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Outcome of inappropriate empirical antibiotic therapy in patients with Staphylococcus aureus bacteraemia: analytical strategy using propensity scores
DC Field | Value | Language |
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dc.contributor.author | Kim, S-H | - |
dc.contributor.author | Park, W-B | - |
dc.contributor.author | Lee, C-S | - |
dc.contributor.author | Kang, C-I | - |
dc.contributor.author | Bang, J-W | - |
dc.contributor.author | Kim, H-B | - |
dc.contributor.author | Kim, N-J | - |
dc.contributor.author | Kim, E-C | - |
dc.contributor.author | Oh, M D | - |
dc.contributor.author | Choe, K-W | - |
dc.date.accessioned | 2010-01-04T05:00:39Z | - |
dc.date.available | 2010-01-04T05:00:39Z | - |
dc.date.issued | 2006-02-08 | - |
dc.identifier.citation | Clin Microbiol Infect. 2006 Jan;12(1):13-21. | en |
dc.identifier.issn | 1198-743X (Print) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16460541 | - |
dc.identifier.uri | https://hdl.handle.net/10371/24858 | - |
dc.description.abstract | Patients with Staphylococcus aureus bacteraemia (SAB) who received either inappropriate or appropriate empirical therapy were compared by using two risk stratification models: (1) a cohort study using a propensity score to adjust for confounding by empirical treatment assignment; and (2) a propensity-matched case-control study. Inappropriate empirical therapy was modelled on the basis of patient characteristics, and included in the multivariate model to adjust for confounding. For case-matching analysis, patients with inappropriate empirical therapy (cases) were matched to those with appropriate empirical therapy (controls) on the basis of the propensity score (within 0.03 on a scale of 0-1). In total, 238 patients with SAB were enrolled in the cohort study. Characteristics associated with inappropriate empirical therapy were methicillin resistance, underlying haematological malignancy, no history of colonisation with methicillin-resistant S. aureus, and a long hospital stay before SAB. These variables were included in the propensity score, which had an area under the receiver operating characteristics curve of 85%. In the cohort study, SAB-related mortality was 39% (45/117) for inappropriate empirical therapy vs. 28% (34/121) for appropriate empirical therapy (odds ratio (OR) 1.60; 95% CI 0.93-2.76). After adjustment for independent predictors for mortality and the propensity score, inappropriate empirical therapy was not associated with mortality (adjusted OR 1.39; 95% CI 0.62-3.15). In the matched case-control study (50 pairs), SAB-related mortality was 32% (16/50) for inappropriate empirical therapy and 28% (14/50) for appropriate empirical therapy (McNemar's test; p 0.85; OR 1.15; 95% CI 0.51-2.64). In conclusion, inappropriate empirical therapy resulted in only a slight tendency towards increased mortality in patients with SAB. | en |
dc.language.iso | en | en |
dc.publisher | Wiley-Blackwell | en |
dc.subject | Aged | en |
dc.subject | Anti-Bacterial Agents/pharmacology/*therapeutic use | en |
dc.subject | Bacteremia/*drug therapy/microbiology/*mortality | en |
dc.subject | Bias (Epidemiology) | en |
dc.subject | Case-Control Studies | en |
dc.subject | Cohort Studies | en |
dc.subject | Female | en |
dc.subject | Humans | en |
dc.subject | Logistic Models | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Multivariate Analysis | en |
dc.subject | Staphylococcal Infections/drug therapy/microbiology/mortality | en |
dc.subject | Staphylococcus aureus/*drug effects | en |
dc.subject | Treatment Outcome | en |
dc.subject | Medication Errors | - |
dc.title | Outcome of inappropriate empirical antibiotic therapy in patients with Staphylococcus aureus bacteraemia: analytical strategy using propensity scores | en |
dc.type | Article | en |
dc.identifier.doi | 10.1111/j.1469-0691.2005.01294.x | - |
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