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Assessment of Tigecycline Prescription and Patients’ Outcomes at Three Different Hospitals in Saudi Arabia


Mansour Tobaiqy
Saad Al Humaid
Derek Stewart
Fayez Omear Alotaibi
Kamal Ahmad Qureshi
Katie MacLure
Fahad Algharib
Ahmed Alsameti
Ahmed Alsaqer
Ahmad Almeman

Abstract

Purpose: To investigate tigecycline prescription and patient outcomes in the Kingdom of Saudi Arabia (KSA).
Methods: A retrospective observational study was conducted in three KSA government hospitals, between January, 2013 and May, 2014. The patients were identified from electronic prescription records; data were retrieved by trained researchers.
Results: Thirty-seven patients who received tigecycline were included (mean age, 52.5 years; range, 17 92); 51.4 % were female. Tigecycline was prescribed for sepsis (59.5 %), pneumonia (21.6 %), and/or intra-abdominal infections (13.5 %). The majority of the patients (86.5 %) were prescribed tigecycline in intensive care unit (ICU) and the remaining patients were in the general medical ward. APCHE II score at the beginning of treatment was 16.8 ± 4.3, indicating severe disease. Susceptibility testing revealed 22 different bacterial pathogens, most commonly Acinetobacter baumannii (20 patients) and Klebsiella pneumoniae (14 patients). A significant proportion (56.7 %) was polymicrobial and 16.2 % involved suspected resistant pathogens. Sixteen patients recovered (5 on tigecycline alone, 5 with additional antimicrobials, and six switched to alternatives) while 21 patients died (nine on tigecycline alone, 12 with additional antimicrobials).
Conclusions: The study revealed that tigecycline prescription was conducted according to marketing authorizations and national guidelines. Infection severity/stage and comorbidities may influence patients’ response, and explain some of the poor outcomes.

Keywords: Kingdom of Saudi Arabia, Prescription patterns, Mortality, Tigecycline, Antimicrobial


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eISSN: 1596-9827
print ISSN: 1596-5996