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Retrospective Evaluation of Therapies for Staphylococcus aureus Endocarditis
Author(s) -
Gentry Chris A.,
Rodvold Keith A.,
Novak Richard M.,
Hershow Ronald C.,
Naderer Odin J.
Publication year - 1997
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1997.tb03788.x
Subject(s) - nafcillin , medicine , vancomycin , endocarditis , staphylococcus aureus , methicillin resistant staphylococcus aureus , infective endocarditis , antibiotics , surgery , anesthesia , penicillin , microbiology and biotechnology , genetics , bacteria , biology
We retrospectively evaluated antiinfective therapy for methicillin‐sensitive (MSSA) and methicillin‐resistant Staphylococcus aureus (MRSA) endocarditis in 54 patients who had 57 treatment courses for the disease. Three treatments were assessed: 27 nafcillin‐treated courses of MSSA endocarditis, 18 vancomycin‐treated courses of MSSA endocarditis, and 11 vancomycin‐treated courses of MRSA endocarditis. At baseline, patients with MSSA treated with vancomycin had more chronic conditions (p<0.01), a lower frequency of intravenous drug use (p<0.01), a lower hematocrit concentration (p<0.05), and a higher serum creatinine concentration (p<0.05) than the nafcillin group. Vancomycin‐treated patients had a higher complication rate during therapy (p<0.05) and a longer duration in an intensive care unit (p<0.01) than the nafcillin group. The trend was for a higher complete response rate in the nafcillin group (74% vs 50%, p=0.12), but no difference in mortality (22% vs 28%, p=0.73). Patients with MRSA infection treated with vancomycin had higher mortality than those with MSSA who received that drug (55% vs 28%, p=0.24). Patients with vancomycin‐treated MSSA endocarditis may have a poorer outcome than those who receive nafcillin, but this may be influenced by different or more severe clinical features. (Pharmacotherapy 1997;17(5):990–997)