Comparison of the efficacy of nafcillin and glycopeptides as definitive therapy for patients with methicillin-susceptible Staphylococcus aureus bacteremia

A retrospective cohort study

Dong Hyun Oh, Jung Ju Kim, Jinnam Kim, Hye Seong, Se Ju Lee, Yong Chan Kim, Eun Jin Kim, In Young Jung, Woo Yong Jeong, Su Jin Jeong, Nam Su Ku, Sang Hoon Han, JunYong Choi, Young Goo Song, June Myung Kim

Research output: Contribution to journalArticle

Abstract

Background: Studies have shown that the prognosis of the treatment of methicillin-susceptible S. aureus (MSSA) with glycopeptides is inferior compared to treatment with β-lactam. However, there are only few studies comparing treatment with antistaphylococcal penicillin alone to glycopeptide treatment. The aim of this study was to compare the efficacy of nafcillin, an antistaphylococcal penicillin, with that of glycopeptides as a definitive therapy for MSSA bacteremia. Methods: Patients with MSSA bacteremia recruited from a tertiary referral hospital were enrolled in this retrospective cohort study. Demographic characteristics, laboratory data, and clinical outcome of the treatment were compared between a group receiving nafcillin and a group receiving glycopeptides. Results: A total of 188 patients with MSSA bacteremia were included in this study. The glycopeptide group had a higher rate of malignancy (28.6 vs. 60.8%, p < 0.001) and proportion of healthcare-associated infections (47.3 vs. 72.2%, p < 0.001) compared to the nafcillin group. The ratio of skin and soft tissue infections (30.0 vs. 16.7%, p = 0.037) and bone and joint infections (17.8 vs. 6.3%, p = 0.022), as well as levels of C-reactive protein (139.60 vs. 107.61 mg/dL, p = 0.022) were higher in the nafcillin group. All-cause 28-day mortality was significantly high in the glycopeptide group (7.7 vs. 20.6%, p = 0.013). Conclusion: In patients with MSSA bacteremia, all-cause 28-day mortality rate was higher in a group treated with glycopeptides than in a group treated with nafcillin. Therefore, the use of nafcillin should be considered as a definitive therapy for MSSA bacteremia.

Original languageEnglish
Article number60
JournalBMC Infectious Diseases
Volume18
Issue number1
DOIs
Publication statusPublished - 2018 Jan 30

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Nafcillin
Methicillin
Glycopeptides
Bacteremia
Staphylococcus aureus
Cohort Studies
Retrospective Studies
Penicillins
Therapeutics
Lactams
Soft Tissue Infections
Mortality
Cross Infection
Tertiary Care Centers
C-Reactive Protein
Joints
Demography
Bone and Bones
Skin

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

Cite this

Oh, Dong Hyun ; Kim, Jung Ju ; Kim, Jinnam ; Seong, Hye ; Lee, Se Ju ; Kim, Yong Chan ; Kim, Eun Jin ; Jung, In Young ; Jeong, Woo Yong ; Jeong, Su Jin ; Ku, Nam Su ; Han, Sang Hoon ; Choi, JunYong ; Song, Young Goo ; Kim, June Myung. / Comparison of the efficacy of nafcillin and glycopeptides as definitive therapy for patients with methicillin-susceptible Staphylococcus aureus bacteremia : A retrospective cohort study. In: BMC Infectious Diseases. 2018 ; Vol. 18, No. 1.
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abstract = "Background: Studies have shown that the prognosis of the treatment of methicillin-susceptible S. aureus (MSSA) with glycopeptides is inferior compared to treatment with β-lactam. However, there are only few studies comparing treatment with antistaphylococcal penicillin alone to glycopeptide treatment. The aim of this study was to compare the efficacy of nafcillin, an antistaphylococcal penicillin, with that of glycopeptides as a definitive therapy for MSSA bacteremia. Methods: Patients with MSSA bacteremia recruited from a tertiary referral hospital were enrolled in this retrospective cohort study. Demographic characteristics, laboratory data, and clinical outcome of the treatment were compared between a group receiving nafcillin and a group receiving glycopeptides. Results: A total of 188 patients with MSSA bacteremia were included in this study. The glycopeptide group had a higher rate of malignancy (28.6 vs. 60.8{\%}, p < 0.001) and proportion of healthcare-associated infections (47.3 vs. 72.2{\%}, p < 0.001) compared to the nafcillin group. The ratio of skin and soft tissue infections (30.0 vs. 16.7{\%}, p = 0.037) and bone and joint infections (17.8 vs. 6.3{\%}, p = 0.022), as well as levels of C-reactive protein (139.60 vs. 107.61 mg/dL, p = 0.022) were higher in the nafcillin group. All-cause 28-day mortality was significantly high in the glycopeptide group (7.7 vs. 20.6{\%}, p = 0.013). Conclusion: In patients with MSSA bacteremia, all-cause 28-day mortality rate was higher in a group treated with glycopeptides than in a group treated with nafcillin. Therefore, the use of nafcillin should be considered as a definitive therapy for MSSA bacteremia.",
author = "Oh, {Dong Hyun} and Kim, {Jung Ju} and Jinnam Kim and Hye Seong and Lee, {Se Ju} and Kim, {Yong Chan} and Kim, {Eun Jin} and Jung, {In Young} and Jeong, {Woo Yong} and Jeong, {Su Jin} and Ku, {Nam Su} and Han, {Sang Hoon} and JunYong Choi and Song, {Young Goo} and Kim, {June Myung}",
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Comparison of the efficacy of nafcillin and glycopeptides as definitive therapy for patients with methicillin-susceptible Staphylococcus aureus bacteremia : A retrospective cohort study. / Oh, Dong Hyun; Kim, Jung Ju; Kim, Jinnam; Seong, Hye; Lee, Se Ju; Kim, Yong Chan; Kim, Eun Jin; Jung, In Young; Jeong, Woo Yong; Jeong, Su Jin; Ku, Nam Su; Han, Sang Hoon; Choi, JunYong; Song, Young Goo; Kim, June Myung.

