A Retrospective Analysis of Practice Patterns in the Treatment of Methicillin‐Resistant <i>Staphylococcus aureus</i> Skin and Soft Tissue Infections at Three Canadian Tertiary Care Centres

Conly, John; Stiver, H Grant; Weiss, Karl; Becker, Debbie; Rosner, Andrew J; Miller, Elizabeth

doi:10.1155/2003/103682

Cited by 11 publications

(16 citation statements)

References 22 publications

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“…In total the charts of 89 patients treated with vancomycin IV for an MRSA infection were reviewed for the study (23). The demographic and clinical characteristics of patients are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Details regarding the methodology and results of the chart review have been previously reported (23). In summary, the charts of all patients admitted to one of three tertiary care teaching hospitals (Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia; The University Health Network, Toronto, Ontario; and Hôpital Maisonneuve-Rosemont, Montreal, Quebec) between January 1, 1997 and August 31, 2000 and treated with vancomycin IV for an active MRSA infection were reviewed.…”

Section: Chart Review Of Mrsa Treatment Patternsmentioning

confidence: 99%

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The Costs and Consequences of Methicillin‐Resistant Staphylococcus aureus Infection Treatments in Canada

Rosner¹,

Becker²,

Wong³

et al. 2004

Canadian Journal of Infectious Diseases and Medical Microbiolog

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BACKGROUND: A multinational randomized controlled trial has shown a trend toward early discharge of patients taking oral linezolid versus intravenous vancomycin (IV) in the treatment of methicillin-resistantStaphylococcus aureus(MRSA) infections. Infection treatments resulting in shorter hospitalization durations are associated with cost savings from the hospital perspective.OBJECTIVE: To determine whether similar economic advantages are associated with oral linezolid, the costs and consequences of linezolid use following vancomycin IV versus the existing practice in the treatment of infections caused by MRSA were compared.METHODS: The charts of all patients admitted to one of three tertiary care teaching hospitals between January 1, 1997 and August 31, 2000 and treated with vancomycin IV for an active MRSA infection (skin and soft tissue only) were reviewed. Based on the vancomycin IV chart review data set and a simulated linezolid data set, the clinical consequences and the associated costs of MRSA treatment with vancomycin IV, and oral and IV forms of linezolid were quantified and compared within the framework of a cost-consequence analysis.RESULTS: Patients treated with oral and IV forms of linezolid compared with the existing practice had a shorter length of stay and required fewer home IV care services, which resulted in a cost savings of $750 (2001 values) to the Canadian health care perspective.CONCLUSIONS: The estimated cost savings associated with linezolid use not only offset the higher acquisition cost of the anti-infective, but may be substantial to health care systems across Canada, especially as the incidence of MRSA continues to rise.

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Section: Resultsmentioning

confidence: 99%

Section: Chart Review Of Mrsa Treatment Patternsmentioning

confidence: 99%

The Costs and Consequences of Methicillin‐Resistant Staphylococcus aureus Infection Treatments in Canada

Rosner¹,

Becker²,

Wong³

et al. 2004

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…Guidelines for IV to oral switch therapy in patients with community-acquired pneumonia are included in national guidelines published by the British Thoracic Society [10] and the Infectious Diseases Society of America/American Thoracic Society [11]; the latter additionally includes criteria for ED. The actual or potential benefits of ES and ED programmes were demonstrated in numerous studies enrolling patients with various types of infections including those caused by bacteria and fungi [7,9,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]29,33]. Indeed, in children with pyelonephritis early IV to oral switch was deemed noninferior to IV therapy only, thereby providing further evidence to support this intervention [34].…”

Section: Benefits Of Es and Ed Programmesmentioning

confidence: 99%

“…Numerous criteria were evaluated in studies evaluating ES and ED programmes in patients with various types of infections including lower respiratory tract infections, urinary tract infections, SSTIs, intraabdominal infections (Table 1) [7,9,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Most programmes assessed ES and ED eligibility 2-4 days following initiation of IV antibiotic therapy.…”

mentioning

confidence: 99%

“…Examples of IV antibiotics that have an oral equivalent include many penicillins, fluoroquinolones and linezolid. Examples of [5,9,12,14,[16][17][18]20,21,23,25] No unexplained tachycardia, haemodynamic instability [7,9,14,16,21,23,25] Clinical improvement, no clinical indication for intravenous therapy [5,7,9,12,[17][18][19][20]23,25] Oral fluids/food tolerated, no reason to believe oral absorption of antimicrobials may be poor; may be by nasogastric/gastric feeding tube [5,7,9,12,[14][15][16][17][18][19][20]22,23,25] Improving white blood cell count [5,9,12,14,16,17,20,…”

mentioning

confidence: 99%

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Implementing criteria-based early switch/early discharge programmes: a European perspective

Nathwani

Lawson

Dryden

et al. 2015

Clinical Microbiology and Infection

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Early switch (ES) from intravenous (IV) to oral antibiotic therapy programmes is increasingly included as a component of hospital antimicrobial stewardship initiatives that aim to optimize antimicrobial therapy while limiting toxicity and resistance. In terms of prioritizing the most cost-effective stewardship interventions, ES has been seen as a 'low-hanging fruit', which refers to selecting the most obtainable targets rather than confronting more complicated issues. Administration of highly bioavailable oral antibiotics should be considered for nearly all non-critically ill patients and has been recommended as an effective and safe strategy for over two decades. However, to accrue the most benefit from ES, it should be combined with an early discharge (ED) plan, protocol, or care pathway. Benefits of this combined approach include improved patient comfort and mobility, reduced incidence of IV-line-related adverse effects, reduced IV antimicrobial preparation time, decreased hospital stays, reduced antimicrobial purchasing and administration costs, decreased patient deconditioning, and shortened recovery times. Results from published studies document decreases in healthcare resource use and costs following implementation of ES programmes, which in most studies facilitate the opportunity for ED and ED programmes. Barriers to the implementation of these programmes include clinician misconceptions, practical considerations, organizational factors, and a striking lack of awareness of IV to oral switch guidance. These and other barriers will need to be addressed to maximize the effectiveness of ES and ED programmes. As national antimicrobial stewardship programmes dictate the inclusion of ES and ED programmes within healthcare facilities, programmes must be developed and success must be documented.

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Randomized Controlled Noninferiority Trial Comparing Daptomycin to Vancomycin for the Treatment of Complicated Skin and Skin Structure Infections in an Observation Unit

Shaw

Meunier

Korfhagen

et al. 2015

The Journal of Emergency Medicine

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A Retrospective Analysis of Practice Patterns in the Treatment of Methicillin‐Resistant Staphylococcus aureus Skin and Soft Tissue Infections at Three Canadian Tertiary Care Centres

Abstract: Considerable variation exists in treatment patterns for MRSA infections. Improvements in the initiation of therapy and the use of IV-to-oral switch therapy may improve care and reduce the duration of hospitalization for MRSA SSTIs.

Cited by 11 publications

References 22 publications

The Costs and Consequences of Methicillin‐Resistant Staphylococcus aureus Infection Treatments in Canada

The Costs and Consequences of Methicillin‐Resistant Staphylococcus aureus Infection Treatments in Canada

Implementing criteria-based early switch/early discharge programmes: a European perspective

Randomized Controlled Noninferiority Trial Comparing Daptomycin to Vancomycin for the Treatment of Complicated Skin and Skin Structure Infections in an Observation Unit

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