Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it>
<p>Abstract</p> <p>Background</p> <p>No studies have evaluated the effect of guideline-recommended weight-based dosing on in-hospital mortality of patients with methicillin-resistant <it>Staphylococcus aureus</it> bacteremia.</p> <p>Methods</p...
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| Format: | Article |
| Language: | English |
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BMC
2012-04-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://www.biomedcentral.com/1471-2334/12/104 |
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| author | Hall Ronald G Giuliano Christopher A Haase Krystal K Hazlewood Kathleen A Frei Chistopher R Forcade Nicolas A Brouse Sara D Bell Todd Bedimo Roger J Alvarez Carlos A |
| author_facet | Hall Ronald G Giuliano Christopher A Haase Krystal K Hazlewood Kathleen A Frei Chistopher R Forcade Nicolas A Brouse Sara D Bell Todd Bedimo Roger J Alvarez Carlos A |
| author_sort | Hall Ronald G |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>No studies have evaluated the effect of guideline-recommended weight-based dosing on in-hospital mortality of patients with methicillin-resistant <it>Staphylococcus aureus</it> bacteremia.</p> <p>Methods</p> <p>This was a multicenter, retrospective, cohort study of patients with methicillin-resistant <it>Staphylococcus aureus</it> bacteremia receiving at least 48 hours of empiric vancomycin therapy between 01/07/2002 and 30/06/2008. We compared in-hospital mortality for patients treated empirically with weight-based, guideline-recommended vancomycin doses (at least 15 mg/kg/dose) to those treated with less than 15 mg/kg/dose. We used a general linear mixed multivariable model analysis with variables identified a priori through a conceptual framework based on the literature.</p> <p>Results</p> <p>A total of 337 patients who were admitted to the three hospitals were included in the cohort. One-third of patients received vancomycin empirically at the guideline-recommended dose. Guideline-recommended dosing was not associated with in-hospital mortality in the univariable (16% vs. 13%, OR 1.26 [95%CI 0.67-2.39]) or multivariable (OR 0.71, 95%CI 0.33-1.55) analysis. Independent predictors of in-hospital mortality were ICU admission, Pitt bacteremia score of 4 or greater, age 53 years or greater, and nephrotoxicity.</p> <p>Conclusions</p> <p>Empiric use of weight-based, guideline-recommended empiric vancomycin dosing was not associated with reduced mortality in this multicenter study.</p> |
| first_indexed | 2024-12-11T03:48:54Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-11T03:48:54Z |
| publishDate | 2012-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-c6845bb065b14cc99cf49defa248742d2022-12-22T01:21:57ZengBMCBMC Infectious Diseases1471-23342012-04-0112110410.1186/1471-2334-12-104Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it>Hall Ronald GGiuliano Christopher AHaase Krystal KHazlewood Kathleen AFrei Chistopher RForcade Nicolas ABrouse Sara DBell ToddBedimo Roger JAlvarez Carlos A<p>Abstract</p> <p>Background</p> <p>No studies have evaluated the effect of guideline-recommended weight-based dosing on in-hospital mortality of patients with methicillin-resistant <it>Staphylococcus aureus</it> bacteremia.</p> <p>Methods</p> <p>This was a multicenter, retrospective, cohort study of patients with methicillin-resistant <it>Staphylococcus aureus</it> bacteremia receiving at least 48 hours of empiric vancomycin therapy between 01/07/2002 and 30/06/2008. We compared in-hospital mortality for patients treated empirically with weight-based, guideline-recommended vancomycin doses (at least 15 mg/kg/dose) to those treated with less than 15 mg/kg/dose. We used a general linear mixed multivariable model analysis with variables identified a priori through a conceptual framework based on the literature.</p> <p>Results</p> <p>A total of 337 patients who were admitted to the three hospitals were included in the cohort. One-third of patients received vancomycin empirically at the guideline-recommended dose. Guideline-recommended dosing was not associated with in-hospital mortality in the univariable (16% vs. 13%, OR 1.26 [95%CI 0.67-2.39]) or multivariable (OR 0.71, 95%CI 0.33-1.55) analysis. Independent predictors of in-hospital mortality were ICU admission, Pitt bacteremia score of 4 or greater, age 53 years or greater, and nephrotoxicity.</p> <p>Conclusions</p> <p>Empiric use of weight-based, guideline-recommended empiric vancomycin dosing was not associated with reduced mortality in this multicenter study.</p>http://www.biomedcentral.com/1471-2334/12/104WeightObesityEfficacyMRSAVancomycinBacteremia |
| spellingShingle | Hall Ronald G Giuliano Christopher A Haase Krystal K Hazlewood Kathleen A Frei Chistopher R Forcade Nicolas A Brouse Sara D Bell Todd Bedimo Roger J Alvarez Carlos A Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it> BMC Infectious Diseases Weight Obesity Efficacy MRSA Vancomycin Bacteremia |
| title | Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it> |
| title_full | Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it> |
| title_fullStr | Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it> |
| title_full_unstemmed | Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it> |
| title_short | Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant <it>Staphylococcus aureus bacteremia: a retrospective cohort study</it> |
| title_sort | empiric guideline recommended weight based vancomycin dosing and mortality in methicillin resistant it staphylococcus aureus bacteremia a retrospective cohort study it |
| topic | Weight Obesity Efficacy MRSA Vancomycin Bacteremia |
| url | http://www.biomedcentral.com/1471-2334/12/104 |
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