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CLINICAL OUTCOMES ASSOCIATED WITH TIME TO ANTIMICROBIAL THERAPY CHANGE FROM VANCOMYCIN TO DAPTOMYCIN IN STAPHYLOCOCCAL BACTEREMIA

Background: Staphylococcus aureus is an aerobic, Gram positive commensal organism that is capable of causing a wide spectrum of disease. This study contributes to previously published literature regarding daptomycin versus vancomycin use in S. aureus bacteremia (SAB).
Methods: Adult patients admitted between 2010 and 2014, billed for ICD-9 code V09.0, 038.11, 038.12, 041.11, or 041.12, and received vancomycin and daptomycin were included in this retrospective analysis. Patients were stratified by time to change in antibiotics from vancomycin to daptomycin to the early switch (1-3 days), intermediate switch (4-7 days), or late switch (8 days or later) group. The primary outcome was treatment failure defined as 30-day recurrence, 60-day all-cause mortality, and 90-day all-cause readmission.
Results: 193 patients were enrolled in the final cohort. The overall treatment failure rate was 18% with no differences between early switch, intermediate switch, and late switch (P=0.72) groups. Independent predictors of treatment success were length of stay (OR=1.035) and time to positive culture (OR=0.961).
Conclusions: Results of this study did not demonstrate a difference in treatment failure based on time to switch from vancomycin to daptomycin. Future research should focus on optimizing use of vancomycin and daptomycin and medical management of SAB.

Identiferoai:union.ndltd.org:uky.edu/oai:uknowledge.uky.edu:pharmacy_etds-1064
Date01 January 2016
CreatorsTennant, Sarah J.
PublisherUKnowledge
Source SetsUniversity of Kentucky
Detected LanguageEnglish
Typetext
Formatapplication/pdf
SourceTheses and Dissertations--Pharmacy

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