TY - JOUR
T1 - Pan-European early switch/early discharge opportunities exist for hospitalised patients with methicillin-resistant Staphylococcus aureus complicated skin and soft-tissue infections
AU - Nathwani, D.
AU - Eckmann, C.
AU - Lawson, W.
AU - Stephens, J.M.
AU - Macahilig, C.
AU - Solem, C.T.
AU - Simoneau, D.
AU - Chambers, R.
AU - Li, J. Z.
AU - Haider, S.
N1 - This article is protected by copyright. All rights reserved.
PY - 2014/10
Y1 - 2014/10
N2 - The objective was to document pan-European real-world treatment patterns and healthcare resource use and estimate opportunities for early switch (ES) from intravenous (IV) to oral antibiotics and early discharge (ED) in hospitalised patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infections (cSSTI). This retrospective observational medical chart review study enrolled 342 physicians across 12 European countries who collected data from 1542 patients with documented MRSA cSSTI, hospitalised (July 2010-June 2011) and discharged alive (by July 2011). Data included clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and oral antibiotic use and ES and ED eligibility using literature-based and expert-validated criteria. The most frequent initial MRSA-active therapies were vancomycin (50.2%), linezolid (15.1%), clindamycin (10.8%) and teicoplanin (10.4%). Patients discharged with MRSA-active antibiotics (n = 480) were most frequently prescribed linezolid (42.1%) and clindamycin (19.8%). IV therapy duration (9.3 ± 6.5 vs. 14.6 ± 9.9 days; p <0.001) and hospital LOS (19.1 ± 12.9 vs. 21.0 ± 18.2 days; p = 0.162) tended to be shorter for patients switched from IV-to-oral therapy compared with patients who received IV only. 33.6% met ES criteria and could have discontinued IV therapy 6.0 ± 5.5 days earlier, and 37.9% met ED criteria and could have been discharged 6.2 ± 8.2 days earlier. More than one-third of European patients hospitalised for MRSA cSSTI could be eligible for ES and ED opportunities, resulting in substantial reductions in IV days and bed-days with potential savings of €2000 per ED-eligible patient.
AB - The objective was to document pan-European real-world treatment patterns and healthcare resource use and estimate opportunities for early switch (ES) from intravenous (IV) to oral antibiotics and early discharge (ED) in hospitalised patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infections (cSSTI). This retrospective observational medical chart review study enrolled 342 physicians across 12 European countries who collected data from 1542 patients with documented MRSA cSSTI, hospitalised (July 2010-June 2011) and discharged alive (by July 2011). Data included clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and oral antibiotic use and ES and ED eligibility using literature-based and expert-validated criteria. The most frequent initial MRSA-active therapies were vancomycin (50.2%), linezolid (15.1%), clindamycin (10.8%) and teicoplanin (10.4%). Patients discharged with MRSA-active antibiotics (n = 480) were most frequently prescribed linezolid (42.1%) and clindamycin (19.8%). IV therapy duration (9.3 ± 6.5 vs. 14.6 ± 9.9 days; p <0.001) and hospital LOS (19.1 ± 12.9 vs. 21.0 ± 18.2 days; p = 0.162) tended to be shorter for patients switched from IV-to-oral therapy compared with patients who received IV only. 33.6% met ES criteria and could have discontinued IV therapy 6.0 ± 5.5 days earlier, and 37.9% met ED criteria and could have been discharged 6.2 ± 8.2 days earlier. More than one-third of European patients hospitalised for MRSA cSSTI could be eligible for ES and ED opportunities, resulting in substantial reductions in IV days and bed-days with potential savings of €2000 per ED-eligible patient.
UR - http://www.scopus.com/inward/record.url?scp=84900351826&partnerID=8YFLogxK
U2 - 10.1111/1469-0691.12632
DO - 10.1111/1469-0691.12632
M3 - Article
C2 - 24673973
SN - 1198-743X
VL - 20
SP - 993
EP - 10000
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 10
ER -