Cost avoidance using linezolid for methicillin-resistant staphylococcus aureus infections in a specialist diabetes foot clinic

Abstract

Objectives: An audit was performed to determine whether linezolid (Zyvox, Pharmacia Limited, Sandwich, UK) was being used in accordance with local guidelines and if this had an effect on admissions for diabetes foot ulceration. Methods: Seven hundred and four patient records from 2005 to 2010 in the Diabetes Foot Clinic, Royal Infirmary of Edinburgh were audited for methicillin-resistant Staphylococcus aureus (MRSA) infections, admissions and antibiotic use. Results: Seventeen percent (n = 119) of patients had proven MRSA infections. Of these, 28% (n = 33) were prescribed linezolid, 94% (n = 31) for up to 14 days and none for >28 days. Eight (24%) had repeated courses. Ninety-one percent (n = 30) either avoided admission or were discharged early with resolution of infection. Four out of 33 patients had reversible blood abnormalities. The total cost for linezolid over this period was £58 000. However, 420 bed days, costing £500/day, were avoided, producing a total saving of £210 000 on inpatient costs. Conclusions: Linezolid guidelines reduced lengths of stay, inpatient costs and overuse of this expensive but effective treatment. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.