Early switch/early discharge opportunities for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections in Brazil
| Autor: | Wing Yu Tang, Cynthia Macahilig, Courtney Johnson, Caitlyn T. Solem, Maria Lavínea Novis de Figueiredo, Richard Chambers, Jaime L. Rocha, Guilherme Henrique Campos Furtado, Seema Haider, Jennifer Stephens, Ricardo Hayden |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Microbiology (medical)
Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Time Factors Economics medicine.drug_class medicine.medical_treatment Antibiotics lcsh:QR1-502 Administration Oral medicine.disease_cause lcsh:Microbiology lcsh:Infectious and parasitic diseases 03 medical and health sciences Internal medicine medicine Humans lcsh:RC109-216 Early discharge Retrospective Studies 0303 health sciences 030306 microbiology business.industry Drug Substitution IV-to-PO switch Soft Tissue Infections Clindamycin Antibiotic therapy Length of Stay Middle Aged Staphylococcal Infections Methicillin-resistant Staphylococcus aureus Patient Discharge Anti-Bacterial Agents Infectious Diseases Intravenous therapy Staphylococcus aureus Clinical criteria Length of stay Vancomycin Administration Intravenous Female Staphylococcal Skin Infections Daptomycin business Brazil medicine.drug |
| Zdroj: | Brazilian Journal of Infectious Diseases, Vol 23, Iss 2, Pp 86-94 (2019) Brazilian Journal of Infectious Diseases, Volume: 23, Issue: 2, Pages: 86-94, Published: 18 JUL 2019 Brazilian Journal of Infectious Diseases v.23 n.2 2019 Brazilian Journal of Infectious Diseases Brazilian Society of Infectious Diseases (BSID) instacron:BSID |
| ISSN: | 1413-8670 |
| Popis: | Background: Early antibiotic switch and early discharge protocols have not been widely studied in Latin America. Our objective was to describe real-world treatment patterns, resource use, and estimate opportunities for early switch from intravenous to oral antibiotics and early discharge for patients hospitalized with methicillin-resistant Staphylococcus aureus complicated skin and soft-tissue infections. Materials/methods: This retrospective medical chart review recruited 72 physicians from Brazil to collect data from patients hospitalized with documented methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections between May 2013 and May 2015, and discharged alive by June 2015. Data collected included clinical characteristics and outcomes, hospital length of stay, methicillin-resistant Staphylococcus aureus-targeted intravenous and oral antibiotic use, and early switch and early discharge eligibility using literature-based and expert-validated criteria. Results: A total of 199 patient charts were reviewed, of which 196 (98.5%) were prescribed methicillin-resistant Staphylococcus aureus -active therapy. Only four patients were switched from intravenous to oral antibiotics while hospitalized. The mean length of methicillin-resistant Staphylococcus aureus-active treatment was 14.7 (standard deviation, 10.1) days, with 14.6 (standard deviation, 10.1) total days of intravenous therapy. The mean length of hospital stay was 22.2 (standard deviation, 23.0) days. The most frequent initial methicillin-resistant Staphylococcus aureus-active therapies were intravenous vancomycin (58.2%), intravenous clindamycin (19.9%), and intravenous daptomycin (6.6%). Thirty-one patients (15.6%) were discharged with methicillin-resistant Staphylococcus aureus -active antibiotics of which 80.6% received oral antibiotics. Sixty-two patients (31.2%) met early switch criteria and potentially could have discontinued intravenous therapy 6.8 (standard deviation, 7.8) days sooner, and 65 patients (32.7%) met early discharge criteria and potentially could have been discharged 5.3 (standard deviation, 7.0) days sooner. Conclusions: Only 2% of patients were switched from intravenous to oral antibiotics in our study while almost one-third were early switch eligible. Additionally, one-third of hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections were early discharge eligible indicating opportunity for reducing intravenous therapy and days of hospital stay. These results provide insight into possible benefits of implementation of early switch/early discharge protocols in Brazil. Keywords: IV-to-PO switch, Length of stay, Clinical criteria, Antibiotic therapy, Economics |
| Databáze: | OpenAIRE |
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