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Infection and Drug Resistance Volume 11, 2018 - Issue
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Original Research

Clinical outcomes after initial treatment of methicillin-resistant Staphylococcus aureus infections

Nobuaki Shime1 Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan;2 Department of Emergency and Critical Care Medicine, Kyoto Medical Centre, Kyoto, JapanCorrespondence[email protected]
,
Nobuyuki Saito3 Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
,
Miya Bokui4 Department of Pharmacy, National Hospital Organization Kyoto Medical Centre, Kyoto, Japan
,
Naoki Sakane5 Clinical Research Institute, National Hospital Organization Kyoto Medical Centre, Kyoto, Japan
,
Mitsuhiro Kamimura6 Department of Pulmonology, National Hospital Organization Disaster Medical Centre, Tokyo, Japan
,
Tsutomu Shinohara7 Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Kochi, Japan
,
Tadashi Kosaka8 Department of Pharmacy, Kyoto Prefectural University, School of Medicine, Kyoto, Japan
,
Hisashi Ishikura9 Department of Surgery, Tokushima Red Cross Hospital, Komatsushima, Japan
&
Atsuko Kobayashi10 Department of Central Laboratory, Takarazuka City Hospital, Hyogo, Japan
 show all
Pages 1073-1081 | Published online: 06 Aug 2018

Figures & data

Table 1 First-choice antimicrobials recommended by the Japanese practice guidelines for the management of infections caused by MRSA

Table 2 Characteristics of entire study sample and of each treatment group

Figure 1 Survival of vancomycin versus non-vancomycin treatment groups at 30 days in the overall sample.

Note: After adjustment for age, APACHE II score, bacteremia, and pneumonia, the risk of dying tended to be higher in the vancomycin-treated group than in the groups treated with other pharmaceuticals.
Abbreviations: APACHE II, acute physiology and chronic health evaluation; MRSA, methicillin-resistant Staphylococcus aureus.
Figure 1 Survival of vancomycin versus non-vancomycin treatment groups at 30 days in the overall sample.

Table 3 Outcome of Cox regression analysis of clinical outcomes; comparison of vancomycin versus other antimicrobials

Figure 2 Thirty-day survival of vancomycin versus non-vancomycin treatment groups presenting with lung infections.

Note: Among patients with lung infections and after adjustment for baseline severity of the illness, survival in the vancomycin-treated group was significantly lower than in the group treated with other drugs.
Abbreviation: MRSA, methicillin-resistant Staphylococcus aureus.
Figure 2 Thirty-day survival of vancomycin versus non-vancomycin treatment groups presenting with lung infections.

Table 4 Concordance of initial anti-MRSA therapy with practice guidelines

Figure S1 Thirty-day survival of linezolid versus non-linezolid treatment groups presenting with lung infections.

Note: Among patients with lung infections and after adjustment for age, a trend was observed toward a higher survival in the linezolid-treated group compared with the group treated with other drugs.
Abbreviation: MRSA, methicillin-resistant Staphylococcus aureus.
Figure S1 Thirty-day survival of linezolid versus non-linezolid treatment groups presenting with lung infections.

Table S1 Relationship between highest trough vancomycin concentrations and clinical outcomes

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