Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis
Background: The Combination Antibiotic Therapy for Methicillin-Resistant Staphylococcus aureus (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard thera...
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| Format: | Journal Article |
| Language: | English |
| Published: |
2023
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| Online Access: | https://hdl.handle.net/10356/171771 |
| _version_ | 1811690152396849152 |
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| author | Legg, Amy Roberts, Matthew A. Davies, Jane Cass, Alan Meagher, Niamh Sud, Archana Daitch, Vered Dishon Benattar, Yael Yahav, Dafna Paul, Mical Chen, Xinxin Yeo, He Ping Lye, David C. Lee, Russel Robinson, J. Owen Foo, Hong Tramontana, Adrian R. Bak, Narin Grenfell, Adelaide Rogers, Benjamin Li, Ying Joshi, Neela O'Sullivan, Matthew McKew, Genevieve Ghosh, Niladri Schneider, Kellie Holmes, Natasha E. Dotel, Ravindra Chia, Timothy Archuleta, Sophia Smith, Simon Warner, Morgyn S. Titin, Christina Kalimuddin, Shirin Roberts, Jason A. Tong, Steven Y. C. Davis, Joshua S. |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Legg, Amy Roberts, Matthew A. Davies, Jane Cass, Alan Meagher, Niamh Sud, Archana Daitch, Vered Dishon Benattar, Yael Yahav, Dafna Paul, Mical Chen, Xinxin Yeo, He Ping Lye, David C. Lee, Russel Robinson, J. Owen Foo, Hong Tramontana, Adrian R. Bak, Narin Grenfell, Adelaide Rogers, Benjamin Li, Ying Joshi, Neela O'Sullivan, Matthew McKew, Genevieve Ghosh, Niladri Schneider, Kellie Holmes, Natasha E. Dotel, Ravindra Chia, Timothy Archuleta, Sophia Smith, Simon Warner, Morgyn S. Titin, Christina Kalimuddin, Shirin Roberts, Jason A. Tong, Steven Y. C. Davis, Joshua S. |
| author_sort | Legg, Amy |
| collection | NTU |
| description | Background: The Combination Antibiotic Therapy for Methicillin-Resistant Staphylococcus aureus (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard therapy (monotherapy) arm. We analyzed the long-term outcomes of participants in CAMERA2 to understand the impact of combination antibiotic therapy and AKI. Methods: Trial sites obtained additional follow-up data. The primary outcome was all-cause mortality, censored at death or the date of last known follow-up. Secondary outcomes included kidney failure or a reduction in kidney function (a 40% reduction in estimated glomerular filtration rate to <60 mL/minute/1.73 m2). To determine independent predictors of mortality in this cohort, adjusted hazard ratios were calculated using a Cox proportional hazards regression model. Results: This post hoc analysis included extended follow-up data for 260 patients. Overall, 123 of 260 (47%) of participants died, with a median population survival estimate of 3.4 years (235 deaths per 1000 person-years). Fifty-five patients died within 90 days after CAMERA2 trial randomization; another 68 deaths occurred after day 90. Using univariable Cox proportional hazards regression, mortality was not associated with either the assigned treatment arm in CAMERA2 (hazard ratio [HR], 0.84 [95% confidence interval [CI],. 59-1.19]; P =. 33) or experiencing an AKI (HR at 1 year, 1.04 [95% CI,. 64-1.68]; P =. 88). Conclusions: In this cohort of patients hospitalized with methicillin-resistant S aureus bacteremia, we found no association between either treatment arm of the CAMERA2 trial or AKI (using CAMERA2 trial definition) and longer-term mortality. |
| first_indexed | 2024-10-01T05:59:27Z |
| format | Journal Article |
| id | ntu-10356/171771 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T05:59:27Z |
| publishDate | 2023 |
| record_format | dspace |
| spelling | ntu-10356/1717712023-11-12T15:37:44Z Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis Legg, Amy Roberts, Matthew A. Davies, Jane Cass, Alan Meagher, Niamh Sud, Archana Daitch, Vered Dishon Benattar, Yael Yahav, Dafna Paul, Mical Chen, Xinxin Yeo, He Ping Lye, David C. Lee, Russel Robinson, J. Owen Foo, Hong Tramontana, Adrian R. Bak, Narin Grenfell, Adelaide Rogers, Benjamin Li, Ying Joshi, Neela O'Sullivan, Matthew McKew, Genevieve Ghosh, Niladri Schneider, Kellie Holmes, Natasha E. Dotel, Ravindra Chia, Timothy Archuleta, Sophia Smith, Simon Warner, Morgyn S. Titin, Christina Kalimuddin, Shirin Roberts, Jason A. Tong, Steven Y. C. Davis, Joshua S. Lee Kong Chian School of Medicine (LKCMedicine) National Centre for Infectious Diseases, Singapore Tan Tock Seng Hospital Yong Loo Lin School of Medicine, NUS Science::Medicine Acute Kidney Injury Nephrotoxicity Background: The Combination Antibiotic Therapy for Methicillin-Resistant Staphylococcus aureus (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard therapy (monotherapy) arm. We analyzed the long-term outcomes of participants in CAMERA2 to understand the impact of combination antibiotic therapy and AKI. Methods: Trial sites obtained additional follow-up data. The primary outcome was all-cause mortality, censored at death or the date of last known follow-up. Secondary outcomes included kidney failure or a reduction in kidney function (a 40% reduction in estimated glomerular filtration rate to <60 mL/minute/1.73 m2). To determine independent predictors of mortality in this cohort, adjusted hazard ratios were calculated using a Cox proportional hazards regression model. Results: This post hoc analysis included extended follow-up data for 260 patients. Overall, 123 of 260 (47%) of participants died, with a median population survival estimate of 3.4 years (235 deaths per 1000 person-years). Fifty-five patients died within 90 days after CAMERA2 trial randomization; another 68 deaths occurred after day 90. Using univariable Cox proportional hazards regression, mortality was not associated with either the assigned treatment arm in CAMERA2 (hazard ratio [HR], 0.84 [95% confidence interval [CI],. 59-1.19]; P =. 33) or experiencing an AKI (HR at 1 year, 1.04 [95% CI,. 64-1.68]; P =. 88). Conclusions: In this cohort of patients hospitalized with methicillin-resistant S aureus bacteremia, we found no association between either treatment arm of the CAMERA2 trial or AKI (using CAMERA2 trial definition) and longer-term mortality. Published version The CAMERA2 trial was supported by the Australian National Health and Medical Research Council (NHMRC) Career Development Fellowships for S. Y. C. T. (1145033) and J. S. D. (1160331). J. A. R. acknowledges funding from the NHMRC for a Centre of Research Excellence (APP2007007) and an Investigator Grant (APP2009736) as well as an Advancing Queensland Clinical Fellowship. 2023-11-07T07:59:59Z 2023-11-07T07:59:59Z 2023 Journal Article Legg, A., Roberts, M. A., Davies, J., Cass, A., Meagher, N., Sud, A., Daitch, V., Dishon Benattar, Y., Yahav, D., Paul, M., Chen, X., Yeo, H. P., Lye, D. C., Lee, R., Robinson, J. O., Foo, H., Tramontana, A. R., Bak, N., Grenfell, A., ...Davis, J. S. (2023). Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis. Open Forum Infectious Diseases, 10(7), ofad337-. https://dx.doi.org/10.1093/ofid/ofad337 2328-8957 https://hdl.handle.net/10356/171771 10.1093/ofid/ofad337 37496601 2-s2.0-85171190383 7 10 ofad337 en Open Forum Infectious Diseases © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons. org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com application/pdf |
| spellingShingle | Science::Medicine Acute Kidney Injury Nephrotoxicity Legg, Amy Roberts, Matthew A. Davies, Jane Cass, Alan Meagher, Niamh Sud, Archana Daitch, Vered Dishon Benattar, Yael Yahav, Dafna Paul, Mical Chen, Xinxin Yeo, He Ping Lye, David C. Lee, Russel Robinson, J. Owen Foo, Hong Tramontana, Adrian R. Bak, Narin Grenfell, Adelaide Rogers, Benjamin Li, Ying Joshi, Neela O'Sullivan, Matthew McKew, Genevieve Ghosh, Niladri Schneider, Kellie Holmes, Natasha E. Dotel, Ravindra Chia, Timothy Archuleta, Sophia Smith, Simon Warner, Morgyn S. Titin, Christina Kalimuddin, Shirin Roberts, Jason A. Tong, Steven Y. C. Davis, Joshua S. Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis |
| title | Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis |
| title_full | Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis |
| title_fullStr | Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis |
| title_full_unstemmed | Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis |
| title_short | Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis |
| title_sort | longer term mortality and kidney outcomes of participants in the combination antibiotics for methicillin resistant staphylococcus aureus camera2 trial a post hoc analysis |
| topic | Science::Medicine Acute Kidney Injury Nephrotoxicity |
| url | https://hdl.handle.net/10356/171771 |
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