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A Retrospective Cohort Study Comparing Dual Therapy With Ceftaroline With Vancomycin or Daptomycin Monotherapy for High-Grade or Persistent MRSA Bacteremia.
Cabanilla, M Gabriela; Bernauer, Michael L; Briski, Matthew J; Atallah, Liana M; Koury, Jason; Thompson, Cecilia M; Rodriguez, Chelsea N; Jakeman, Bernadette; Byrd, Thomas F.
Afiliación
  • Cabanilla MG; Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
  • Bernauer ML; Department of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
  • Briski MJ; Independent Researcher, Albuquerque, NM, USA.
  • Atallah LM; Department of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
  • Koury J; Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
  • Thompson CM; Department of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
  • Rodriguez CN; TriCore Reference Laboratories, Albuquerque, NM, USA.
  • Jakeman B; Department of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
  • Byrd TF; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM, USA.
J Pharm Technol ; 40(3): 134-141, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38784026
ABSTRACT

Background:

Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious clinical infection associated with a high risk of mortality. Dual therapy is often used in patients with persistent bacteremia.

Objective:

This study aimed to compare the outcomes of vancomycin or daptomycin monotherapy with those of dual therapy with ceftaroline in high-grade or persistent MRSA bacteremia.

Methods:

We conducted a retrospective cohort study at a university teaching hospital between January 2014 and June 2021, involving adults initially treated with vancomycin or daptomycin. Patients were categorized into monotherapy and dual therapy groups. The primary outcome was 30-day mortality. Secondary outcomes included microbiological relapse and antibiotic-related adverse events.

Results:

In a group of 155 patients, 30-day mortality rates were similar between the monotherapy (23.4%) and dual therapy (22.6%) groups, with comparable microbiological relapse rates (6.5%). In inverse probability of treatment weighting analysis, we found no significant association between dual therapy and mortality (adjusted risk ratio [ARR] 1.38, 95% CI 0.64-2.41, P = 0.38) or microbiological relapse (ARR 0.95, 95% CI 0.31-2.73, P = 0.93). Dual therapy was associated with a lower risk of antibiotic-related adverse events (ARR 0.45, 95% CI 0.21-0.89, P = 0.02). Infectious diseases (ID) consultation was associated with a reduced mortality risk (ARR 0.27, 95% CI 0.07-0.95, P = 0.04).

Conclusions:

Dual therapy with ceftaroline did not reduce mortality risk compared with monotherapy in patients with MRSA bacteremia. However, patients with ID consultations showed a 73% reduction in mortality rates. Large-scale, prospective, and randomized controlled trials are needed to provide conclusive evidence regarding the potential benefits of dual therapy with ceftaroline for MRSA bacteremia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pharm Technol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pharm Technol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos