https://scholars.lib.ntu.edu.tw/handle/123456789/535221
標題: | A retrospective clinical comparison of daptomycin vs daptomycin and a beta-lactam antibiotic for treating vancomycin-resistant Enterococcus faecium bloodstream infections | 作者: | YU-CHUNG CHUANG PAO-YU CHEN Lin C.-Y. YEE-CHUN CHEN JANN-TAY WANG SHAN-CHWEN CHANG |
公開日期: | 2018 | 出版社: | Nature Publishing Group | 卷: | 8 | 期: | 1 | 起(迄)頁: | 1632 | 來源出版物: | Scientific Reports | 摘要: | There is limited clinical evidence to support the combination of daptomycin and beta-lactam antibiotics (DAP + BLA) for treatment of vancomycin-resistant enterococci (VRE) bloodstream infections (BSI). We conducted a prospective observational cohort study of VRE-BSI during 2010-2015. The primary endpoint was mortality at the end of treatment. We included 114 patients who received DAP for VRE-BSI. Of these 87 (76.3%) received DAP + BLA. There were no significant differences in mortality between the DAP and DAP + BLA groups on univariable analysis (10/27 vs. 34/87, P = 0.85). A subgroup analysis of patients with enterococcal DAP minimum inhibitory concentrations (MICs) ?2 mg/L, revealed that those treated with DAP + BLA had a lower mortality (adjusted hazard ratio [aHR], 0.23; 95% confidence interval [CI], 0.06-0.93; P = 0.04) after adjustment for other significant predictors of mortality, including the DAP dose. In addition, patients receiving high-dose (?9 mg/kg) DAP + BLA independently had a better survival than those receiving low-dose DAP alone (aHR = 5.16), low-dose DAP + BLA (aHR = 5.39), and high-dose DAP alone (aHR = 19.01) (P < 0.05 for all comparisons). For patients with VRE-BSIs, the DAP MIC of the isolate and the DAP dose influence the effect of DAP + BLA on outcome. A high-dose DAP + BLA might improve survival. These findings support the use of high-dose DAP + BLA for treatment of VRE-BSI. ? 2018 The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85041139175&doi=10.1038%2fs41598-018-19986-8&partnerID=40&md5=97a4cbdab5bdead9c1002e030467f63e https://scholars.lib.ntu.edu.tw/handle/123456789/535221 |
ISSN: | 2045-2322 | DOI: | 10.1038/s41598-018-19986-8 | SDG/關鍵字: | antiinfective agent; beta lactam; daptomycin; aged; bacteremia; combination drug therapy; Enterococcus faecium; female; Gram positive infection; human; isolation and purification; male; microbiology; middle aged; procedures; retrospective study; survival analysis; treatment outcome; vancomycin resistant Enterococcus; very elderly; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; beta-Lactams; Daptomycin; Drug Therapy, Combination; Enterococcus faecium; Female; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Retrospective Studies; Survival Analysis; Treatment Outcome; Vancomycin-Resistant Enterococci |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。