Cutaneous Abscess

ABSSSI (cutaneous abscess) patientABSSSI (cutaneous abscess) patient
Not an actual patient

Patients like Marco may be considered an appropriate candidate for SIVEXTRO

Diagnosis: ABSSSI (cutaneous abscess)

20-year-old nursing home worker with skin abrasion on hand (possibly MRSA)

Patient profile:

  • 20-year-old Hispanic male
  • Works in a nursing home
  • 5'11", 180 lbs, BMI of 25.1 kg/m2

Medical history:

  • No significant medical history

Drug allergies:

  • Sulfa medications

Current presentation:

  • Skin abrasion on left hand filled with pus
  • Redness, significant pain, and drainage at infection site

Relevant Acute Findings

Vital signs:

  • Temp: 99.0°F; RR: 15; HR: 86

Physical examination:

  • Lesion surface area on left hand that measures 103 cm2 with erythema extending >5 cm from abscess margin
  • Wound is warm, tender, and indurated with a purulent serosanguineous discharge

Laboratory test results:

  • WBC count: 12,500 x 103/mL with left shift

Diagnosis:

  • ABSSSI—major cutaneous abscess; possibly MRSA

Next steps:

  • Obtain wound culture and send for pathogen identification, susceptibility, and sensitivity
  • Initiate empiric antimicrobial therapy
ABSSSI (cutaneous abscess) patientABSSSI (cutaneous abscess) patient
Not an actual patient

Patients like Becky may be considered an appropriate candidate for SIVEXTRO

Diagnosis: ABSSSI (cutaneous abscess)

31-year-old female with tick bite on lower back

Patient profile:

  • 31-year-old white female
  • 5'2", 131 lbs, BMI of 24 kg/m2

Medical history:

  • No significant medical history

Drug allergies:

  • None reported

Current presentation:

  • Tick bite on lower back filled with pus
  • Moderate swelling, redness, and drainage at infection site

Relevant Acute Findings

Vital signs:

  • Temp: 101.3°F; RR: 17; HR: 85

Physical examination:

  • Lesion surface area on lower back that measures 92 cm2 with erythema extending >6 cm from abscess margin
  • Wound is warm, moderately painful to touch, and indurated with a seropurulent discharge

Laboratory test results:

  • WBC count: 10,500 x 103/mL with left shift
  • Gram stain shows abundant Gram-positive cocci in clusters

Diagnosis:

  • ABSSSI—major cutaneous abscess

Next steps:

  • Send specimen for culture and for pathogen identification, susceptibility, and sensitivity
  • Initiate empiric antimicrobial therapy

ABSSSI=acute bacterial skin and skin structure infections; BMI=body mass index; HR=heart rate; RR=respiratory rate; Temp=temperature; WBC=white blood cell.

ABSSSI=acute bacterial skin and skin structure infections.
ABSSSI=acute bacterial skin and skin structure infections; IV=intravenous.
ABSSSI=acute bacterial skin and skin structure infections; MRSA=methicillin-resistant Staphylococcus aureus; MSSA=methicillin-susceptible Staphylococcus aureus.
ABSSSI=acute bacterial skin and skin structure infections.
1. Prokocimer P, De Anda C, Fang E, et al. Tedizolid phosphate vs linezolid for treatment of acute bacterial skin and skin structure infections: the ESTABLISH-1 randomized trial. JAMA. 2013;309(6):559-569.
ABSSSI=acute bacterial skin and skin structure infections; IV=intravenous.
1. Moran GJ, Fang E, Corey GR, et al. Tedizolid for 6 days versus linezolid for 10 days for acute bacterial skin and skin-structure infections (ESTABLISH-2): a randomised, double-blind, phase 3, non-inferiority trial. Lancet Infect Dis. 2014;14(8):696-705.
ABSSSI=acute bacterial skin and skin structure infections.
1. Prokocimer P, De Anda C, Fang E, et al. Tedizolid phosphate vs linezolid for treatment of acute bacterial skin and skin structure infections: the ESTABLISH-1 randomized trial. JAMA. 2013;309(6):559-569.
2. Moran GJ, Fang E, Corey GR, et al. Tedizolid for 6 days versus linezolid for 10 days for acute bacterial skin and skin-structure infections (ESTABLISH-2): a randomised, double-blind, phase 3, non-inferiority trial. Lancet Infect Dis. 2014;14(8):696-705.
ABSSSI=acute bacterial skin and skin structure infections.
1. Pollack CV Jr, Amin A, Ford WT Jr, et al. Acute bacterial skin and skin structure infections (ABSSSI): practice guidelines for management and care transitions in the emergency department and hospital. J Emerg Med. 2015;48(4):508-519.
2. Lane S, Johnston K, Sulham KA, et al. Identification of patient characteristics influencing setting of care decisions for patients with acute bacterial skin and skin structure infections: Results of a discrete choice experiment. Clin Ther. 2016;38(3):531-544.
Selected Important Safety Information

