Abstract |
Data suggest that vancomycin is less effective for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) with vancomycin Etest® MIC (MICEtest) ≥1.5 mg/L. No published studies have evaluated the relationship between vancomycin exposure and outcomes among patients with MRSA BSIs vancomycin MICEtest ≥1.5 mg/L. This study was a retrospective cohort of 71 hospitalized, adult, non-dialysis patients with MRSA BSIs treated with vancomycin. All but three patients had a vancomycin MICEtest of 1.5 mg/L. Achievement of CART-derived AUC24-48h of at least 550 mg*h/L (AUC24-48h/MIC of 366 mg*h/L) was associated with a lower incidence of treatment failure. In multivariate analyses, the risk ratio was 0.45 for the CART-derived AUC24-48h threshold, indicating that achievement of the CART-derived AUC24-48h threshold of 550 was associated with a 2-fold decrease in treatment failure. These findings suggest a potential association between vancomycin exposure and outcomes in patients with MRSA BSIs with MICEtest ≥1.5 mg/L. As this study was retrospective, these findings provide the basis for a future large-scale, multi-center prospective study.
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Authors | D M Martirosov, M R Bidell, M P Pai, M H Scheetz, S L Rosenkranz, T P Lodise |
Journal | Diagnostic microbiology and infectious disease
(Diagn Microbiol Infect Dis)
Vol. 88
Issue 3
Pg. 259-263
(Jul 2017)
ISSN: 1879-0070 [Electronic] United States |
PMID | 28449844
(Publication Type: Journal Article)
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Copyright | Copyright © 2017. Published by Elsevier Inc. |
Chemical References |
- Anti-Bacterial Agents
- Vancomycin
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(pharmacology, therapeutic use)
- Bacteremia
(drug therapy, microbiology)
- Disk Diffusion Antimicrobial Tests
- Female
- Humans
- Male
- Methicillin-Resistant Staphylococcus aureus
(drug effects, isolation & purification)
- Middle Aged
- Pilot Projects
- Retrospective Studies
- Staphylococcal Infections
(drug therapy, microbiology)
- Treatment Outcome
- Vancomycin
(pharmacology, therapeutic use)
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