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Impact of initial antibiotic choice and delayed appropriate treatment on the outcome of Staphylococcus aureus bacteremia

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Abstract

The study presented here investigated the impact of initial antibiotic choice (β-lactams vs vancomycin) on the outcome of 342 patients with Staphylococcus aureus bacteremia (50.9% with methicillin-resistant isolates) encountered between 1 January 2002 and 30 June 2003. Initial antibiotics were inappropriate (β-lactams) in 60 (34.5%) methicillin-resistant cases and suboptimal (vancomycin) in 62 (36.9%) methicillin-susceptible cases. Time to effective antibiotic therapy was longer in methicillin-resistant cases (25.5±28.6 vs 9.6±16.6 h; p<0.0005). All-cause in-hospital mortality was higher with inappropriate therapy (35.0 vs 20.9%; p=0.02). Initial vancomycin treatment was associated with a higher incidence of delayed clearance (≥3 days) of methicillin-susceptible bacteremia (56.3 vs 37.0%; p=0.03). The results indicate inappropriate initial therapy is associated with higher in-hospital mortality and initial vancomycin may delay clearance.

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Acknowledgement

This study was supported by Medical Education Funds, St John Hospital & Medical Center.

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Authors and Affiliations

  1. Section of Infectious Diseases, Department of Medicine, St John Hospital & Medical Center, 22101 Moross Road, Detroit, MI, 48236, USA

    R. Khatib, S. Saeed, M. Sharma, K. Riederer, M. G. Fakih & L. B. Johnson

  2. Wayne State University, School of Medicine, Medical Education, St John Hospital & Medical Center, 22101 Moross Road, Detroit, MI, 48236, USA

    R. Khatib, M. Sharma, M. G. Fakih & L. B. Johnson

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  1. R. Khatib
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  2. S. Saeed
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  3. M. Sharma
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  4. K. Riederer
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  5. M. G. Fakih
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  6. L. B. Johnson
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Correspondence to R. Khatib.

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Khatib, R., Saeed, S., Sharma, M. et al. Impact of initial antibiotic choice and delayed appropriate treatment on the outcome of Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis 25, 181–185 (2006). https://doi.org/10.1007/s10096-006-0096-0

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