Clinical outcome of ampicillin or ampicillin/sulbactam versus glycopeptides in ampicillin-susceptible Enterococcus faecalis/faecium bacteremia: a 10-year retrospective cohort study.

Autor: Seong YJ; Department of Internal Medicine, Busan Medical Center, Busan, Korea., Song JE; Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea., Lee E; Department of Biology, Duke University, Durham, NC, USA., Kim EJ; Department of Infectious Diseases, Ajou University School of Medicine, 164 World cup-ro, Yeongtong- gu, Suwon, 16499, Republic of Korea., Heo JY; Department of Infectious Diseases, Ajou University School of Medicine, 164 World cup-ro, Yeongtong- gu, Suwon, 16499, Republic of Korea., Choi YH; Department of Infectious Diseases, Ajou University School of Medicine, 164 World cup-ro, Yeongtong- gu, Suwon, 16499, Republic of Korea. yhwa1805@aumc.ac.kr., Kim YC; Division of Infectious Diseases, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Republic of Korea. AMOMJ@yuhs.ac.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Sep 02; Vol. 24 (1), pp. 906. Date of Electronic Publication: 2024 Sep 02.
DOI: 10.1186/s12879-024-09824-w
Abstrakt: Background: Glycopeptides for ampicillin-susceptible Enterococcus faecalis/faecium bacteremia are readily prescribed depending on the severity of the condition. However, there is limited data on the outcomes of glycopeptide use compared to ampicillin-containing regimens for ampicillin-susceptible E. faecalis/faecium bacteremia. From an antibiotic stewardship perspective, it is important to determine whether the use of glycopeptides is associated with improved clinical outcomes in patients with ampicillin-susceptible E. faecalis/faecium bacteremia.
Methods: This retrospective cohort study was conducted at a university-affiliated hospital between January 2010 and September 2019. We collected data from patients with positive blood cultures for Enterococcus species isolates. The clinical data of patients who received ampicillin-containing regimens or glycopeptides as definitive therapy for ampicillin-susceptible E. faecalis/faecium bacteremia were reviewed. Multivariate logistic regression analysis was performed to identify risk factors for 28-day mortality.
Results: Ampicillin-susceptible E. faecalis/faecium accounted for 41.2% (557/1,353) of enterococcal bacteremia cases during the study period. A total of 127 patients who received ampicillin-containing regimens (N = 56) or glycopeptides (N = 71) as definitive therapy were included in the analysis. The 28-day mortality rate was higher in patients treated with glycopeptides (19.7%) than in those treated with ampicillin-containing regimens (3.6%) (p = 0.006). However, in the multivariate model, antibiotic choice was not an independent predictor of 28-day mortality (adjusted OR, 3.7; 95% CI, 0.6-23.6).
Conclusions: Glycopeptide use was not associated with improved mortality in patients with ampicillin-susceptible E. faecalis/faecium bacteremia. This study provides insights to reduce the inappropriate use of glycopeptides in ampicillin-susceptible E. faecalis/faecium bacteremia treatment and promote antimicrobial stewardship.
(© 2024. The Author(s).)
Databáze: MEDLINE
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