fighting Drug Approved by FDA By Heather Punke T he U.S. Food and Drug Administration has ap- proved Cubist Pharmaceuticals' new drug, Sivex- tro, for the treatment of acute bacterial skin in- fections, including those caused by methicillin-resistant Staphylococcus aureus. Sivextro is a six-day course of therapy with IV and oral treatment options. "Sivextro provides physicians with flexibility to transition patients from IV to oral treatment as required," Michael Bonney, CEO of Cubist, said. "The oral option provides opportunity for outpatient care, which could reduce the need for costly hospitalization." MRSA is responsible for more than 11,000 American deaths each year, according to Ralph Corey, MD, a professor of medi- cine and infectious disease at Duke Clinical Research Institute and Duke University Medical Center in Durham, N.C.. "Not every antibiotic will work for every patient and more drug options are an imperative," he said. "Physi- cians should evaluate the use of Sivextro. A six-day course of therapy with the option to choose — and, if needed, change — from IV to oral administration is a welcome new development." n Updated Guidelines for Skin, Soft Tissue Infections By Heather Punke T he spread of methicillin-resistant Staphylococcus aureus has led to a giant increase in the number of skin and soft tissue infections, according to the Infectious Dis- eases Society of America. This surge of SSTIs led the IDSA to publish updated practice guidelines for the diagnosis and management of the infections. Visits to the emergency room for SSTIs nearly tripled from 1.2 million in 1995 to 3.4 mil- lion in 2005, and much of that increase is due to MRSA. More than 6 million physician office visits are attributable to SSTIs each year. However, many of these infections either clear up without treatment or can be treated with incision and draining alone and do not require antibiotics. The new guidelines, published in Clinical Infectious Diseases, contain a chart to help clini- cians diagnose and treat the SSTI based on whether or not it is purulent (producing boils or abscesses that contain pus). The guidelines can also help determine the severity of the infection. The updated guidelines also exclusively provide recommendations for treating SSTIs in immunocompromised patients, which can be challenging because they likely have been exposed to many antibiotics and may be resistant to some medications. "We've provided guidance to help physicians make the correct diagnosis, establish the source and cause and determine the severity of infection, which is crucial," said Dennis Stevens, MD, PhD, lead author of the guidelines. "Antibiotics are life-saving drugs for many types of SSTIs, but should only be given when needed, and these guidelines will help physi- cians know when they are and are not necessary." n Hospital Elevator Buttons More Germy Than Bathrooms By Heather Punke H ospital elevator buttons are commonly colonized by bacteria and have a higher prevalence of colonization than bathroom surfaces, according to research pub- lished in Open Medicine. Researchers swabbed 120 elevator buttons — both interior floor buttons and exterior up and down buttons — and 96 bathroom surfaces in three tertiary care hospitals in Toronto. Prevalence of bacteria colonization on elevator buttons was 61 percent as opposed to the 43 percent prevalence on toilet surfaces. However, most of the bacteria were not clinically relevant, they found. The risk of transmitting pathogens via elevator buttons can be mitigated by simple coun- termeasures, according to the researchers. They suggested strategically placing alcohol- based hand sanitizer dispensers inside and outside elevators and increasing public educa- tion about hand hygiene for people who frequently use the elevators. Making elevator buttons large enough to allow pressing them with elbows could also cut down on pathogen transmission. n Clinical App Provides Antimicrobial Usage Guidelines at Point of Care By Akanksha Jayanthi A new app released by the University of Nebraska Medical Center in Omaha is addressing antimicro- bial resistance by providing point-of-care access to antimicrobial usage guidelines. The app, created by the Infectious Diseases Division in the Department of Internal Medicine, outlines clinical protocols and dosing information for antimicrobial use in a handheld format. The department developed the app to help guide physicians to better antimicrobial use to help reduce resistance and im- prove patient outcomes. n

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