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- Title
Association of vancomycin trough concentration on the treatment outcome of patients with bacteremia caused by Enterococcus species.
- Authors
Sohn, Yujin; Rim, John Hoon; Cho, Yunsuk; Hyun, Jonghoon; Baek, Yaejee; Kim, Moohyun; Kim, Jung Ho; Seong, Hye; Ahn, Jin Young; Lee, Sang-Guk; Lim, Jong-Beack; Jeong, Su Jin; Ku, Nam Su; Choi, Jun Yong; Yeom, Joon-Sup; Song, Young Goo
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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
SEOUL (Korea); BACTEREMIA; STAPHYLOCOCCUS aureus infections; TREATMENT effectiveness; GRAM-positive bacterial infections; METHICILLIN-resistant staphylococcus aureus; ENTEROENDOCRINE cells; ANTIBIOTICS; RETROSPECTIVE studies; VANCOMYCIN; STAPHYLOCOCCAL diseases; ENTEROCOCCUS; MICROBIAL sensitivity tests
- Publication
BMC Infectious Diseases, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-021-06809-x