Search

Background: Snakebite envenomation remains a significant public health concern in Asir Province of Saudi Arabia., Aim: To characterize snake species and the clinical presentation, outcome and management of snakebite cases admitted to 4 major hospitals in Asir Province, Saudi Arabia ., Methods: This retrospective study reviewed medical records of paediatric and adult snakebite cases admitted to 4 regional hospitals in Saudi Arabia between January 2000 and December 2021 using search terms "snakebite", "cobra", "polyvalent antivenin", "antivenom", "compartment syndrome", and "fasciotomy". The data were analysed using R software version 4.2., Results: Sixty-nine patients were identified, of whom 30 (43.5%) were children aged <18 years. Severe local or systemic manifestations occurred in 33 patients (47.8%) while compartment syndrome was suspected in 14 patients (20.3%), requiring fasciotomy in 11 (15.9%). The systemic manifestations included neurotoxicity (13 patients; 18.8%), coagulopathy (31 patients; 44.9%), rhabdomyolysis with creatine phosphokinase >1000 U/L (8 patients; 11.6%), and acute kidney injury (4 patients; 5.8%), with 2 progressing to end-stage renal disease. Three patients (4.5%) died. A majority (94%) received initial 5-vial antivenom dose, with 39% requiring additional doses. Antivenom-related adverse reactions were mild and transient in 6 patients (9%). Blood products and antibiotics were used in 30% and 67% of cases, respectively. Anticholinesterase therapy was administered to 3 patients (4.3%)., Conclusion: Snakebites pose a significant public health threat in Asir Province of Saudi Arabia. Antivenom, in addition to supportive care, remains the cornerstone of therapy, however, to optimize patient outcomes, our study highlights the need for a more comprehensive approach to management, as well as vigilant monitoring with prompt recognition and interventions., (Copyright: © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. All papers published in EMHJ are available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Objectives: To assess current practices of different healthcare providers for treating extensively drug-resistant (XDR)  Acinetobacter baumannii (AB) infections  in tertiary-care centers in Saudi Arabia. , Methods: This cross-sectional study was performed in  tertiary-care centers of Saudi Arabia between March and June 2014. A questionnaire consisting of 3 parts (respondent characteristics; case scenarios on ventilator-associated pneumonia [VAP] and tracheobronchitis [VAT], and antibiotic choices in each scenario) was developed and sent electronically to participants in 34 centers across Saudi Arabia. , Results: One-hundred and eighty-three respondents completed the survey. Most of the respondents (54.6%) preferred to use colistin-based combination therapy to treat VAP caused by XDR AB, and 62.8% chose to continue treatment for 2 weeks. Most of the participants (80%) chose to treat VAT caused by XDR AB with intravenous antibiotics. A significant percentage of intensive care unit (ICU) fellows (41.3%) and clinical pharmacists (35%) opted for 2 million units (mu) of colistin every 8 hours without a loading dose, whereas 60% of infectious disease consultants, 45.8% of ICU consultants, and 44.4% of infectious disease fellows preferred a 9 mu loading dose followed by 9 mu daily in divided doses. The responses for the scenarios were different among healthcare providers (p less than 0.0001). , Conclusion: Most of the respondents in our survey preferred to use colistin-based combination therapy and intravenous antibiotics to treat VAP and VAT caused by XDR AB. However, colistin dose and duration varied among the healthcare providers.