Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study

C. J. Kim; K. H. Song; K. H. Park; M. Kim; P. G. Choe; M. D. Oh; S. H. Lee; H. C. Jang; S. J. Kang; H. Y. Kim; S. Cheon; Y. G. Kwak; H. J. Choi; K. T. Kwon; J. H. Jeon; E. S. Kim; H. B. Kim; J. E. Cho; Y. J. Choi; J. I. Park; S. I. Jung; N. J. Kim; W. B. Park; N. H. Kim; M. J. Lee; K. H. Kim; Y. K. Kim; H. K. Choi; M. S. Han; Y. S. Kim; C. R. Cho; H. S. Song; Y. S. Lee; H. I. Kim; S. M. Kiem; D. K. Kim; S. A. Song; M. J. Kang; J. G. Shin

doi:10.1016/j.cmi.2018.09.018

Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study

C. J. Kim, K. H. Song, K. H. Park, M. Kim, P. G. Choe, M. D. Oh, S. H. Lee, H. C. Jang, S. J. Kang, H. Y. Kim, S. Cheon, Y. G. Kwak, H. J. Choi, K. T. Kwon, J. H. Jeon, E. S. Kim, H. B. Kim, J. E. Cho, Y. J. Choi, J. I. ParkS. I. Jung, N. J. Kim, W. B. Park, N. H. Kim, M. J. Lee, K. H. Kim, Y. K. Kim, H. K. Choi, M. S. Han, Y. S. Kim, C. R. Cho, H. S. Song, Y. S. Lee, H. I. Kim, S. M. Kiem, D. K. Kim, S. A. Song, M. J. Kang, J. G. Shin

Internal Medicine

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Objectives: To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment. Methods: We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as <14 or ≥14 days in the SS group and <28 or ≥28 days in the LW group. Results: Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00–2.83; p 0.05). Conclusions: Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB.

Original language	English
Pages (from-to)	723-732
Number of pages	10
Journal	Clinical Microbiology and Infection
Volume	25
Issue number	6
DOIs	https://doi.org/10.1016/j.cmi.2018.09.018
Publication status	Published - 2019 Jun

Bibliographical note

Funding Information:
Supported in part by the National Strategic Coordinating Center for Clinical Research (grant HI10C2020), which is run by the Ministry of Health and Welfare of the Korean Government; and the National Research Foundation of Korea (NRF), funded by the Korean Ministry of Education, Science and Technology (MoEST; grants HI10C2020 and NRF-2016R1C1B2011720). All authors report no conflicts of interest relevant to this article. We thank the members of the KIND study group and associated staff for their cooperation in this study. In addition to the authors, the following individuals participated in the study group: J. E. Cho, Y. J. Choi and J. I. Park (Seoul National University Bundang Hospital); S.-I. Jung (Chonnam National University Hospital); N. J. Kim, W. B. Park, N.-H. Kim and M. J. Lee (Seoul National University Hospital); K. H. Kim (Pusan National University Hospital); Y. K. Kim, H. K. Choi and M. S. Han (Yonsei University Wonju College of Medicine); Y.-S. Kim (Chungnam National University Hospital); C. R. Cho, H. S. Song and Y. S. Lee (Inje University Ilsan Paik Hospital); H.-I. Kim (Daegu Fatima Hospital); S. M. Kiem, D.-K. Kim, S.-A. Song, M. J. Kang and J. G. Shin (Inje University Haeundae Paik Hospital.

Funding Information:
Supported in part by the National Strategic Coordinating Center for Clinical Research (grant HI10C2020 ), which is run by the Ministry of Health and Welfare of the Korean Government ; and the National Research Foundation of Korea (NRF) , funded by the Korean Ministry of Education, Science and Technology (MoEST; grants HI10C2020 and NRF-2016R1C1B2011720 ). All authors report no conflicts of interest relevant to this article.

