Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study
- 주제(키워드) Antibacterial agents , bacteraemia , complications , Staphylococcus aureus
- 주제(기타) Infectious Diseases; Microbiology
- 설명문(일반) [Kim, C. -J.; Choi, H. J.] Ewha Womans Univ, Sch Med, Dept Internal Med, Div Infect Dis, Seoul, South Korea; [Song, K. -H.; Kim, M.; Kim, E. S.; Kim, H. B.] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Seognnam, South Korea; [Song, K. -H.; Choe, P. G.; Oh, M. -D.; Kim, E. S.; Kim, H. B.] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Park, K. -H.] Chonnam Natl Univ Hosp, Dept Infect Dis, Gwangju, South Korea; [Choe, P. G.; Oh, M. -D.] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Lee, S. H.] Pusan Natl Univ, Sch Med, Dept Internal Med, Busan, South Korea; [Lee, S. H.] Pusan Natl Univ Hosp, Med Res Inst, Busan, South Korea; [Jang, H. -C.; Kang, S. -J.] Chonnam Natl Univ, Hwasun Hosp, Dept Internal Med, Hwasun, South Korea; [Kim, H. Y.] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Wonju, South Korea; [Cheon, S.] Chungnam Natl Univ, Sch Med, Dept Internal Med, Div Infect Dis, Daejon, South Korea; [Kwak, Y. G.] Inje Univ, Ilsan Paik Hosp, Dept Internal Med, Goyang, South Korea; [Kwon, K. T.] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea; [Jeon, J. H.; Kiem, S. M.; Kim, D. -K.; Song, S. -A.; Kang, M. J.; Shin, J. G.] Inje Univ, Haeundae Paik Hosp, Busan, South Korea; [Cho, J. E.; Choi, Y. J.; Park, J. I.] Seoul Natl Univ, Bundang Hosp, Seongnam, Gyeonggi Do, South Korea; [Jung, S. -I.; Kim, Y. -S.] Chonnam Natl Univ Hosp, Gwangju, South Korea; [Kim, N. J.; Park, W. B.; Kim, N. -H.; Lee, M. J.] Seoul Natl Univ Hosp, Seoul, South Korea; [Kim, K. H.] Pusan Natl Univ Hosp, Busan, South Korea; [Kim, Y. K.; Choi, H. K.; Han, M. S.] Yonsei Univ, Wonju Coll Med, Wonju, South Korea; [Cho, C. R.; Song, H. S.; Lee, Y. S.] Inje Univ, Ilsan Paik Hosp, Goyang, South Korea; [Kim, H. -I.] Daegu Fatima Hosp, Daegu, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Bronze
- 발행기관 ELSEVIER SCI LTD
- 발행년도 2019
- URI http://www.dcollection.net/handler/ewha/000000159896
- 본문언어 영어
- Published As http://dx.doi.org/10.1016/j.cmi.2018.09.018
- PubMed https://pubmed.ncbi.nlm.nih.gov/30287412
초록/요약
Objectives: 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. Methods: 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 as < 14 or >= 14 days in the SS group and < 28 or >= 28 days in the LW group. Results: 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). Conclusions: 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. (c) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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