10/7/2023 0 Comments Total system care fullMRSA was detected via nasal PCR in 12% of patients 15.7% PRE and 7.4% POST). Incidence of MRSA in DFI in the cohort was 14.7% overall (12% PRE and 17.6% POST). Most patients were male (98% PRE 97% POST) with a median age of 64 (IQR, 56–72) years. ResultsĪ total of 151 patients were included (83 PRE 68 POST). Secondary outcomes included the proportion of patients needing MRSA coverage added back for MRSA after de-escalation, hospital readmission, length of hospital stay (LOS), patient mortality, and acute kidney injury. A Wilcoxon Rank Sum test was used to assess the difference between the groups for the primary outcome. The primary outcome was median (interquartile range ) hours of empiric inpatient MRSA-targeted antibiotic therapy. Patients were allocated into two groups: PRE (-) and POST (-) protocol implementation for de-escalation or avoidance of MRSA-targeted antibiotics. Eligible patients were identified from the Corporate Data Warehouse and reviewed via electronic health record. This was a retrospective quasi-experimental study of patients admitted to South Texas Veterans Health Care System for DFI, with or without osteomyelitis (OM), who had an MRSA nasal PCR and culture data. This study evaluates the effect of MRSA nasal PCR testing on MRSA-targeted antibiotic use and clinical outcomes in patients with DFI. This approach has the potential to increase unnecessary use of broad-spectrum antibiotics therefore, additional strategies are needed to optimize appropriate antibiotic use. Diabetic Foot Infection (DFI) guidelines recommend empiric methicillin-resistant Staphylococcus aureus (MRSA)-targeted therapy in settings where there is high prevalence of MRSA infections or in cases of severe infection however, they do not provide recommendations for de-escalation.
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