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Association of vancomycin trough concentration on the treatment outcome of patients with bacteremia caused by Enterococcus species
- Source :
- BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-8 (2021), BMC Infectious Diseases
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background Pharmacokinetic-pharmacodynamic (PK/PD) targets of vancomycin therapy have been recognized for methicillin-resistant Staphylococcus aureus infections but not for other gram-positive bacterial infections. Therefore, we investigated whether vancomycin concentration targets such as the trough level and ratio of the area under the curve to minimum inhibitory concentration (AUC/MIC) are associated with the treatment outcome in enterococcal bacteremia. Methods A retrospective cohort analysis enrolled patients with bacteremia caused by vancomycin-susceptible Enterococcus faecium and Enterococcus faecalis who were treated with vancomycin from January 2007 to December 2017 at a tertiary hospital located in Seoul, South Korea. Patients without vancomycin concentrations were excluded from the study. The primary outcome was 28-day all-cause mortality. Results A total of 37 patients were enrolled—26 with E. faecium infection and 11 with E. faecalis infection. The 28-day all-cause mortality rate was 21.6 %. In univariate analysis, vancomycin trough level (≤ 15 µg/mL; p = 0.042), age (p = 0.044), and septic shock (p = 0.049) were associated with 28-day mortality but not AUC24/MIC (> 389; p = 0.479). In multivariate analysis, vancomycin trough concentration (≤ 15 µg/mL; p = 0.041) and younger age (p = 0.031) were associated with 28-day mortality in patients with enterococcal bacteremia. Conclusions In this study, a vancomycin trough level of 15 µg/mL or lower was associated with 28-day mortality in enterococcal bacteremia. However, relatively large prospective studies are needed to examine the efficacy of vancomycin PK/PD parameters in patients with enterococcal bacteremia.
- Subjects :
- Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Bacteremia
Microbial Sensitivity Tests
Infectious and parasitic diseases
RC109-216
Gastroenterology
Enterococcus faecalis
Vancomycin
Internal medicine
medicine
Humans
Trough Concentration
Retrospective Studies
Trough level
biology
business.industry
Research
Area under the curve
AUC/MIC
Staphylococcal Infections
biochemical phenomena, metabolism, and nutrition
biology.organism_classification
medicine.disease
Anti-Bacterial Agents
Infectious Diseases
Treatment Outcome
Enterococcus
business
Enterococcus faecium
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....6470efb681328db25accc23fd0a83e29