In the UK, methicillin-resistant Staphylococcus aureus (MRSA)-associated skin and
soft tissue infections (SSTIs) are predominantly managed in the hospital using intravenous (IV)
glycopeptides. We set out to explore the potential for and relative healthcare costs of earlier hospital discharge through switch to oral
antibiotic therapy (
linezolid or
rifampicin and
doxycycline) or continuation of IV
therapy (
teicoplanin) via an outpatient parenteral antimicrobial
therapy (OPAT) service. Over 16 months, 173 patients were retrospectively identified with MRSA SSTI, of whom 82.8 % were treated with IV
therapy. Thirty-seven patients were potentially suitable for earlier discharge with outpatient
therapy. The model assumed 3 days of inpatient management and a maximum of 14 days of outpatient
therapy. For the status quo, where patients received only inpatient care with IV
therapy, hospital costs were calculated at £12,316 per patient, with 97 % of costs accounted for by direct bed day costs. The mean total cost savings achievable through OPAT or oral
therapy was estimated to be £6,136 and £6,159 per patient treated, respectively. A significant proportion of patients with MRSA SSTI may be suitable for outpatient management with either oral
therapy or via OPAT, with the potential for significant reduction in healthcare costs.