CHI-TAI FANGShau W.-Y.PO-REN HSUEHYEE-CHUN CHENJANN-TAY WANGCHIEN-CHING HUNGHuang L.Y.L.SHAN-CHWEN CHANG2020-03-272020-03-2720060305-7453https://scholars.lib.ntu.edu.tw/handle/123456789/480328Objectives: To evaluate whether appropriate early empirical glycopeptide therapy improves outcomes of patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. Methods: We retrospectively collected the data for all adult patients with confirmed MRSA bacteraemia diagnosed and treated at National Taiwan University Hospital during the period 1 April 1997-31 March 2001, and followed their survival up to three years. The main outcome measures were MRSA-related death and all-cause mortality. Results: There were 77 MRSA-related deaths among 162 patients. There was no statistically significant difference in MRSA-related deaths between patients receiving glycopeptides before or within 48 h after blood culture (n = 43) (55%, 18/33, non-septic shock group; 90%, 9/10, septic shock group) or those whose glycopeptide therapy was begun more than 48 h after blood culture (n = 119) (37%, 40/107, non-septic shock group; 83%, 10/12, septic shock group) (P = 0.11 and 1.00, respectively). The outcome measure of all-cause mortality from 30 days to 3 years yields similar results. Multivariate logistic regression analysis and Cox analysis showed that the length of delay (daily increment) between blood culture sampling and start of glycopeptide therapy did not have a statistically significant impact on MRSA-related death or all-cause 30-day mortality after adjusting for the effect of other variables [adjusted odds ratio 0.99, 95% confidence interval (95% CI) 0.88-1.12; adjusted hazard ratio 0.87, 95% CI 0.74-1.02, respectively). Conclusions: The hypothesis that earlier empirical use of glycopeptide therapy reduces mortality in patients with hospital-acquired MRSA bacteraemia was not supported. ? The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.[SDGs]SDG3aminoglycoside antibiotic agent; beta lactam antibiotic; ciprofloxacin; clindamycin; cotrimoxazole; erythromycin; metronidazole; polypeptide antibiotic agent; teicoplanin; vancomycin; adult; aged; article; bacteremia; bacterial strain; bacterium isolation; blood culture; confidence interval; controlled study; disease severity; drug blood level; drug dose regimen; drug eruption; drug substitution; female; follow up; hospital infection; human; Kaplan Meier method; leukopenia; major clinical study; male; methicillin resistant Staphylococcus aureus; mortality; multivariate logistic regression analysis; outcomes research; prognosis; retrospective study; septic shock; skin manifestation; statistical analysis; statistical significance; survival rate; Taiwan; Adolescent; Adult; Anti-Bacterial Agents; Bacteremia; Drug Administration Schedule; Humans; Methicillin Resistance; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus; Teicoplanin; Vancomycinjournal article10.1093/jac/dkl006164437002-s2.0-32644446540