Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study
| Autor: | Sungmin Kiem, D.-K. Kim, C.R. Cho, Shinhye Cheon, H.S. Song, J.H. Jeon, Young Ho Lee, Jae-Gook Shin, Wan Beom Park, Hong Bin Kim, Yee Gyung Kwak, Pyeong Gyun Choe, J.I. Park, Hee-Chang Jang, Yongsun Kim, Myoung Don Oh, M.S. Han, Ki-Jeong Park, H.Y. Kim, Myoung Joo Kang, Sook-In Jung, M. Kim, Hyukjae Choi, H.-I. Kim, Nam Joong Kim, Y.J. Choi, Sanghyuk Lee, Chung Jong Kim, Myung Jin Lee, Yeon Sook Kim, Seung-Ji Kang, Eun Sun Kim, Kyoung Ho Song, S.-A. Song, J.E. Cho, Kye-Hyung Kim, Nak Hyun Kim, K.T. Kwon, Hee Kyoung Choi |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male medicine.medical_specialty Staphylococcus aureus Multivariate analysis Time Factors Adolescent medicine.drug_class medicine.medical_treatment 030106 microbiology Antibiotics Bacteremia Prosthesis 03 medical and health sciences Young Adult 0302 clinical medicine Anti-Infective Agents Recurrence Internal medicine Medicine Endocarditis Humans 030212 general & internal medicine Prospective Studies Aged First episode Aged 80 and over business.industry General Medicine Middle Aged Staphylococcal Infections medicine.disease Survival Analysis Confidence interval Pneumonia Infectious Diseases Treatment Outcome Female business Cohort study |
| Zdroj: | Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 25(6) |
| ISSN: | 1469-0691 |
| Popis: | To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment.We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as14 or ≥14 days in the SS group and28 or ≥28 days in the LW group.Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00-2.83; p 0.05).Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB. |
| Databáze: | OpenAIRE |
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