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Abstract
BackgroundThere are limited data in the literature on the indirect costs associated with skin and soft tissue infections (SSTIs) in the pediatric population. This study aimed to conduct a systematic review of the indirect costs associated with SSTIs in children.MethodsThe search was conducted in PubMed, SCOPUS, and Web of Science up to January 2020. Thirteen search strategies were designed combining MeSH terms and free terms. SSTIs were defined as bacterial or viral infections, dermatomycoses, and parasitic infestations. Only primary studies were included. All analyzed costs were converted to 2020 Euros.ResultsThirteen of the identified publications presented indirect costs of SSTIs in children and were conducted in Argentina, Australia, Brazil, Hungary, New Zealand, Poland, Spain, Taiwan, and the USA. Nine studies described indirect costs associated with infection of Varicella-zoster virus: lost workdays by outpatient caregivers ranged from 0.27 to 7.8, and up to 6.14 if caring for inpatients; total productivity losses ranged from €1.16 to €257.46 per patient. Three studies reported indirect costs associated with acute bacterial SSTIs (community-associated methicillin-resistant Staphylococcus aureus) in children: total productivity losses ranged from €1,814.39 to €8,224.06 per patient, based on impetigo, cellulitis, and folliculitis. One study of parasitic infestations (Pediculus humanus capitis) reported total indirect costs per patient of €68.57 (formal care) plus €21.41 due to time lost by parents in purchasing treatment.ConclusionsThe economic burden of SSTIs is highly relevant but underestimated due to the lack of studies reporting indirect costs. Further cost studies will allow a better understanding of the magnitude of the financial burden of the disease.
Highlights
There are limited data in the literature on the indirect costs associated with skin and soft tissue infections (SSTIs) in the pediatric population
This study followed the guidelines for conducting systematic reviews of economic evaluations studies published by the Centre for Reviews and Dissemination – Centre for reviews and dissemination (CRD) [17] and the research protocol was registered in Open Science Framework
Twenty-nine articles were excluded based on full-text evaluation, and 5 articles identified from a review of references were added, bringing the final total to 13 studies
Summary
There are limited data in the literature on the indirect costs associated with skin and soft tissue infections (SSTIs) in the pediatric population. Skin and soft-tissue infections (SSTIs) as a category include a broad set of Lizano-Díez et al BMC Health Services Research (2021) 21:1325 the first period of life, as evidenced in both the innate and adaptive response [4]. Many SSTIs are caused by bacteria and are referred to as acute bacterial skin and skin structure infections (ABSSSIs). These infections can pose a challenge for the medical community, with the increase in antimicrobial resistance, and are associated with high direct and indirect costs to both the healthcare system and society. The prevalence of community-acquired MRSA (CA-MRSA), meaning MRSA colonization and infection that is not associated with a healthcare setting, among children with no identified risk factors is on the rise and is becoming a public health problem [7, 8]
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