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Abstract
Objectives
To describe treatment patterns and medical resource use for methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTI) in Saudi Arabia and Lebanon in terms of drug selection against the infecting pathogen as well as hospital resource utilization and clinical outcomes among patients with these infections.
Methods
This retrospective chart review study evaluated 2011–2012 data from five hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of MRSA cSSTI, which was culture-proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients with each infection type to capture demographics, treatment patterns, hospital resource utilization, and clinical outcomes. Statistical analysis was descriptive.
Results
Data were abstracted from medical records of 87 patients with MRSA cSSTI; mean age 52.4±25.9 years and 61% male. Only 64% of patients received an MRSA active initial therapy, with 56% of first-line regimens containing older beta-lactams. The mean total length of stay was 26.3 days, with the majority (19.1 days) spent in general wards. Surgical procedures included incision and drainage (22% of patients), debridement (14%), and amputation (5%). Mechanical ventilation was required by 9% of patients, with a mean duration of 18 days per patient. Hemodialysis was required by four patients (5%), two of whom were reported to have moderate to severe renal disease on admission, for a mean of 5.5 days. Inpatient mortality was 8%. Thirty-nine percent were prescribed at least one antibiotic at discharge, with the most commonly prescribed discharge antibiotics being clindamycin (44%), ciprofloxacin (18%), trimethoprim/sulfamethoxazole (12%), and linezolid (9%).
Conclusion
This Middle Eastern real-world study of resource use and treatment patterns in MRSA cSSTI indicates that management of this condition could be further optimized in terms of drug selection and resource utilization.
Acknowledgments
The authors would like to thank Monica Katyal for her assistance with data collection and analysis. This study was sponsored by Pfizer.
Author contributions
AFA, AOA, MJM, RM, NR, SH, CTS, and JMS contributed to study design. CM, AFA, AOA, MJM, RM, THA, and FF were involved in data acquisition. CTS and SC undertook data analysis. All authors contributed to data interpretation, manuscript drafting, and approved the final manuscript.
Disclosure
Shelby Corman, Jennifer Stephens, and Caitlyn Solem are employees of Pharmerit International who were paid consultants of Pfizer in connection with the development of this manuscript and study design, management, and statistical analysis for the study. Cynthia Macahilig is an employee of Medical Data Analytics, a subcontractor to Pharmerit International, who was a paid consultant of Pfizer in the study design, management, and data collection for the study. Nirvana Raghubir and Seema Haider are employees and shareholders of Pfizer. Adel Alothman received honoraria for several presentations from Pfizer, MSD, and Alhikma; received travel support from Pfizer, MSD, Gilead, and Alhikma to attend symposia; and received honoraria for patient data collection related to this study from Pfizer. Abdulhakeem Althaqafi received a research grant (RR13/248/J) sponsored by Pfizer, and received honoraria for patient data collection related to this study from Pfizer. Fayssal Farahat received honoraria for patient data collection related to this study from Pfizer. Madonna Matar has received travel support for attending meetings, and received honoraria for patient data collection related to this study from Pfizer. Rima Moghnieh and received honoraria for patient data collection related to this study from Pfizer and sponsorship for attending medical meetings from Pfizer and MSD. Thamer Alenazi has received travel support for attending medical meetings from MSD and Pfizer. The authors report no other conflicts of interest in this work.