Publisher Copyright:
© 2018 European Society of Clinical Microbiology and Infectious Diseases

All Science Journal Classification (ASJC) codes

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.cmi.2018.09.018

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Kim, C. J., Song, K. H., Park, K. H., Kim, M., Choe, P. G., Oh, M. D., Lee, S. H., Jang, H. C., Kang, S. J., Kim, H. Y., Cheon, S., Kwak, Y. G., Choi, H. J., Kwon, K. T., Jeon, J. H., Kim, E. S., Kim, H. B., Cho, J. E., Choi, Y. J., ... Shin, J. G. (2019). Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study. Clinical Microbiology and Infection, 25(6), 723-732. https://doi.org/10.1016/j.cmi.2018.09.018

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title = "Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study",

abstract = "Objectives: To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment. Methods: We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as <14 or ≥14 days in the SS group and <28 or ≥28 days in the LW group. Results: Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00–2.83; p 0.05). Conclusions: Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB.",

author = "Kim, {C. J.} and Song, {K. H.} and Park, {K. H.} and M. Kim and Choe, {P. G.} and Oh, {M. D.} and Lee, {S. H.} and Jang, {H. C.} and Kang, {S. J.} and Kim, {H. Y.} and S. Cheon and Kwak, {Y. G.} and Choi, {H. J.} and Kwon, {K. T.} and Jeon, {J. H.} and Kim, {E. S.} and Kim, {H. B.} and Cho, {J. E.} and Choi, {Y. J.} and Park, {J. I.} and Jung, {S. I.} and Kim, {N. J.} and Park, {W. B.} and Kim, {N. H.} and Lee, {M. J.} and Kim, {K. H.} and Kim, {Y. K.} and Choi, {H. K.} and Han, {M. S.} and Kim, {Y. S.} and Cho, {C. R.} and Song, {H. S.} and Lee, {Y. S.} and Kim, {H. I.} and Kiem, {S. M.} and Kim, {D. K.} and Song, {S. A.} and Kang, {M. J.} and Shin, {J. G.}",

note = "Funding Information: Supported in part by the National Strategic Coordinating Center for Clinical Research (grant HI10C2020), which is run by the Ministry of Health and Welfare of the Korean Government; and the National Research Foundation of Korea (NRF), funded by the Korean Ministry of Education, Science and Technology (MoEST; grants HI10C2020 and NRF-2016R1C1B2011720). All authors report no conflicts of interest relevant to this article. We thank the members of the KIND study group and associated staff for their cooperation in this study. In addition to the authors, the following individuals participated in the study group: J. E. Cho, Y. J. Choi and J. I. Park (Seoul National University Bundang Hospital); S.-I. Jung (Chonnam National University Hospital); N. J. Kim, W. B. Park, N.-H. Kim and M. J. Lee (Seoul National University Hospital); K. H. Kim (Pusan National University Hospital); Y. K. Kim, H. K. Choi and M. S. Han (Yonsei University Wonju College of Medicine); Y.-S. Kim (Chungnam National University Hospital); C. R. Cho, H. S. Song and Y. S. Lee (Inje University Ilsan Paik Hospital); H.-I. Kim (Daegu Fatima Hospital); S. M. Kiem, D.-K. Kim, S.-A. Song, M. J. Kang and J. G. Shin (Inje University Haeundae Paik Hospital. Funding Information: Supported in part by the National Strategic Coordinating Center for Clinical Research (grant HI10C2020 ), which is run by the Ministry of Health and Welfare of the Korean Government ; and the National Research Foundation of Korea (NRF) , funded by the Korean Ministry of Education, Science and Technology (MoEST; grants HI10C2020 and NRF-2016R1C1B2011720 ). All authors report no conflicts of interest relevant to this article. Publisher Copyright: {\textcopyright} 2018 European Society of Clinical Microbiology and Infectious Diseases",

year = "2019",

month = jun,

doi = "10.1016/j.cmi.2018.09.018",

language = "English",

volume = "25",

pages = "723--732",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier Limited",

number = "6",

}

Kim, CJ, Song, KH, Park, KH, Kim, M, Choe, PG, Oh, MD, Lee, SH, Jang, HC, Kang, SJ, Kim, HY, Cheon, S, Kwak, YG, Choi, HJ, Kwon, KT, Jeon, JH, Kim, ES, Kim, HB, Cho, JE, Choi, YJ, Park, JI, Jung, SI, Kim, NJ, Park, WB, Kim, NH, Lee, MJ, Kim, KH, Kim, YK, Choi, HK, Han, MS, Kim, YS, Cho, CR, Song, HS, Lee, YS, Kim, HI, Kiem, SM, Kim, DK, Song, SA, Kang, MJ & Shin, JG 2019, 'Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study', Clinical Microbiology and Infection, vol. 25, no. 6, pp. 723-732. https://doi.org/10.1016/j.cmi.2018.09.018

TY - JOUR

T1 - Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia

T2 - a cohort study

AU - Kim, C. J.

