Los Angeles—Low medication adherence by patients with S. aureus skin and soft tissue infections resulted in nearly half of them getting a new infection or needing additional treatment for the existing skin infection.

The research, published recently in Antimicrobial Agents and Chemotherapy, reports that the patients took, on average, only 57% of the prescribed antibiotic doses after leaving the hospital.

For the study, led by researchers from the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), antibiotic dosing was measured at enrollment, 14 days, and 30 days by using medication containers fitted with electronic caps that monitored when the pill container was opened. That helped study authors uncover a large discrepancy in patient reports and the electronic measurement.

In fact, 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,” lead researcher Loren G. Miller, MD, MPH, explained in a LA BioMed press release. “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.”

Of 87 patients who had complete records after hospitalization for S aureus–associated skin and soft tissue infections, 40 needed additional treatment within 30 days of leaving the hospital because of a new skin infection, because they required incision and drainage of their infections, or because new antibiotics were necessary.

Results indicate that higher rates of nonadherence to antibiotic regimens were identified 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 reported they didn't have a regular healthcare provider.

“In conclusion, we found patient adherence to oral antibiotic therapy for SSTI after hospital discharge was low (57%) and associated with poor clinical outcome,” study authors write. “Patients commonly overstate their medication adherence, which may make identifying patients at risk for non-adherence and poor outcomes challenging. Further studies are needed to improve post-discharge antibiotic adherence after SSTIs.”

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