Current practices and challenges in the management of acute bacterial skin and skin structure infections (ABSSSI): results from an Italian multicenter survey with expert discussion

Background and objectives Acute bacterial skin and skin structure infections (ABSSSI) are common infections associated with relevant clinical and organizational burden. Their management requires appropriate antibiotic therapy and integrated healthcare organization; however, real-world practices remain heterogeneous. The objective was to explore current clinical and organizational practices in ABSSSI management across expert Italian centres, identifying strengths, critical issues, and unmet needs through a multicentre survey with expert interpretation.Methods A structured 107-item questionnaire was administered via e-mail to 9 Italian centres with consolidated experience in ABSSSI management. A single senior specialist provided a comprehensive response for each centre. Findings were subsequently discussed by a multidisciplinary group of key opinion leaders to contextualize results and identify priority areas for improvement.Results Marked heterogeneity was observed across centres in organizational models and care pathways. Infectious Diseases specialists were central to management, although 24/7 availability was limited. Access to microbiology services and vulnology support varied across centres. No centre reported fully structured ABSSSI care pathways, although informal internal manuals were common. Dedicated multidisciplinary teams were present in a minority of centres. Structured communication with general practitioners and defined hospital-to-community pathways were generally lacking. Monitoring systems and dedicated databases were inconsistently implemented, with limited pharmacoeconomic evaluation.Conclusions This multicentre survey highlights substantial variability in ABSSSI management across Italian expert centres, with key gaps in care pathways, specialist availability, and data collection. Addressing these issues may improve standardization and efficiency of care.