Patients with neutropenia: The safety and efficacy of SIVEXTRO® (tedizolid phosphate) in patients with neutropenia (neutrophil counts <1000 cells/mm3) have not been adequately evaluated. In an animal model of infection, the antibacterial activity of SIVEXTRO was reduced in the absence of granulocytes. Alternative therapies should be considered when treating patients with neutropenia.

Clostridium difficile–associated diarrhea (CDAD), ranging from mild diarrhea to fatal colitis, has been reported with nearly all systemic antibacterial agents, including SIVEXTRO. Evaluate all patients who present with diarrhea following antibiotic use. Careful medical history is necessary because CDAD has been reported to occur more than two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, antibacterial use not directed against C. difficile should be discontinued, if possible.

Development of drug-resistant bacteria: Prescribing SIVEXTRO in the absence of a proven or strongly suspected bacterial infection or prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Adverse reactions: The most common adverse reactions for SIVEXTRO are nausea (8%), headache (6%), diarrhea (4%), vomiting (3%), and dizziness (2%).

Drug interactions with BCRP substrates: SIVEXTRO (when administered orally) can increase the plasma concentrations of orally administered Breast Cancer Resistance Protein (BCRP) substrates and the potential for adverse reactions. Monitor for adverse reactions related to the concomitant BCRP substrates if coadministration cannot be avoided.

Before prescribing SIVEXTRO, please read the accompanying Prescribing Information.

MULT-1044371-0307 07/15

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Indication and Usage

Indication: SIVEXTRO® (tedizolid phosphate) is an oxazolidinone-class antibacterial indicated for the treatment of adults with acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible isolates of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus group (including Streptococcus anginosus, Streptococcus intermedius and Streptococcus constellatus), and Enterococcus faecalis.

Usage: To reduce the development of drug-resistant bacteria and maintain the effectiveness of SIVEXTRO and other antibacterial drugs, SIVEXTRO should be used only to treat ABSSSI that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

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Selected Important Safety Information

Patients with neutropenia: The safety and efficacy of SIVEXTRO® (tedizolid phosphate) in patients with neutropenia (neutrophil counts <1000 cells/mm3) have not been adequately evaluated. In an animal model of infection, the antibacterial activity of SIVEXTRO was reduced in the absence of granulocytes. Alternative therapies should be considered when treating patients with neutropenia.

Clostridium difficile–associated diarrhea (CDAD), ranging from mild diarrhea to fatal colitis, has been reported with nearly all systemic antibacterial agents, including SIVEXTRO. Evaluate all patients who present with diarrhea following antibiotic use. Careful medical history is necessary because CDAD has been reported to occur more than two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, antibacterial use not directed against C. difficile should be discontinued, if possible.

Development of drug-resistant bacteria: Prescribing SIVEXTRO in the absence of a proven or strongly suspected bacterial infection or prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Adverse reactions: The most common adverse reactions for SIVEXTRO are nausea (8%), headache (6%), diarrhea (4%), vomiting (3%), and dizziness (2%).

Drug interactions with BCRP substrates: SIVEXTRO (when administered orally) can increase the plasma concentrations of orally administered Breast Cancer Resistance Protein (BCRP) substrates and the potential for adverse reactions. Monitor for adverse reactions related to the concomitant BCRP substrates if coadministration cannot be avoided.

Before prescribing SIVEXTRO, please read the accompanying Prescribing Information.