Document Detail


Outcome of vancomycin treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia.
MedLine Citation:
PMID:  17984229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Limited data on the clinical outcome of vancomycin treatment compared with that of beta-lactam treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia (MSSA-B) are available. We used different and complementary approaches: (i) a retrospective cohort study using a propensity score to adjust for confounding by treatment assignment and (ii) a matched case-control study. Of all patients with S. aureus bacteremia (SAB) in two university-affiliated hospitals over a 7-year period, 294 patients with MSSA-B were enrolled in the cohort study. The cases for the case-control study were defined as patients who received vancomycin treatment for MSSA-B; the controls, who were patients that received beta-lactam treatment for MSSA-B, were selected at a 1:2 (case:control) ratio according to the objective matching scoring system and the propensity score system. In the cohort study, SAB-related mortality in patients with vancomycin treatment (37%, 10/27) was significantly higher than that in those with beta-lactam treatment (18%, 47/267) (P = 0.02). In addition, multivariate analysis revealed that vancomycin treatment was associated with SAB-related mortality when independent predictors for SAB-related mortality and propensity score were considered (adjusted odds ratio of 3.3, 95% confidence interval of 1.2 to 9.5). In the case-control study using the objective matching scoring system and the propensity score system, SAB-related mortality in case patients was 37% (10/27) and in control patients 11% (6/54) (P < 0.01). Our data suggest that vancomycin is inferior to beta-lactam in the treatment of MSSA-B.
Authors:
Sung-Han Kim; Kye-Hyung Kim; Hong-Bin Kim; Nam-Joong Kim; Eui-Chong Kim; Myoung-don Oh; Kang-Won Choe
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-11-05
Journal Detail:
Title:  Antimicrobial agents and chemotherapy     Volume:  52     ISSN:  0066-4804     ISO Abbreviation:  Antimicrob. Agents Chemother.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-31     Completed Date:  2008-05-06     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0315061     Medline TA:  Antimicrob Agents Chemother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  192-7     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Seoul National University College of Medicine, 28 Youngundong, Chongrogu, Seoul 110-744, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / pharmacology*,  therapeutic use*
Bacteremia / drug therapy*,  microbiology,  mortality
Case-Control Studies
Cohort Studies
Female
Hospitals, University
Humans
Korea
Male
Methicillin / pharmacology*,  therapeutic use
Microbial Sensitivity Tests
Middle Aged
Staphylococcal Infections / drug therapy,  microbiology,  mortality
Staphylococcus aureus / drug effects*
Treatment Outcome
Vancomycin / therapeutic use*
beta-Lactams / pharmacology,  therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/beta-Lactams; 1404-90-6/Vancomycin; 61-32-5/Methicillin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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