Document Detail


Treatment of Methicillin-Resistant Staphylococcus aureus Infections with a Minimal Inhibitory Concentration of 2 μg/mL to Vancomycin: Old (Trimethoprim/Sulfamethoxazole) versus New (Daptomycin or Linezolid) Agents (December).
MedLine Citation:
PMID:  23212935     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:Guidelines recommend that agents other than vancomycin be considered for some types of infection due to methicillin-resistant Staphylococcus aureus (MRSA) when the minimum inhibitory concentration (MIC) to vancomycin is 2 μg/mL or more. Alternative therapeutic options include daptomycin and linezolid, 2 relatively new and expensive drugs, and trimethoprim/sulfamethoxazole (TMP/SMX), an old and inexpensive agent.OBJECTIVE:To compare the clinical efficacy and potential cost savings associated with use of TMP/SMX compared to linezolid and daptomycin.METHODS:A retrospective study was conducted at Detroit Medical Center. For calendar year 2009, unique adults (age >18 years) with infections due to MRSA with an MIC to vancomycin of 2 µg/mL were included if they received 2 or more doses of TMP/SMX and/or daptomycin and/or linezolid. Data were abstracted from patient charts and pharmacy records.RESULTS:There were 328 patients included in the study cohort: 143 received TMP/SMX alone, 89 received daptomycin alone, 75 received linezolid alone, and 21 patients received a combination of 2 or more of these agents. In univariate analysis, patients who received TMP/SMX alone had significantly better outcomes, including in-hospital (p = 0.003) and 90-day mortality (p < 0.001) compared to patients treated with daptomycin or linezolid. Patients receiving TMP/SMX were also younger (p < 0.001), had fewer comorbid conditions (p < 0.001), had less severe acute severity of illness (p < 0.001), and received appropriate therapy more rapidly (p = 0.001). In multivariate models the association between TMP/SMX treatment and mortality was no longer significant. Antimicrobial cost savings associated with using TMP/SMX averaged $2067.40 per patient.CONCLUSIONS:TMP/SMX monotherapy compared favorably to linezolid and daptomycin in terms of treatment efficacy and mortality. Use of TMP/SMX instead of linezolid or daptomycin could potentially significantly reduce antibiotic costs. TMP/SMX should be considered for the treatment of MRSA infection with MIC of 2 μg/mL to vancomycin.
Authors:
Michelle L Campbell; Dror Marchaim; Jason M Pogue; Bharath Sunkara; Suchitha Bheemreddy; Pradeep Bathina; Harish Pulluru; Neelu Chugh; Melanie N Wilson; Judy Moshos; Kimberley Ku; Kayoko Hayakawa; Emily T Martin; Paul R Lephart; Michael J Rybak; Keith S Kaye
Related Documents :
23829875 - Preliminary investigations into the analgesic effects of topical ocular 1% morphine sol...
23235195 - Efficacy and safety of clinical use of etanercept for the treatment of moderate-to-seve...
23606935 - Safety and efficacy of defibrotide for the treatment of severe hepatic veno-occlusive d...
24675245 - Evaluating the efficacy of current treatments for reducing postoperative ileus: a rando...
12180745 - Changes in markers of bone turnover and inflammatory variables during alendronate thera...
7670215 - Low-dose chemonucleolysis combined with percutaneous nucleotomy in herniated cervical d...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  -     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
< Detroit Medical Center, Wayne State University, Harper University Hospital, Detroit, MI.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Avoiding Serotonin Syndrome: The Nature of the Interaction Between Tramadol and Selective Serotonin ...
Next Document:  Self-Assembled Tetragonal Prismatic Molecular Cage Highly Selective for Anionic ? Guests.