ABSTRACT
The number of complicated skin and soft tissue infections (cSSTIs) in the Arabian Gulf region has risen in recent years, particularly those caused by multi-drug resistant (MDR) pathogens. The high prevalence of diabetes, obesity, and associated cardio-metabolic comorbidities in the region renders medical and surgical management of cSSTI patients with MDR infections challenging. An experienced panel of international and regional cSSTI experts (consensus group on cSSTIs) was convened to discuss clinical considerations for MDR infections from societal, antimicrobial stewardship, and cost perspectives, to develop best practice recommendations. This article discusses antibiotic therapies suitable for treating MDR cSSTIs in patients from the Gulf region and recommends that these should be tailored according to the local bacterial ecology by country and region. The article highlights the need for a comprehensive patient treatment pathway and defined roles of each of the multidisciplinary teams involved with managing patients with MDR cSSTIs. Aligned and inclusive definitions of cSSTIs for clinical and research purposes, thorough and updated epidemiological data on cSSTIs and methicillin-resistant Staphylococcus aureus in the region, clearcut indications of novel agents and comprehensive assessment of comparative data should be factored into decision-making are necessary.
ABSTRACT
Background: Antibiotics have changed the practice of medicine. The widespread use of antibiotics has led to the emergence of drug resistance. The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance [Global-PPS] is a motivated project to develop the point-prevalence surveys [PPS] carried out by the European Surveillance of Antimicrobial Consumption [ESAC]
Objective: To monitor the prescription of antibiotics, improve the quality of antibiotics prescription and determine the variations in drug prescription. Design: A Prospective Study. Setting: Salmaniya Medical Complex, Bahrain
Method: The Laboratory of Medical Microbiology [UA, Belgium] designed the Global-PPS WebPPS program, a web-based application for data-entry and reporting. Online registration of participating hospitals on the WebPPS program was performed by the locally designated personnel. All wards in the hospital were included in the data collection. Three hundred seventy two patients were included in the study. Data collected from 1 February 2015 to 30 April 2015 were documented
Result: Three hundred seventy-two patients were included in the study. Three hundred and seven [82.5%] patients were adults, 45 [12.1%] were children and 20 [5.4%] were neonates. Two hundred sixty-three [70.7%] were on antibiotics. All the children, 45 [12.1%] were on antibiotics. beta-lactams other than penicillin was prescribed in 158 [42.5%] patients followed by penicillin in 57 [15.3%] patients. The most common indication for antibiotics use was pneumonia, 43 [11.5%] patients and lower urinary tract infections, 31 [8.3%] patients
Conclusion: The point prevalence study has shown an overuse of antimicrobials with an increasing use of drugs, particularly among pediatrics. Therefore, antibiotic supervising initiatives to limit the overuse is needed