AU - Song, K. H.

AU - Park, K. H.

AU - Kim, M.

AU - Choe, P. G.

AU - Oh, M. D.

AU - Lee, S. H.

AU - Jang, H. C.

AU - Kang, S. J.

AU - Kim, H. Y.

AU - Cheon, S.

AU - Kwak, Y. G.

AU - Choi, H. J.

AU - Kwon, K. T.

AU - Jeon, J. H.

AU - Kim, E. S.

AU - Kim, H. B.

AU - Cho, J. E.

AU - Choi, Y. J.

AU - Park, J. I.

AU - Jung, S. I.

AU - Kim, N. J.

AU - Park, W. B.

AU - Kim, N. H.

AU - Lee, M. J.

AU - Kim, K. H.

AU - Kim, Y. K.

AU - Choi, H. K.

AU - Han, M. S.

AU - Kim, Y. S.

AU - Cho, C. R.

AU - Song, H. S.

AU - Lee, Y. S.

AU - Kim, H. I.

AU - Kiem, S. M.

AU - Kim, D. K.

AU - Song, S. A.

AU - Kang, M. J.

AU - Shin, J. G.

N1 - Funding Information: Supported in part by the National Strategic Coordinating Center for Clinical Research (grant HI10C2020), which is run by the Ministry of Health and Welfare of the Korean Government; and the National Research Foundation of Korea (NRF), funded by the Korean Ministry of Education, Science and Technology (MoEST; grants HI10C2020 and NRF-2016R1C1B2011720). All authors report no conflicts of interest relevant to this article. We thank the members of the KIND study group and associated staff for their cooperation in this study. In addition to the authors, the following individuals participated in the study group: J. E. Cho, Y. J. Choi and J. I. Park (Seoul National University Bundang Hospital); S.-I. Jung (Chonnam National University Hospital); N. J. Kim, W. B. Park, N.-H. Kim and M. J. Lee (Seoul National University Hospital); K. H. Kim (Pusan National University Hospital); Y. K. Kim, H. K. Choi and M. S. Han (Yonsei University Wonju College of Medicine); Y.-S. Kim (Chungnam National University Hospital); C. R. Cho, H. S. Song and Y. S. Lee (Inje University Ilsan Paik Hospital); H.-I. Kim (Daegu Fatima Hospital); S. M. Kiem, D.-K. Kim, S.-A. Song, M. J. Kang and J. G. Shin (Inje University Haeundae Paik Hospital. Funding Information: Supported in part by the National Strategic Coordinating Center for Clinical Research (grant HI10C2020 ), which is run by the Ministry of Health and Welfare of the Korean Government ; and the National Research Foundation of Korea (NRF) , funded by the Korean Ministry of Education, Science and Technology (MoEST; grants HI10C2020 and NRF-2016R1C1B2011720 ). All authors report no conflicts of interest relevant to this article. Publisher Copyright: © 2018 European Society of Clinical Microbiology and Infectious Diseases

PY - 2019/6

Y1 - 2019/6

N2 - Objectives: To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment. Methods: We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as <14 or ≥14 days in the SS group and <28 or ≥28 days in the LW group. Results: Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00–2.83; p 0.05). Conclusions: Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB.

AB - Objectives: To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment. Methods: We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as <14 or ≥14 days in the SS group and <28 or ≥28 days in the LW group. Results: Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00–2.83; p 0.05). Conclusions: Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB.

UR - http://www.scopus.com/inward/record.url?scp=85055269146&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055269146&partnerID=8YFLogxK

U2 - 10.1016/j.cmi.2018.09.018

DO - 10.1016/j.cmi.2018.09.018

M3 - Article

C2 - 30287412

AN - SCOPUS:85055269146

SN - 1198-743X

VL - 25

SP - 723

EP - 732

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

IS - 6

ER -

Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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