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KMID : 0311120220630070611
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Yonsei Medical Journal
2022 Volume.63 No. 7 p.611 ~ p.628
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Comparison of Clinical Outcomes for Glycopeptides and Beta-Lactams in Methicillin-Susceptible Staphylococcus Aureus Bloodstream Infections
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La Yeon-Ju
Kim Hye-Rim
Oh Dong-Hyun
Ahn Jin-Young
Kim Yong-Chan
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Abstract
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Purpose: This study aimed to provide compelling evidence of anti-staphylococcal beta-lactam use for methicillin-susceptibleStaphylococcus aureus bloodstream infection (MSSA BSI).
Materials and Methods: We retrospectively collected data on patients with MSSA BSI who were admitted to two academic tertia ry-care hospitals from 2010 to 2018. Only patients who received nafcillin, cefazolin, vancomycin, or teicoplanin as definitive ther apy were included. The primary outcome was 28-day mortality. To perform unbiased comparisons between both treatments, weused 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), includ ing nafcillin or cefazolin; and glycopeptides (n=156), including vancomycin or teicoplanin. In the IPTW analysis, glycopeptideswere 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 com pared to definitive therapy with glycopeptides.
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KEYWORD
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Methicillin-susceptible Staphylococcus aureus, bloodstream infection, beta-lactams, glycopeptides, inverse probability of treatment weighting
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