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Comparison of Clinical Outcomes for Glycopeptides and Beta-Lactams in Methicillin-Susceptible Staphylococcus Aureus Bloodstream Infections

Authors
 Yeon Ju La  ;  Hye Rim Kim  ;  Dong Hyun Oh  ;  Jin Young Ahn  ;  Yong Chan Kim 
Citation
 YONSEI MEDICAL JOURNAL, Vol.63(7) : 611-618, 2022-07 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2022-07
MeSH
Anti-Bacterial Agents / therapeutic use ; Bacteremia* / drug therapy ; Cefazolin / adverse effects ; Glycopeptides / therapeutic use ; Humans ; Methicillin / therapeutic use ; Nafcillin / adverse effects ; Retrospective Studies ; Sepsis* / complications ; Staphylococcal Infections* / complications ; Staphylococcal Infections* / drug therapy ; Staphylococcus aureus ; Teicoplanin / therapeutic use ; Vancomycin / therapeutic use ; beta-Lactams / therapeutic use
Keywords
Methicillin-susceptible Staphylococcus aureus ; beta-lactams ; bloodstream infection ; glycopeptides ; inverse probability of treatment weighting
Abstract
Purpose: This study aimed to provide compelling evidence of anti-staphylococcal beta-lactam use for methicillin-susceptible Staphylococcus aureus bloodstream infection (MSSA BSI).

Materials and methods: We retrospectively collected data on patients with MSSA BSI who were admitted to two academic tertiary-care hospitals from 2010 to 2018. Only patients who received nafcillin, cefazolin, vancomycin, or teicoplanin as definitive therapy were included. The primary outcome was 28-day mortality. To perform unbiased comparisons between both treatments, we used inverse probability of treatment weighting (IPTW) analysis.

Results: A total of 359 patients were divided into two groups based on the definitive therapy used: beta-lactams (n=203), including nafcillin or cefazolin; and glycopeptides (n=156), including vancomycin or teicoplanin. In the IPTW analysis, glycopeptides were associated with significantly increased odds of 28-day mortality (adjusted odds ratio, 3.37; 95% confidence interval, 1.71-6.61; p<0.001). The rate of primary outcome in prespecified subgroups was largely consistent with the main analysis.

Conclusion: Definitive therapy with beta-lactams in patients with MSSA BSI was associated with lower 28-day mortality compared to definitive therapy with glycopeptides.
Files in This Item:
T202202561.pdf Download
DOI
10.3349/ymj.2022.63.7.611
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Chan(김용찬)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189452
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