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dc.contributor.authorDavis, Joshua S
dc.contributor.authorSud, Archana
dc.contributor.authorO'Sullivan, Matthew VN
dc.contributor.authorRobinson, James O
dc.contributor.authorFerguson, Patricia E
dc.contributor.authorFoo, Hong
dc.contributor.authorvan Hal, Sebastiaan J
dc.contributor.authorRalph, Anna P
dc.contributor.authorHowden, Benjamin P
dc.contributor.authorBinks, Paula M
dc.contributor.authorKirby, Adrienne
dc.contributor.authorTong, Steven YC
dc.contributor.authorCombination Antibiotics for MEthicillin Resistant Staphylococcus aureus (CAMERA) study group
dc.contributor.authorSubedi, Shrada
dc.contributor.authoret al.
dc.date.accessioned2020-05-20T05:42:40Z
dc.date.available2020-05-20T05:42:40Z
dc.date.issued2016
dc.identifier.issn1537-6591
dc.identifier.doi10.1093/cid/civ808
dc.identifier.urihttp://hdl.handle.net/10072/394071
dc.description.abstractBACKGROUND: In vitro laboratory and animal studies demonstrate a synergistic role for the combination of vancomycin and antistaphylococcal β-lactams for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Prospective clinical data are lacking. METHODS: In this open-label, multicenter, clinical trial, adults with MRSA bacteremia received vancomycin 1.5 g intravenously twice daily and were randomly assigned (1:1) to receive intravenous flucloxacillin 2 g every 6 hours for 7 days (combination group) or no additional therapy (standard therapy group). Participants were stratified by hospital and randomized in permuted blocks of variable size. Randomization codes were kept in sealed, sequentially numbered, opaque envelopes. The primary outcome was the duration of MRSA bacteremia in days. RESULTS: We randomly assigned 60 patients to receive vancomycin (n = 29), or vancomycin plus flucloxacillin (n = 31). The mean duration of bacteremia was 3.00 days in the standard therapy group and 1.94 days in the combination group. According to a negative binomial model, the mean time to resolution of bacteremia in the combination group was 65% (95% confidence interval, 41%-102%; P = .06) that in the standard therapy group. There was no difference in the secondary end points of 28- and 90-day mortality, metastatic infection, nephrotoxicity, or hepatotoxicity. CONCLUSIONS: Combining an antistaphylococcal β-lactam with vancomycin may shorten the duration of MRSA bacteremia. Further trials with a larger sample size and objective clinically relevant end points are warranted.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherOxford University Press (OUP)
dc.relation.ispartofpagefrom173
dc.relation.ispartofpageto180
dc.relation.ispartofissue2
dc.relation.ispartofjournalClinical Infectious Diseases
dc.relation.ispartofvolume62
dc.subject.fieldofresearchBiological sciences
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchcode31
dc.subject.fieldofresearchcode32
dc.subject.keywordsMRSA
dc.subject.keywordsStaphylococcus aureus
dc.subject.keywordsbacteremia
dc.subject.keywordsclinical trial
dc.subject.keywordsvancomycin
dc.titleCombination of Vancomycin and β-Lactam Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Pilot Multicenter Randomized Controlled Trial
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationDavis, JS; Sud, A; O'Sullivan, MVN; Robinson, JO; Ferguson, PE; Foo, H; van Hal, SJ; Ralph, AP; Howden, BP; Binks, PM; Kirby, A; Tong, SYC; Combination Antibiotics for MEthicillin Resistant Staphylococcus aureus (CAMERA) study group; Subedi, S; et al., Combination of Vancomycin and β-Lactam Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Pilot Multicenter Randomized Controlled Trial., Clin Infect Dis, 2016, 62 (2), pp. 173-180
dcterms.dateAccepted2015-08-28
dc.date.updated2020-05-20T05:13:49Z
dc.description.versionAccepted Manuscript (AM)
gro.rights.copyright© 2016 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Clinical Infectious Diseases following peer review. The definitive publisher-authenticated version Combination of Vancomycin and β-Lactam Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Pilot Multicenter Randomized Controlled Trial , Clinical Infectious Diseases, Volume 62, Issue 2, Pages 173–180, 2020 is available online at: https://doi.org/10.1093/cid/civ808
gro.hasfulltextFull Text
gro.griffith.authorSubedi, Shradha


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