In: BMC Infectious Diseases, Vol. 18, No. 1, 60, 30.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of the efficacy of nafcillin and glycopeptides as definitive therapy for patients with methicillin-susceptible Staphylococcus aureus bacteremia

T2 - A retrospective cohort study

AU - Oh, Dong Hyun

AU - Kim, Jung Ju

AU - Kim, Jinnam

AU - Seong, Hye

AU - Lee, Se Ju

AU - Kim, Yong Chan

AU - Kim, Eun Jin

AU - Jung, In Young

AU - Jeong, Woo Yong

AU - Jeong, Su Jin

AU - Ku, Nam Su

AU - Han, Sang Hoon

AU - Choi, JunYong

AU - Song, Young Goo

AU - Kim, June Myung

PY - 2018/1/30

Y1 - 2018/1/30

N2 - Background: Studies have shown that the prognosis of the treatment of methicillin-susceptible S. aureus (MSSA) with glycopeptides is inferior compared to treatment with β-lactam. However, there are only few studies comparing treatment with antistaphylococcal penicillin alone to glycopeptide treatment. The aim of this study was to compare the efficacy of nafcillin, an antistaphylococcal penicillin, with that of glycopeptides as a definitive therapy for MSSA bacteremia. Methods: Patients with MSSA bacteremia recruited from a tertiary referral hospital were enrolled in this retrospective cohort study. Demographic characteristics, laboratory data, and clinical outcome of the treatment were compared between a group receiving nafcillin and a group receiving glycopeptides. Results: A total of 188 patients with MSSA bacteremia were included in this study. The glycopeptide group had a higher rate of malignancy (28.6 vs. 60.8%, p < 0.001) and proportion of healthcare-associated infections (47.3 vs. 72.2%, p < 0.001) compared to the nafcillin group. The ratio of skin and soft tissue infections (30.0 vs. 16.7%, p = 0.037) and bone and joint infections (17.8 vs. 6.3%, p = 0.022), as well as levels of C-reactive protein (139.60 vs. 107.61 mg/dL, p = 0.022) were higher in the nafcillin group. All-cause 28-day mortality was significantly high in the glycopeptide group (7.7 vs. 20.6%, p = 0.013). Conclusion: In patients with MSSA bacteremia, all-cause 28-day mortality rate was higher in a group treated with glycopeptides than in a group treated with nafcillin. Therefore, the use of nafcillin should be considered as a definitive therapy for MSSA bacteremia.

AB - Background: Studies have shown that the prognosis of the treatment of methicillin-susceptible S. aureus (MSSA) with glycopeptides is inferior compared to treatment with β-lactam. However, there are only few studies comparing treatment with antistaphylococcal penicillin alone to glycopeptide treatment. The aim of this study was to compare the efficacy of nafcillin, an antistaphylococcal penicillin, with that of glycopeptides as a definitive therapy for MSSA bacteremia. Methods: Patients with MSSA bacteremia recruited from a tertiary referral hospital were enrolled in this retrospective cohort study. Demographic characteristics, laboratory data, and clinical outcome of the treatment were compared between a group receiving nafcillin and a group receiving glycopeptides. Results: A total of 188 patients with MSSA bacteremia were included in this study. The glycopeptide group had a higher rate of malignancy (28.6 vs. 60.8%, p < 0.001) and proportion of healthcare-associated infections (47.3 vs. 72.2%, p < 0.001) compared to the nafcillin group. The ratio of skin and soft tissue infections (30.0 vs. 16.7%, p = 0.037) and bone and joint infections (17.8 vs. 6.3%, p = 0.022), as well as levels of C-reactive protein (139.60 vs. 107.61 mg/dL, p = 0.022) were higher in the nafcillin group. All-cause 28-day mortality was significantly high in the glycopeptide group (7.7 vs. 20.6%, p = 0.013). Conclusion: In patients with MSSA bacteremia, all-cause 28-day mortality rate was higher in a group treated with glycopeptides than in a group treated with nafcillin. Therefore, the use of nafcillin should be considered as a definitive therapy for MSSA bacteremia.

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U2 - 10.1186/s12879-018-2978-z

DO - 10.1186/s12879-018-2978-z

M3 - Article

VL - 18

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

IS - 1

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