Multicenter Prospective Observational Study of the Comparative Efficacy and Safety of Vancomycin versus Teicoplanin in Patients with Health Care-Associated Methicillin-Resistant Staphylococcus aureus Bacteremia

Yoon, Young Kyung; Park, Dae Won; Kim, Hyo Youl; Kim, So Hyun; Lee, Chang Seop; Lee, Mi Suk; Ryu, Seong Yeol; Jang, Hee Chang; Choi, Young Ju; Kang, Cheol In; Choi, Hee Jung; Lee, Seung Soon; Kim, Shin‐Woo; Kim, Sang Il; Kim, Eu Suk; Kim, Jeong Yeon; Yang, Kyung Sook; Peck, Kyong Ran

doi:10.1128/aac.00520-13

Cited by 44 publications

(34 citation statements)

References 36 publications

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“…31,32 The addition of gentamicin and/or rifampin to vancomycin for the treatment of MRSA bacteremia and native valve endocarditis appears to offer no meaningful benefit and to confer significant risk for harm. Addition of a β-lactam antibiotic to vancomycin or daptomycin for the treatment of MRSA bacteremia is interesting but unproven.…”

Section: Discussionmentioning

confidence: 99%

Clinical Management ofStaphylococcus aureusBacteremia

Holland

Arnold

Fowler

2014

JAMA

380

261

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Importance Several management strategies may improve outcomes in patients with Staphylococcus aureus bacteremia (SAB). The strength of evidence supporting these management strategies, however, varies widely. Objective To perform a systematic review of the evidence for two unresolved questions involving management strategies for SAB: 1) is transesophageal echocardiography (TEE) necessary in all cases of SAB; and 2) what is the optimal antibiotic therapy for methicillin resistant Staphylococcus aureus (MRSA) bacteremia? Evidence acquisition A PubMed search from inception through May 2014 was performed to find studies that addressed the role of TEE in SAB. A second search of PubMed, EMBASE, and The Cochrane Library from 1/1/1990 to 5/28/2014 was performed to find studies that addressed antibiotic treatment of MRSA bacteremia. Studies that reported outcomes of systemic antibiotic therapy for MRSA bacteremia were included. All searches were augmented by review of bibliographic references from included studies. The quality of evidence was assessed using the GRADE system by consensus of independent evaluations by at least two authors. Results In 9 studies with a total of 3513 patients, use of TEE was associated with higher rates of diagnosis of endocarditis (14–25%) when compared with TTE (2–14%). Five studies proposed criteria to identify patients in whom TEE might safely be avoided. Only one high-quality trial of antibiotic therapy for MRSA bacteremia was identified from the 83 studies considered. Conclusions and relevance Most contemporary management strategies for SAB are based upon low quality evidence. TEE is indicated in most patients with SAB. It may be possible to identify a subset of SAB patients for whom TEE can be safely avoided. Vancomycin and daptomycin are the first-line antibiotic choices for MRSA bacteremia. Well-designed studies to address the management of SAB are desperately needed.

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Section: Discussionmentioning

confidence: 99%

Clinical Management ofStaphylococcus aureusBacteremia

Holland

Arnold

Fowler

2014

JAMA

380

261

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“…These results can be explained by inadequate dosing of teicoplanin secondary to greater protein binding compared with vancomycin. Recent data and meta-analysis suggest that teicoplanin may not be inferior to vancomycin [6]. One meta-analysis noted a lower risk of nephrotoxicity with teicoplanin than with vancomycin [5].…”

Section: Teicoplaninmentioning

confidence: 99%

Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia

2016

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Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available.

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“…In addition, most studies have focused on MRSA, but the role of vancomycin MIC in MSSA infection has not been fully evaluated. A number of studies, including systematic reviews and meta-analyses, have demonstrated increased mortality in the setting of SAB with vancomycin MICs of Ն2.0 g/ml (21)(22)(23)(24)(25)(26)(27)(28). Conversely, others have shown an increased risk of mortality in individuals with MICs of Ͻ2.0 g/ml (29)(30)(31)(32).…”

mentioning

confidence: 99%

Vancomycin MIC Does Not Predict 90-Day Mortality, Readmission, or Recurrence in a Prospective Cohort of Adults with Staphylococcus aureus Bacteremia

Baxi

Clemenzi-Allen

Gahbauer

et al. 2016

Antimicrob Agents Chemother

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Staphylococcus aureus is a leading cause of bacteremia (1, 2). Even when an individual is appropriately treated, the risk of mortality from S. aureus bacteremia (SAB) is 20 to 40% per episode (3-8). Furthermore, the morbidity from SAB is striking, with 10 to 15% of episodes being complicated by endocarditis or a risk of metastatic disease elsewhere in the body (9, 10). The financial consequences of SAB are also significant, with health care costs ranging from $12,078 to $25,573 per episode of SAB (11-13). Typically, SAB is treated with narrow-spectrum beta-lactam antibiotics for methicillin-susceptible S. aureus (MSSA) isolates and the glycopeptide antibiotic vancomycin for methicillin-resistant S. aureus (MRSA) isolates (14-17). Isolates with vancomycin MICs of Յ2 g/ml are considered susceptible, those with MICs of 4 to 8 g/ml are considered intermediately resistant, and those with MICs of Ͼ8 g/ml are designated resistant (18). The question of whether infection by S. aureus strains with vancomycin MICs of 2 g/ml is associated with worse outcomes has been a topic of much research, although a consensus has not been reached. Compared with research methods such as Epsilometer testing (Etest) or broth microdilution (BMD), automated MIC measurements can be off by 1 dilution in either direction (e.g., a value of 2 g/ml could mean 1 or 4 g/ml if repeated) (19,20), which adds to the deliberation over interpreting study results, although consistency between BMD and Etest results can also vary. In addition, most studies have focused on MRSA, but the role of vancomycin MIC in MSSA infection has not been fully evaluated. A number of studies, including systematic reviews and meta-analyses, have demonstrated increased mortality in the setting of SAB with vancomycin MICs of Ն2.0 g/ml (21-28). Conversely, others have shown an increased risk of mortality in individuals with MICs of Ͻ2.0 g/ml (29-32). In spite of these data, the majority of studies have failed to show any significant increase in the risk of mortality attributable to vancomycin MIC (5,26,. A recent rigorous meta-analysis failed to demonstrate increased 30-day or in-hospital mortality attributable to vancomycin MIC, irrespective of the MIC cutoff that was chosen (1.5, 2.0, 4.0, or 8.0 g/ml) (5). Although valuable, meta-analyses are lim-

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Multicenter Prospective Observational Study of the Comparative Efficacy and Safety of Vancomycin versus Teicoplanin in Patients with Health Care-Associated Methicillin-Resistant Staphylococcus aureus Bacteremia

Cited by 44 publications

References 36 publications

Clinical Management ofStaphylococcus aureusBacteremia

Clinical Management ofStaphylococcus aureusBacteremia

Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia

Vancomycin MIC Does Not Predict 90-Day Mortality, Readmission, or Recurrence in a Prospective Cohort of Adults with Staphylococcus aureus Bacteremia

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