What is ABSSSI?

ABSSSI is defined as a bacterial infection of Skin with a lesion size area of ≥75 cm2 (lesion size measured by the area of redness, edema or induration). ABSSSIs consist of the most frequently diagnosed skin infections worldwide. The symptoms observed in ABSSSI are extensive cellulitis, wound infection, major cutaneous abscesses, and burn infections.

There are several pathogens that lead to ABSSSIs, such as Methicillin sensitive Staphylococcus aureus (MSSA) Methicillin-resistant Staphylococcus aureus (MRSA), Beta-hemolytic Streptococcus, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, and others. ABSSSIs may be either community-acquired or hospital-acquired, and the predisposing factors include trauma, chronic cutaneous lesions, preexisting skin conditions (e.g. tinea pedis), edema due to venous insufficiency, and immunosuppression. The most serious ABSSSIs which require hospitalization for parenteral antibiotic therapy are identified based on:

(1) The nature of the potential causative pathogens (e.g. their virulence and resistance patterns) and

(2) Host factors pointing to the severity of the disease.

Despite recent antibiotic launches for ABSSSI, unmet needs still exist for an oral anti-MRSA agent with a safety profile appropriate for extended treatment, especially in the outpatient setting. Management of an ABSSSI is based on a multidisciplinary approach. The first step of management of an ABSSSI is the evaluation of hemodynamic state. For hemodynamically unstable patients, resuscitation and appropriate antimicrobial coverage should begin immediately.

Eradication of the causative organism, alleviation of signs and symptoms, avoidance of complications and preventing recurrences are the main goals of ABSSSI therapy. Treatment for ABSSSI usually includes an antimicrobial therapy, surgical drainage, and antibiotic therapy. The therapeutic approaches favored in treating skin infections include adjunctive therapies, early and appropriate empiric antibiotic therapy, wound culture with susceptibility testing and surgical drainage and debridement. Adjunctive therapies comprise daily dressing changes, use of topical solutions including non-specific antimicrobial drugs, hyperbaric oxygen treatments, debridement, and surgical interventions planned at the initiation of treatment.

What is the ABSSSI Treatment?

The treatment of typical cases of cellulitis (major subtype of ABSSSI) includes an oral antibiotic with activity against streptococci. Major treatment options for mild cases of non-purulent infections include penicillin, amoxicillin, amoxicillin-clavulanate, dicloxacillin, cephalexin, and clindamycin.

Oral and intravenous options for the treatment of ABSSSIs with activity against MRSA include several long-standing therapies, such as sulfamethoxazole-trimethoprim, clindamycin, minocycline, doxycycline, vancomycin, daptomycin, linezolid, ceftaroline, and telavancin. Antibiotics with activity against MRSA are considered when the infection is associated with penetrating trauma, such as IV drug use.

The medications for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections, this broader classification further impacting the ABSSSI market positively. Antibiotic therapy was relatively straightforward before the spread of methicillin-resistant Staphylococcus aureus (MRSA) in skin infections. With the emergence of MRSA in the community setting, initial ABSSSI management has been changed and readdressed. Dalvance (Allergen; US), Orbactiv (The Medicines Company) and Sivextro (Cubist Pharmaceuticals) are some of the few drugs that have been approved or in development for ABSSSI treatment that also proved to be efficient against MRSA. Both Dalvance and Orbactiv have a long half-life and can be dosed less frequently.

Treatment of ABSSSI is quite challenging, as there is an increased antimicrobial resistance among both Gram-positive and Gram-negative bacteria with methicillin-resistant, however the mainstays of treatment continue to be antimicrobial therapies combined with appropriate surgical intervention however, in an overall perspective, recent, and extensive research and development activities being conducted for development of novel drugs, increase understanding of the related comorbidities, along with the large number of upcoming pipeline drugs, is expected to create a lucrative environment for growth of ABSSSI treatment market.

Original Source: - ABSSSI Market