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

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