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Outcome of vancomycin treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia

Cited 183 time in Web of Science Cited 202 time in Scopus
Authors
Kim, Sung-Han; Kim, Kye-Hyung; Kim, Hong-Bin; Kim, Nam-Joong; Kim, Eui-Chong; Oh, Myoung-don; Choe, Kang-Won
Issue Date
2007-11-07
Publisher
American Society for Microbiology
Citation
Antimicrob Agents Chemother. 2008 Jan;52(1):192-7. Epub 2007 Nov 5.
Keywords
AdultAgedAnti-Bacterial Agents/*pharmacology/*therapeutic useBacteremia/*drug therapy/microbiology/mortalityCase-Control StudiesCohort StudiesFemaleHospitals, UniversityHumansKoreaMaleMethicillin/*pharmacology/therapeutic useMicrobial Sensitivity TestsMiddle AgedStaphylococcal Infections/drug therapy/microbiology/mortalityStaphylococcus aureus/*drug effectsTreatment OutcomeVancomycin/*therapeutic usebeta-Lactams/pharmacology/therapeutic use
Abstract
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.
ISSN
0066-4804 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17984229

http://hdl.handle.net/10371/29675
DOI
https://doi.org/10.1128/AAC.00700-07
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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