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Rebound Inverts the Staphylococcus aureus Bacteremia Prevention Effect of Antibiotic Based Decontamination Interventions in ICU Cohorts with Prolonged Length of Stay.
- Source :
- Antibiotics (2079-6382); Apr2024, Vol. 13 Issue 4, p316, 28p
- Publication Year :
- 2024
-
Abstract
- Could rebound explain the paradoxical lack of prevention effect against Staphylococcus aureus blood stream infections (BSIs) with antibiotic-based decontamination intervention (BDI) methods among studies of ICU patients within the literature? Two meta-regression models were applied, each versus the group mean length of stay (LOS). Firstly, the prevention effects against S. aureus BSI [and S. aureus VAP] among 136 studies of antibiotic-BDI versus other interventions were analyzed. Secondly, the S. aureus BSI [and S. aureus VAP] incidence in 268 control and intervention cohorts from studies of antibiotic-BDI versus that among 165 observational cohorts as a benchmark was modelled. In model one, the meta-regression line versus group mean LOS crossed the null, with the antibiotic-BDI prevention effect against S. aureus BSI at mean LOS day 7 (OR 0.45; 0.30 to 0.68) inverted at mean LOS day 20 (OR 1.7; 1.1 to 2.6). In model two, the meta-regression line versus group mean LOS crossed the benchmark line, and the predicted S. aureus BSI incidence for antibiotic-BDI groups was 0.47; 0.09–0.84 percentage points below versus 3.0; 0.12–5.9 above the benchmark in studies with 7 versus 20 days mean LOS, respectively. Rebound within the intervention groups attenuated and inverted the prevention effect of antibiotic-BDI against S. aureus VAP and BSI, respectively. This explains the paradoxical findings. [ABSTRACT FROM AUTHOR]
- Subjects :
- STAPHYLOCOCCUS aureus
LENGTH of stay in hospitals
BACTEREMIA
ANTIBIOTICS
Subjects
Details
- Language :
- English
- ISSN :
- 20796382
- Volume :
- 13
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Antibiotics (2079-6382)
- Publication Type :
- Academic Journal
- Accession number :
- 176875229
- Full Text :
- https://doi.org/10.3390/antibiotics13040316