The Length of Hospital Stay of Patients with Venous Thromboembolism: A Cross-Sectional Study from Jordan.

Background and Objectives: Venous thromboembolism is one of the leading causes of mortality and disability worldwide. Treatment with anticoagulation therapy is essential and requires a delicate approach to select the most appropriate option to improve patient outcomes, including the length of hospital stay (LOS). The aim of this study was to determine the LOS among patients with acute onset of VTE in several public hospitals in Jordan. Materials and Methods: In this study, we recruited hospitalized patients with a confirmed diagnosis of VTE. We reviewed the electronic medical records and charts of VTE admitted patients in addition to a detailed survey to collect the patients' self-reported data. Hospital LOS was categorized into three levels: 1-3 days, 4-6 days, and ≥7 days. An ordered logistic regression model was used to study the significant predictors of LOS. Results: A total of 317 VTE patients were recruited, with 52.4% of them were male and 35.3% aged between 50 and 69 years. Most patients had a deep vein thrombosis (DVT) diagnosis (84.2%), and most of the VTE cases were admitted for the first-time (64.6%). The majority of the patients were smokers (57.2%), overweight/obese (66.3%), and hypertensive (59%). Most of the VTE patients received Warfarin overlapped with low molecular weight heparins as their treatment regimen (>70%). Almost half of the admitted VTE patients (45%) were hospitalized for at least 7 days. Longer LOS was significantly associated with hypertension. Conclusions: We recommend using therapies that have been proven to reduce hospital LOS, such as non-vitamin K antagonist oral anticoagulants or direct oral anticoagulants, to treat VTE patients in Jordan. Additionally, preventing and controlling comorbidities such as hypertension is essential.

Management of urinary tract infections and antibiotic susceptibility patterns of bacterial isolates.

AIM OF STUDY: Urinary tract infections (UTIs) are among the most common infections affecting individuals of different ages worldwide. Antimicrobial agents are usually the first-line treatment for UTIs, and the use of the prescribed antibiotic is escalating, resulting in increased rates of bacterial resistance and UTI recurrence. The current study aimed to identify the causative bacteria in Jordan, to explore their resistance pattern to antibiotics and to describe drug-related problems (DRPs) associated with UTI management. METHODS: This prospective, descriptive study was conducted in two major health institutions in two cities in Jordan over a period of six months. The study population included inpatients and outpatients diagnosed with UTIs. Patients' data were collected directly from patients using data collection sheet and from patients' charts. RESULTS: A total of 273 patients were included, of whom 56.4% were women. Urine cultures were obtained from 81% of the patients. Escherichia coli was the most common causative pathogen (50.6%), followed by Klebsiella pneumonia (10.8%). Extended spectrum beta-lactamase (ESBL) producing E. coli was the most commonly detected organism across all types of UTIs. Ceftriaxone and imipenem/cilastatin were most commonly administered to hospitalised patients, whilst ciprofloxacin and co-triamzaxole were the most commonly prescribed in outpatient clinics. The susceptibility results for parenteral antibiotics showed high rates of resistance to cefazolin and ticarcillin. Additionally, high rates of resistance to fluoroquinolones were identified. Further, several DRPs were identified. High rates of resistance to commonly prescribed antibiotics were detected. DRPs (ie, inappropriate antibiotic dosage, unnecessary antibiotic prescribing, inappropriate duration of therapy and prescribing of ineffective antibiotics) were relatively common. CONCLUSION: The present study highlights the need for clinical pharmacists to manage the high level of drug related problems by providing updated information about proper drug selection, rational drug use and patient education and counselling.