Uncomplicated Staphylococcus aureus Bacteremia Treatment Duration and Outcomes at an Academic Medical Center

Taupin, Daniel; Karchmer, Adolf W.; Davis, Roger B.; LaSalvia, Mary T.

doi:10.1093/ofid/ofaa457

Cited by 3 publications

(10 citation statements)

References 11 publications

(16 reference statements)

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“…In addition, there were clinical and statistically significant differences in basal characteristics between groups, which could have resulted in selection bias. In the study by Taupin et al , 22 there were no differences in variables such as age, sex, sensitivity to oxacillin, and community origin, but there were differences in terms of immunosuppression and the presence of valvular heart disease, which were greater in the long-course group. In the study by Chong et al , 23 no differences were found in both comparisons regarding age, sex, community origin, antibiotic treatment, MRSA isolation, and comorbidities such as diabetes mellitus (DM), immunosuppression, hemodialysis dependence, liver cirrhosis, prosthetic device, among others.…”

Section: Resultsmentioning

confidence: 85%

“…A total of 3146 individual studies were identified, of which 6 non-RCTs 22 – 27 with a total of 1700 patients were finally included. No RCTs met the inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…No RCTs met the inclusion criteria. Of the selected studies, four were retrospective cohorts 22 , 25 – 27 conducted in Switzerland, Denmark, the Netherlands, and the United States. Another study was a prospective cohort 23 from South Korea, and finally one was a post hoc analysis 24 from the United Kingdom.…”

Section: Resultsmentioning

confidence: 99%

“…Some studies 22 – 25 did not evaluate confounding factors like patients’ clinical status or comorbidities. In addition, there were clinical and statistically significant differences in basal characteristics between groups, which could have resulted in selection bias.…”

Section: Resultsmentioning

confidence: 99%

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Short-term versus usual-term antibiotic treatment for uncomplicated Staphylococcus aureus bacteremia: a systematic review and meta-analysis

Grillo Perez,

Diaz-Brochero,

Garzon Herazo

et al. 2024

Therapeutic Advances in Infection

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Introduction: Uncomplicated Staphylococcus aureus bacteremia remains a leading cause of morbidity and mortality in hospitalized patients. Current guidelines recommend a minimum of 14 days of treatment. Objective: To evaluate the efficacy and safety of short versus usual antibiotic therapy in adults with uncomplicated S. aureus bacteremia (SAB). Methods: We developed a search strategy to identify systematic review and meta-analysis of non-randomized studies (NRS), comparing short versus usual or long antibiotic regimens for uncomplicated SAB in MEDLINE, Embase, and the Cochrane Register up to June 2023. The risk of bias was assessed using the ROBINS I tool. The meta-analysis was performed using Review Manager software with a random effect model. Results: Six NRS with a total of 1700 patients were included. No significant differences were found when comparing short versus prolonged antibiotic therapy as defined by the authors for 90-day mortality [odds ratio (OR): 1.09; 95% confidence interval (CI): 0.82–1.46, p: 0.55; I2 = 0%] or 90-day recurrence or relapse of bacteremia [OR: 0.72; 95% CI: 0.31–1.68, p: 0.45; I2 = 26%]. Sensitivity analysis showed similar results when comparing a predefined duration of <14 days versus ⩾14 days and when excluding the only study with a high risk of bias. Conclusion: Shorter-duration regimens could be considered as an alternative option for uncomplicated SAB in low-risk cases. However, based on a small number of studies with significant methodological limitations and risk of bias, the benefits and harms of shorter regimens should be analyzed with caution. Randomized clinical trials are needed to determine the best approach regarding the optimal duration of therapy.

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Section: Resultsmentioning

confidence: 85%

“…A total of 3146 individual studies were identified, of which 6 non-RCTs 22 – 27 with a total of 1700 patients were finally included. No RCTs met the inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Short-term versus usual-term antibiotic treatment for uncomplicated Staphylococcus aureus bacteremia: a systematic review and meta-analysis

Grillo Perez,

Diaz-Brochero,

Garzon Herazo

et al. 2024

Therapeutic Advances in Infection

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“…Consequently, there is likely to be systematic difference in the clinical management of CRBI conditional on the organism type. The perception by clinicians that MSSA and MRSA CRBIs are associated with poorer outcomes may encourage clinicians to adopt a more aggressive strategy of hospital admission, prescription of a longer course of intravenous antibiotics (typically at least 14 days for uncomplicated Staphylococcus aureus bacteraemia 9 ) and prompt removal of vascular catheters, which is reflected in our study showing a greater likelihood of hospital admission and a shorter median time to catheter removal in patients with Gram positive CRBI 10 . Even though our study did not demonstrate a difference in the risk of metastatic infection and death from CRBI between organism types, it is noteworthy that almost 20% of CRBI required ICU admission, had evidence of metastatic infection or had died from CRBI.…”

Section: Discussionmentioning

confidence: 99%

Haemodialysis vascular catheter‐related blood stream infection: Organism types and clinical outcomes

et al. 2023

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Catheter‐related bloodstream infection (CRBI) is an important complication of catheter use for haemodialysis, but it remains unclear whether clinical outcomes following CRBI are influenced by organism type. This study aims to compare clinical outcomes following CRBI from Gram‐positive and non‐Gram‐positive organisms. This was a retrospective cohort study of patients with kidney failure receiving haemodialysis (HD) via vascular catheters who had a documented episode of CRBI in Western Australia between 2005 and 2018. The associations between organism type, likelihood of hospitalization, catheter removal and death from CRBI were examined using adjusted logistic regression models. There were 111 episodes of CRBI in 99 patients (6.1 episodes per 1000‐catheter‐days at risk). Of the study cohort, 53 (48%) were male and 38 (34%) identified as Aboriginal or Torres Strait Islander. Gram‐positive organisms were identified in 73 (66%) CRBI episodes, most commonly Staphylococcus aureus. Of those with non‐Gram‐positive CRBI, 9 (24%) were attributed to Pseudomonas aeruginosa. One‐hundred and two (92%) episodes of CRBI required hospitalization and 15 (13%) patients died from CRBI. Compared with non‐Gram‐positive CRBI, Gram‐positive CRBI was associated with an increased risk of hospitalization and catheter removal, with adjusted odds ratio of 9.34 (95% CI 1.28–68.03) and 3.47 (95% CI 1.25–9.67), respectively. There was no association between organism type and death from CRBI. Staphylococcus aureus remains the most common organism causing CRBI in HD patients. CRBI is associated with substantial morbidity, particularly CRBI attributed to Gram‐positive organisms.

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Long versus short course anti-microbial therapy of uncomplicated Staphylococcus aureus bacteraemia: a systematic review

Schnizer,

Schellong,

Rose

et al. 2024

Clinical Microbiology and Infection

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Uncomplicated Staphylococcus aureus Bacteremia Treatment Duration and Outcomes at an Academic Medical Center

Cited by 3 publications

References 11 publications

Short-term versus usual-term antibiotic treatment for uncomplicated Staphylococcus aureus bacteremia: a systematic review and meta-analysis

Short-term versus usual-term antibiotic treatment for uncomplicated Staphylococcus aureus bacteremia: a systematic review and meta-analysis

Haemodialysis vascular catheter‐related blood stream infection: Organism types and clinical outcomes

Long versus short course anti-microbial therapy of uncomplicated Staphylococcus aureus bacteraemia: a systematic review

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