| Autor: |
Willekens, Rein, Puig-Asensio, Mireia, Suanzes, Paula, Fernández-Hidalgo, Nuria, Larrosa, Maria N, González-López, Juan J, Rodríguez-Pardo, Dolors, Pigrau, Carles, Almirante, Benito |
| Předmět: |
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| Zdroj: |
Journal of Antimicrobial Chemotherapy (JAC); Aug2022, Vol. 77 Issue 8, p2288-2295, 8p |
| Abstrakt: |
Objectives: To evaluate the effectiveness of empirical therapy with β-lactam/β-lactamase inhibitor combinations (BL/BLICs) for MSSA bacteraemia.Methods: We conducted a post hoc analysis of all adult patients with MSSA bacteraemia who were hospitalized at a Spanish university hospital between 2013 and 2018. We compared 30 day mortality among patients receiving initial therapy with BL/BLICs (de-escalated to cloxacillin or cefazolin within 96 h) versus cloxacillin or cefazolin, using propensity score analysis with the inverse probability of treatment weighting (IPTW) method.Results: We evaluated 373 patients with MSSA bacteraemia. Among them, 198 patients met the eligibility criteria, including 127 patients in the BL/BLICs group and 71 patients in the cloxacillin/cefazolin group. Patients in the BL/BLICs group had a higher Charlson comorbidity index (median, 2 [IQR, 1-4.5] versus 2 [IQR, 0-4]); an increased proportion of high-risk sources (i.e. endocarditis, respiratory sources and bacteraemia of unknown origin [34.6% versus 18.3%]); and an earlier start of antibiotic treatment (median, 0 days [IQR, 0-0] versus 1 day [IQR, 1-2]). Thirty day mortality did not significantly differ between the BL/BLICs and the cloxacillin/cefazolin groups (27 patients [21.3%] versus 13 patients [18.3%]; IPTW-adjusted OR = 0.53 [95% CI, 0.18-1.51]). For secondary outcomes, 7 day mortality and 90 day relapse were not statistically different between study groups (8.7% versus 5.6% [P = 0.62] and 6.2% versus 3.8% [P = 0.81], respectively).Conclusions: BL/BLICs might be an effective empirical treatment for MSSA bacteraemia when de-escalated to cloxacillin or cefazolin within 96 h from the index blood culture. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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