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- Title
Comparison of Vancomycin Treatment Failures for Methicillin-Resistant Staphylococcus aureus Bacteremia Stratified by Minimum Inhibitory Concentration.
- Authors
Wingler, Mary Joyce B.; T. Childress, Darrell; Maldonado, Ricardo A.
- Abstract
Background: Optimal treatment of methicillin-resistant Staphylococcus aureus bacteremias (MRSABs) with vancomycin minimum inhibitory concentrations (MICs) high within the susceptible range is of concern due to the high rate of mortality and increased prevalence. Objective: The purpose of this study is to evaluate vancomycin treatment failures in patients with MRSAB stratified by vancomycin MIC. Methods: In this retrospective chart review, patients ≥19 years of age with MRSAB between July 2010 and December 2016 were included if they received intravenous vancomycin for ≥72 hours. Vancomycin treatment failures were compared between patients with vancomycin MICs of ≤1 mg/L and 2 mg/L. Vancomycin treatment failure was defined as microbiological failure at 7 days. Inpatient mortality, 30-day readmission, vancomycin-associated nephrotoxicity, and early bacteremia clearance at 48 to 96 hours were assessed as secondary endpoints. Results: Fifty-eight patients were included in the vancomycin MIC ≤1 mg/L group and 22 patients in the vancomycin MIC 2 mg/L group. No significant difference was found in vancomycin treatment failures at 7 days between groups (88% vs 91%, respectively; P =.850). At 96 hours, there was no significant difference in vancomycin treatment failures between groups (72% vs 90%, respectively; P =.127). No significant difference was found in mortality (P >.99) or 30-day readmission (P >.99). Conclusions: In this study, vancomycin treatment failures were not more prevalent in patients with vancomycin MIC of 2 mg/L at 7 days. Regardless of MIC, antibiotics should be switched to an alternative agent at 7 days for persistent bacteremia.
- Subjects
NEPHROTOXICOLOGY; STAPHYLOCOCCAL diseases; TREATMENT effectiveness; VANCOMYCIN; RETROSPECTIVE studies; PATIENT readmissions; METHICILLIN-resistant staphylococcus aureus; DESCRIPTIVE statistics; HOSPITAL mortality; PHARMACODYNAMICS
- Publication
Journal of Pharmacy Technology, 2019, Vol 35, Issue 5, p203
- ISSN
8755-1225
- Publication type
Article
- DOI
10.1177/8755122519852679