Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia
There is a paucity of literature describing de-escalation techniques in patients with polymicrobial infections with one offending organism being methicillin-susceptible Staphylococcus aureus (MSSA) being treated with β-lactam therapy. The purpose of this study is to determine treatment outcomes for...
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| Format: | Article |
| Language: | English |
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Hindawi Limited
2023-01-01
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| Series: | Advances in Pharmacological and Pharmaceutical Sciences |
| Online Access: | http://dx.doi.org/10.1155/2023/7684613 |
| _version_ | 1797398796996444160 |
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| author | Laila M. Najia Eric Pyles Arnaldo Lopez-Ruiz Bibidh Subedi |
| author_facet | Laila M. Najia Eric Pyles Arnaldo Lopez-Ruiz Bibidh Subedi |
| author_sort | Laila M. Najia |
| collection | DOAJ |
| description | There is a paucity of literature describing de-escalation techniques in patients with polymicrobial infections with one offending organism being methicillin-susceptible Staphylococcus aureus (MSSA) being treated with β-lactam therapy. The purpose of this study is to determine treatment outcomes for patients with polymicrobial infections with MSSA bacteremia or pneumonia who are treated with cefepime (FEP), meropenem (MEM), or piperacillin-tazobactam (TZP). This trial design represents a retrospective observational three-group comparison study of patients at a community teaching hospital system. Patients reviewed included those who had a MSSA bacteremia or pneumonia in addition to a confirmed polymicrobial infection or presence of a coinfection and received definitive therapy with FEP, MEM, or TZP. The primary outcome is defined as the resolution of fever of ≥100.4°F, hypothermia (≤95°F), leukocytosis (WBC °>° 12,000 cells/mm3), and leukopenia with WBC °<° 4,000 cells/mm3. Secondary outcomes included duration of definite therapy, in-hospital mortality, hospital and ICU length of stay (LOS), 30-day readmission rates for a presumed infection, and hospital-acquired Clostridioides difficile infection (HCDI). From August 1, 2016, to August 30, 2019, 45 patients met eligibility criteria. There were no observed differences in primary endpoint (p = 0.65) or secondary endpoints, i.e., in-hospital mortality (p = 0.10), hospital LOS (p = 0.75), ICU LOS (p = 0.53), 30-day readmission rates for presumed infection (p = 0.07), or HCDI (p = 0.34). There was no difference in treatment success with FEP, MEM, or TZP for polymicrobial infections with one offending organism being MSSA. Due to the lack of evidence in this unique patient population and observed results of our study, randomized studies are warranted to determine appropriate therapy in this complex patient population. |
| first_indexed | 2024-03-09T01:30:42Z |
| format | Article |
| id | doaj.art-cfb62a09a4b04d4baefa142e47ff3aba |
| institution | Directory Open Access Journal |
| issn | 2633-4690 |
| language | English |
| last_indexed | 2024-03-09T01:30:42Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Advances in Pharmacological and Pharmaceutical Sciences |
| spelling | doaj.art-cfb62a09a4b04d4baefa142e47ff3aba2023-12-10T00:00:01ZengHindawi LimitedAdvances in Pharmacological and Pharmaceutical Sciences2633-46902023-01-01202310.1155/2023/7684613Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or PneumoniaLaila M. Najia0Eric Pyles1Arnaldo Lopez-Ruiz2Bibidh Subedi3Department of PharmacyDepartment of PharmacyDepartment of Critical Care MedicineDepartment of PharmacyThere is a paucity of literature describing de-escalation techniques in patients with polymicrobial infections with one offending organism being methicillin-susceptible Staphylococcus aureus (MSSA) being treated with β-lactam therapy. The purpose of this study is to determine treatment outcomes for patients with polymicrobial infections with MSSA bacteremia or pneumonia who are treated with cefepime (FEP), meropenem (MEM), or piperacillin-tazobactam (TZP). This trial design represents a retrospective observational three-group comparison study of patients at a community teaching hospital system. Patients reviewed included those who had a MSSA bacteremia or pneumonia in addition to a confirmed polymicrobial infection or presence of a coinfection and received definitive therapy with FEP, MEM, or TZP. The primary outcome is defined as the resolution of fever of ≥100.4°F, hypothermia (≤95°F), leukocytosis (WBC °>° 12,000 cells/mm3), and leukopenia with WBC °<° 4,000 cells/mm3. Secondary outcomes included duration of definite therapy, in-hospital mortality, hospital and ICU length of stay (LOS), 30-day readmission rates for a presumed infection, and hospital-acquired Clostridioides difficile infection (HCDI). From August 1, 2016, to August 30, 2019, 45 patients met eligibility criteria. There were no observed differences in primary endpoint (p = 0.65) or secondary endpoints, i.e., in-hospital mortality (p = 0.10), hospital LOS (p = 0.75), ICU LOS (p = 0.53), 30-day readmission rates for presumed infection (p = 0.07), or HCDI (p = 0.34). There was no difference in treatment success with FEP, MEM, or TZP for polymicrobial infections with one offending organism being MSSA. Due to the lack of evidence in this unique patient population and observed results of our study, randomized studies are warranted to determine appropriate therapy in this complex patient population.http://dx.doi.org/10.1155/2023/7684613 |
| spellingShingle | Laila M. Najia Eric Pyles Arnaldo Lopez-Ruiz Bibidh Subedi Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia Advances in Pharmacological and Pharmaceutical Sciences |
| title | Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia |
| title_full | Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia |
| title_fullStr | Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia |
| title_full_unstemmed | Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia |
| title_short | Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia |
| title_sort | antistaphylococcal efficacy of cefepime meropenem and piperacillin tazobactam in patients with polymicrobial infection with mssa bacteremia or pneumonia |
| url | http://dx.doi.org/10.1155/2023/7684613 |
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