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Outcome of vancomycin treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia
Cited 211 time in
Web of Science
Cited 236 time in Scopus
- Authors
- 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
- 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
- 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://aac.asm.org/cgi/reprint/52/1/192.pdf
https://hdl.handle.net/10371/45514
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