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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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Thorlacius-Ussing, Louise ; Sandholdt, Håkon ; Nissen, Jette ; Rasmussen, Jon ; Skov, Robert ; Frimodt-Møller, Niels ; Dahl Knudsen, Jenny ; Østergaard, Christian ; Benfield, Thomas. / Comparable outcomes of short-course and prolonged-course therapy in selected cases of methicillin-susceptible Staphylococcus aureus bacteremia:A pooled cohort study. In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2021 ; Vol. 73, No. 5. pp. 866-872.

Bibtex

@article{e38f3a7f2c1a430d94d77f8cbae8277c,
title = "Comparable outcomes of short-course and prolonged-course therapy in selected cases of methicillin-susceptible Staphylococcus aureus bacteremia:A pooled cohort study",
abstract = "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.",
keywords = "Adult, Anti-Bacterial Agents/therapeutic use, Bacteremia/drug therapy, Cohort Studies, Humans, Methicillin/pharmacology, Retrospective Studies, Staphylococcal Infections/drug therapy, Staphylococcus aureus, treatment, short-course, duration, bacteremia",
author = "Louise Thorlacius-Ussing and H{\aa}kon Sandholdt and Jette Nissen and Jon Rasmussen and Robert Skov and Niels Frimodt-M{\o}ller and {Dahl Knudsen}, Jenny and Christian {\O}stergaard and Thomas Benfield",
note = "{\textcopyright} The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.",
year = "2021",
month = sep,
day = "1",
doi = "10.1093/cid/ciab201",
language = "English",
volume = "73",
pages = "866--872",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "University of Chicago Press",
number = "5",

}

RIS

TY - JOUR

T1 - Comparable outcomes of short-course and prolonged-course therapy in selected cases of methicillin-susceptible Staphylococcus aureus bacteremia:A pooled cohort study

AU - Thorlacius-Ussing, Louise

AU - Sandholdt, Håkon

AU - Nissen, Jette

AU - Rasmussen, Jon

AU - Skov, Robert

AU - Frimodt-Møller, Niels

AU - Dahl Knudsen, Jenny

AU - Østergaard, Christian

AU - Benfield, Thomas

N1 - © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - 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.

AB - 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.

KW - Adult

KW - Anti-Bacterial Agents/therapeutic use

KW - Bacteremia/drug therapy

KW - Cohort Studies

KW - Humans

KW - Methicillin/pharmacology

KW - Retrospective Studies

KW - Staphylococcal Infections/drug therapy

KW - Staphylococcus aureus

KW - treatment

KW - short-course

KW - duration

KW - bacteremia

UR - http://www.scopus.com/inward/record.url?scp=85116390548&partnerID=8YFLogxK

U2 - 10.1093/cid/ciab201

DO - 10.1093/cid/ciab201

M3 - Journal article

C2 - 33677515

VL - 73

SP - 866

EP - 872

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 5

ER -

ID: 64082839