OBJECTIVES: Skin and soft tissue infections (SSTI) are among the most common hospital infections, and represent a heterogeneous range of infection types with numerous treatment options. While recent research has begun to characterize treatment patterns and associated outcomes, little is known about country-specific practice patterns. The purpose of this analysis was to characterize current practice patterns in the treatment of SSTIs in select European countries. METHODS: A retrospective analysis was conducted using Arlington Medical Resources’ (AMR’s) Hospital Antibiotic Market audit January-June 2013. The audit is comprised of data elements including patient demographics, diagnosis, therapy sequence, switching, and concomitance, hospital and intensive care unit, length of stay, discharge drug, and drug costs. RESULTS: A sample of adult inpatients with SSTIs projected to national volume in Germany (n=427,516), United Kingdom (UK; n=292,265), Italy (n=199,588) and Spain (195,084) were included for analysis. Demographic characteristics were similar across countries; diabetes and heart disease were the most common comorbidities. Practice patterns varied considerably; the most common first-line treatment was ampicillin/sulbactam (22.1%) in Germany, flucloxacillin (31.9%) in UK, ceftriaxone (10.7%) in Italy, and amoxicillin/clavulanate (21.2%) in Spain. MRSA rates across all SSTIs were 3.5%, 4.9%, 3.3%, and 3.4% in Germany, UK, Italy, and Spain, respectively. Empiric treatment with MRSA-active agents was less common, with teicoplanin (7.8% in Italy), clindamycin (5.9% in Spain) and vancomycin (5.8% in Spain) among the most commonly used agents. 38.5%, 71.0%, 48.0%, and 52.3% of patients were discharged onto continued treatment in Germany, UK, Italy, and Spain, respectively. Treatment switching was frequent across countries. CONCLUSIONS: Treatment of SSTIs is heterogeneous across European countries; further research is needed to understand the association between empiric treatment, treatment switching, and patient outcomes. This analysis, however, highlights the potential need for reassessment of treatment guidelines for SSTI and the potential need for new SSTI treatments.