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Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study
- Source :
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 25(6)
- Publication Year :
- 2018
-
Abstract
- 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.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 as14 or ≥14 days in the SS group and28 or ≥28 days in the LW group.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).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.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Adult
Male
medicine.medical_specialty
Staphylococcus aureus
Multivariate analysis
Time Factors
Adolescent
medicine.drug_class
medicine.medical_treatment
030106 microbiology
Antibiotics
Bacteremia
Prosthesis
03 medical and health sciences
Young Adult
0302 clinical medicine
Anti-Infective Agents
Recurrence
Internal medicine
Medicine
Endocarditis
Humans
030212 general & internal medicine
Prospective Studies
Aged
First episode
Aged, 80 and over
business.industry
General Medicine
Middle Aged
Staphylococcal Infections
medicine.disease
Survival Analysis
Confidence interval
Pneumonia
Infectious Diseases
Treatment Outcome
Female
business
Cohort study
Subjects
Details
- ISSN :
- 14690691
- Volume :
- 25
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
- Accession number :
- edsair.doi.dedup.....f0cea578714e6f8cc3d8ee8c4b43321b