Antibiotic Choice May Not Explain Poorer Outcomes in Patients With Staphylococcus aureus Bacteremia and High Vancomycin Minimum Inhibitory Concentrations
Natasha E Holmes, John D Turnidge, Wendy J Munckhof, James O Robinson, Tony M Korman, Matthew VN O'Sullivan, Tara L Anderson, Sally A Roberts, Wei Gao, Keryn J Christiansen, Geoffrey W Coombs, Paul DR Johnson, Benjamin P Howden
Journal of Infectious Diseases | OXFORD UNIV PRESS INC | Published : 2011
BACKGROUND: There are concerns about reduced efficacy of vancomycin in patients with Staphylococcus aureus bacteremia (SAB), especially when the minimum inhibitory concentration (MIC) nears the upper limit of the susceptible range. METHODS: We examined the relationship between antibiotic treatment, 30-day mortality, and microbiologic parameters in a large Australasian cohort of patients with SAB. RESULTS: We assessed 532 patients with SAB from 8 hospitals. All patients with methicillin-resistant S. aureus (MRSA) bacteremia were treated with vancomycin, and patients with methicillin-susceptible S. aureus (MSSA) bacteremia received either flucloxacillin or vancomycin. Increasing vancomycin MIC..View full abstract
N. E. H., J. D. T., W. J. M., T. M. K., G. W. C., K. J. C., P. D. R. J., and B. P. H. have received financial support to attend the "Positive Perspectives" educational seminar sponsored by Novartis Australia. J. D. T. has received financial support from Pfizer Australia and Novartis Australia. W. J. M. has received financial support to attend the "Susceptibility and Resistance: Selecting Appropriate Therapy for Serious Gram Positive Infections" educational seminar sponsored by Novartis Australia. G. W. C. has received financial support to attend the Second Asia Pacific SMART (Study for Monitoring Antimicrobial Resistance Trends) Investigators Meeting 2010 from Merck Sharp & Dohme. B. P. H. was previously a daptomycin advisory board member for Novartis Australia. All other authors: no conflicts.Funding for microbiologic testing of the isolates was provided by the Australian Society for Antimicrobials.