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Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study

Title
Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study
Authors
Kim C.-J.Song K.-H.Park K.-H.Kim M.Choe P.G.Oh M.-D.Lee S.H.Jang H.-C.Kang S.-J.Kim H.Y.Cheon S.Kwak Y.G.Choi H.J.Kwon K.T.Jeon J.H.Kim E.S.Kim H.B.Cho J.E.Choi Y.J.Park J.I.Jung S.-I.Kim N.J.Park W.B.Kim N.-H.Lee M.J.Kim K.H.Kim Y.K.Choi H.K.Han M.S.Kim Y.-S.Cho C.R.Song H.S.Lee Y.S.Kim H.-I.Kiem S.M.Kim D.-K.Song S.-A.Kang M.J.Shin J.G.
Ewha Authors
최희정김충종
SCOPUS Author ID
최희정scopus
Issue Date
2019
Journal Title
Clinical Microbiology and Infection
ISSN
1198-743XJCR Link
Citation
Clinical Microbiology and Infection vol. 25, no. 6, pp. 723 - 732
Keywords
Antibacterial agentsbacteraemiacomplicationsStaphylococcus aureus
Publisher
Elsevier B.V.
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Objectives: 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. Methods: 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 as <14 or ≥14 days in the SS group and <28 or ≥28 days in the LW group. Results: 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). Conclusions: 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. © 2018 European Society of Clinical Microbiology and Infectious Diseases
DOI
10.1016/j.cmi.2018.09.018
Appears in Collections:
의과대학 > 의학과 > Journal papers
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