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Comparable outcomes of short-course and prolonged-course therapy in selected cases of methicillin-susceptible Staphylococcus aureus bacteremia:A pooled cohort study

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  • Louise Thorlacius-Ussing
  • Håkon Sandholdt
  • Jette Nissen
  • Jon Rasmussen
  • Robert Skov
  • Niels Frimodt-Møller
  • Jenny Dahl Knudsen
  • Christian Østergaard
  • Thomas Benfield
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BACKGROUND: The recommended duration of antimicrobial treatment for Staphylococcus aureus bacteremia (SAB) is a minimum of 14 days. We compared the clinical outcomes of patients receiving short-course (SC; 6-10 days), or prolonged-course (PC; 11-16 days) antibiotic therapy for low-risk methicillin-susceptible SAB (MS-SAB).

METHODS: Adults with MS-SAB in 1995-2018 were included from 3 independent retrospective cohorts. Logistic regression models fitted with inverse probability of treatment weighting were used to assess the association between the primary outcome of 90-day mortality and treatment duration for the individual cohorts as well as a pooled cohort analysis.

RESULTS: A total of 645, 219, and 141 patients with low-risk MS-SAB were included from cohorts I, II, and III. Median treatment duration in the 3 SC groups was 8 days (interquartile range [IQR], 7-10), 9 days (IQR, 8-10), and 8 days (IQR, 7-10). In the PC groups, patients received a median therapy of 14 days (IQR, 13-15), 14 days (IQR, 13-15), and 13 days (IQR, 12-15). No significant differences in 90-day mortality were observed between the SC and PC group in cohort I (odds ratio [OR], 0.85 [95% confidence interval {CI}, .49-1.41]), cohort II (OR, 1.24 [95% CI, .60-2.62]), or cohort III (OR, 1.15 [95% CI, .24-4.01]). This result was consistent in the pooled cohort analysis (OR, 1.05 [95% CI, .71-1.51]). Furthermore, duration of therapy was not associated with the risk of relapse.

CONCLUSIONS: In patients with low-risk MS-SAB, shorter courses of antimicrobial therapy yielded similar clinical outcomes as longer courses of therapy.

Original languageEnglish
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume73
Issue number5
Pages (from-to)866-872
Number of pages7
ISSN1058-4838
DOIs
Publication statusPublished - 1 Sep 2021

    Research areas

  • Adult, Anti-Bacterial Agents/therapeutic use, Bacteremia/drug therapy, Cohort Studies, Humans, Methicillin/pharmacology, Retrospective Studies, Staphylococcal Infections/drug therapy, Staphylococcus aureus

ID: 64082839