Document Detail

Prevalence and outcomes of antimicrobial treatment for Staphylococcus aureus bacteremia in outpatients with ESRD.
MedLine Citation:
PMID:  22904350     Owner:  NLM     Status:  MEDLINE    
Staphylococcus bacteremia is a common and life-threatening medical emergency, but it is treatable with appropriate antibiotic therapy. To identify opportunities that may reduce morbidity and mortality associated with S. aureus, we analyzed data from 293,094 chronic hemodialysis outpatients to characterize practices of antibiotic selection. In the study population, the overall rate of bacteremia was 15.4 per 100 outpatient-years; the incidence rate for methicillin-sensitive (MSSA) was 2.1 per 100 outpatient-years, and the incidence rate for methicillin-resistant (MRSA) S. aureus was 1.9 per 100 outpatient-years. One week after the collection of the index blood culture, 56.1% of outpatients with MSSA bacteremia were receiving vancomycin, and 16.7% of outpatients with MSSA were receiving cefazolin. Among MSSA-bacteremic patients who did not die or get hospitalized 1 week after blood culture collection, use of cefazolin was associated with a 38% lower risk for hospitalization or death compared with vancomycin (adjusted HR=0.62, 95% CI=0.46-0.84). In conclusion, vancomycin is commonly used to treat MSSA bacteremia in outpatients receiving chronic dialysis, but there may be more risk of treatment failure than observed among those individuals who receive a β-lactam antibiotic such as cefazolin.
Kevin E Chan; H Shaw Warren; Ravi I Thadhani; David J R Steele; Jeffrey L Hymes; Franklin W Maddux; Raymond M Hakim
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-08-16
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  23     ISSN:  1533-3450     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2012-11-27     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1551-9     Citation Subset:  IM    
Clinical Research Division, Fresenius Medical Care North America, 920 Winter Street, Waltham, MA 02451, USA.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Bacteremia / drug therapy*,  epidemiology*
Cefazolin / therapeutic use*
Kidney Failure, Chronic / epidemiology*,  therapy
Longitudinal Studies
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Renal Dialysis
Retrospective Studies
Risk Factors
Staphylococcal Infections / drug therapy,  epidemiology
Staphylococcus aureus*
Treatment Outcome
United States / epidemiology
Vancomycin / therapeutic use*
Reg. No./Substance:
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin; 25953-19-9/Cefazolin
Comment In:
Nat Rev Nephrol. 2012 Oct;8(10):556   [PMID:  22945487 ]

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

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