A randomized clinical trial to compare fleroxacin-rifampicin with flucloxacillin or vancomycin for the treatment of staphylococcal infection
| Autor: | Christiane Petignat, Daniel Genné, Jacques Schrenzel, Gérard A. Schockmel, Patrick Francioli, Thomas Bregenzer, Daniel Pablo Lew, Ursula Flueckiger, Werner Zimmerli, Stéphan Juergen Harbarth, Frédérique Jacobs |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
Fleroxacin Rifampin/administration & dosage/adverse effects/ therapeutic use Staphylococcus Administration Oral Bacteremia Catheters Indwelling Administration Oral Adult Aged Bacteremia/drug therapy Catheters Indwelling/microbiology Drug Therapy Combination Female Fleroxacin/administration & dosage/adverse effects/*therapeutic use Floxacillin/administration & dosage/adverse effects/*therapeutic use Humans Male Methicillin Resistance/drug effects Middle Aged Prospective Studies Rifampin/administration & dosage/adverse effects/*therapeutic use Safety Staphylococcal Infections/diagnosis/*drug therapy/metabolism Staphylococcus/drug effects/isolation & purification Staphylococcus aureus/drug effects/isolation & purification Treatment Outcome Vancomycin/administration & dosage/adverse effects/*therapeutic use Prospective Studies Vancomycin/administration & dosage/adverse effects/ therapeutic use ddc:616 education.field_of_study Standard treatment Fleroxacin/administration & dosage/adverse effects/ therapeutic use Middle Aged Staphylococcal Infections Floxacillin/administration & dosage/adverse effects/ therapeutic use Infectious Diseases Treatment Outcome Staphylococcus/drug effects/isolation & purification Vancomycin Drug Therapy Combination Female Rifampin Safety Methicillin Resistance/drug effects medicine.drug Microbiology (medical) Adult medicine.medical_specialty Staphylococcus aureus Population Staphylococcal infections Floxacillin Staphylococcus aureus/drug effects/isolation & purification Bacteremia/drug therapy Internal medicine medicine Humans education Aged Staphylococcal Infections/diagnosis/ drug therapy/metabolism business.industry medicine.disease Surgery Catheters Indwelling/microbiology Methicillin Resistance Flucloxacillin business Rifampicin |
| Zdroj: | Clinical Infectious Diseases, vol. 39, no. 9, pp. 1285-92 Clinical Infectious Diseases, Vol. 39, No 9 (2004) pp. 1285-1292 |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background. Oral combination therapy with fluoroquinolones plus rifampicin is a promising alternative to standard parenteral therapy for staphylococcal infections. Methods. In a multicenter, randomized trial, we compared the efficacy, safety, and length of hospital stay for patients with staphylococcal infections treated either with an oral combination of a fluoroquinolone (fleroxacin) plus rifampicin or with standard parenteral treatment (flucloxacillin or vancomycin). Patients were included if cultures showed the presence of bacteremia or deep-seated infections with Staphylococcus aureus (104 patients) or catheter-related bacteremia due to drug-susceptible, coagulase-negative staphylococci (23 patients). Results. The cure rate in the intention-to-treat analysis was 78% for the fleroxacin-rifampicin group (68 patients) and 75% for the standard therapy group (59 patients; 47 received flucloxacillin, and 12 received vancomycin); in the population of clinically evaluable patients (n = 119), the cure rate was 82% and 80%, respectively; and in the population of microbiologically evaluable patients (n = 103), the cure rate was 86% and 84%, respectively. Clinical and bacteriological failures after S. aureus infections were documented in similar proportions of patients. The median length of hospital stay after study entry was 12 days in the fleroxacin-rifampicin group, compared with 23 days in the standard treatment group (P = .006). More adverse events probably related to the study drug were reported in the fleroxacin-rifampicin group than in the standard therapy group (15 of 68 vs. 5 of 59 patients; P = .05). Conclusions. This study suggests that an oral regimen containing a fluoroquinolone plus rifampicin may be effective for treating staphylococcal infections, allowing earlier discharge from the hospital |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|