Abstract:
STUDY OBJECTIVE:To determine whether early administration of adjuvant β-lactam in combination with vancomycin (COMBO) affects clinical outcomes compared to standard vancomycin therapy alone (STAN) among patients with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection. DESIGN:Retrospective, multicenter cohort study. SETTING:Five academic or community hospitals throughout the United States. PATIENTS:Adults with MRSA bloodstream infections treated with vancomycin (≥ 72 hrs) with or without an intravenous β-lactam (≥ 48 hrs) initiated within 24 hours of initiating vancomycin. MEASUREMENTS AND MAIN RESULTS:The primary outcome was clinical failure, a composite endpoint including 30-day mortality, persistent bacteremia (≥ 7 days), bacteremia relapse, or change in antibiotic therapy during treatment due to clinical worsening. A multivariable logistic regression examined the impact of patient-, treatment-, and pathogen-level characteristics on clinical failure. A total of 201 patients were evaluated of whom 97 (48.3%) met the criteria for study inclusion; 40 (41.2%) in STAN and 57 (58.8%) in COMBO groups. Among patients in the STAN and COMBO groups, 30% and 24.6% experienced clinical failure, respectively (p=0.552). The median (interquartile range) duration of bacteremia in the STAN and COMBO groups was 4 days (2.5-6.5) and 3 days (2-5), respectively (p=0.048). In a multivariable analysis, receipt of COMBO therapy was inversely associated with clinical failure (adjusted odds ratio [aOR] 0.237, 95% confidence interval [CI] [0.057-0.982]; p=0.047). Other independent predictors of clinical failure included complicated bacteremia (aOR 6.856, 95% CI [1.641-28.649]; p=0.008) and antibiotic therapy not continued at discharge (aOR 45.404, 95% CI [9.383-219.714]; p<0.001). CONCLUSIONS:Receipt of COMBO therapy did not decrease the rate of clinical failure but was associated with expedited bacteremia clearance. Early adjuvant β-lactam therapy deserves continued evaluation and clinical consideration.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Casapao AM,Jacobs DM,Bowers DR,Beyda ND,Dilworth TJ,REACH-ID Study Group.doi
10.1002/phar.2034subject
Has Abstractpub_date
2017-11-01 00:00:00pages
1347-1356issue
11eissn
0277-0008issn
1875-9114journal_volume
37pub_type
杂志文章,多中心研究相关文献
PHARMACOTHERAPY文献大全abstract:BACKGROUND:As one of the most accessible health care professionals, pharmacists are in an ideal position to provide tobacco-cessation and prevention services. Although there is growing interest in expanding the pharmacist's role in tobacco treatment, few published studies have assessed the efficacy or effectiveness of ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.27.7.1040
更新日期:2007-07-01 00:00:00
abstract::The prevalence of diabetes mellitus has grown to staggering numbers, and its incidence is expected to rise in the next 2 decades. The need for novel approaches to treat hyperglycemia cannot be ignored. Current agents have been shown to modestly improve glycemia and in some cases prevent complications of diabetes, but ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/PHAR.1010
更新日期:2012-01-01 00:00:00
abstract::Subtherapeutic tacrolimus trough concentrations were noted in a 52-year-old woman who had undergone liver transplantation. Her tacrolimus dosage was increased from 7 to 28 mg twice/day, and ketoconazole therapy was added; however, her tacrolimus concentration remained undetectable. Metoclopramide 10 mg 4 times/day was...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.24.5.532.33357
更新日期:2004-04-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the efficacy of amlodipine and valsartan in African-American patients with hypertension using ambulatory blood pressure monitoring (ABPM). DESIGN:Prospective, randomized, double-blind, crossover comparison study. SETTING:University-affiliated cardiac center clinic. PATIENTS:Twenty African-...
journal_title:Pharmacotherapy
pub_type: 杂志文章,随机对照试验
doi:10.1592/phco.26.7.889
更新日期:2006-07-01 00:00:00
abstract::Certain enteric ailments are particularly common among homosexual men. They are primarily infectious diseases and include not only such common venereal diseases as gonorrhea and syphilis but also infections not usually regarded as being sexually transmitted. Among the latter are shigellosis, salmonellosis, giardiasis,...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/j.1875-9114.1982.tb03170.x
更新日期:1982-01-01 00:00:00
abstract::Drug-induced thrombocytopenia is a rare but serious adverse event that has been associated with multiple drugs including β-lactams. Although it mostly occurs with prolonged medication use, some cases of rapid-onset thrombocytopenia have been reported. We describe the case of a 69-year-old man who developed severe and ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1675
更新日期:2015-12-01 00:00:00
abstract::The use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) has significantly reduced morbidity and mortality across the continuum of vascular disease. The utilization of these agents, however, remains suboptimal. The drugs are not prescribed in many patients because of concerns ...
journal_title:Pharmacotherapy
pub_type: 评论,杂志文章
doi:10.1592/phco.24.6.697.34731
更新日期:2004-05-01 00:00:00
abstract:STUDY OBJECTIVE:A safe alternative to erythropoiesis-stimulating agents to treat anemia is warranted in patients with cancer and anemia; thus the objective of this trial was to compare the efficacy and safety of intravenous (IV) iron isomaltoside with oral iron in patients with cancer and anemia by testing the noninfer...
journal_title:Pharmacotherapy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/phar.1729
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To review the current pharmacotherapy for idiopathic pulmonary arterial hypertension (IPAH). METHODS:A search of the primary literature was conducted by using MEDLINE, the National Institutes of Health medical research Web site (www.clinicaltrials.gov), and the United States Food and Drug Administration's Ce...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.2006.26.1.68
更新日期:2006-01-01 00:00:00
abstract::Rapacuronium is a new steroidal, nondepolarizing, neuromuscular blocking agent. It appears to be the least potent of all available nondepolarizing muscle relaxants. Its onset of action resembles that of succinylcholine, and its recovery times are shorter than those of other nondepolarizing agents. The clinical duratio...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.19.15.1118.30572
更新日期:1999-10-01 00:00:00
abstract::Bedaquiline is a diarylquinoline antitubercular drug with a novel mechanism of action against Mycobacterium tuberculosis. Bedaquiline works by inhibiting bacterial adenosine triphosphate (ATP) synthase and represents the first novel class of antituberculosis agents in more than 40 years. Bedaquiline is indicated for t...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1482
更新日期:2014-11-01 00:00:00
abstract::Posttransplantation hypertension has been identified as an independent risk factor for chronic allograft dysfunction and loss. Based on available morbidity and mortality data, posttransplantation hypertension must be identified and managed appropriately. During the past decade, calcium channel blockers have been recom...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.23.6.788.32180
更新日期:2003-06-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the pharmacodynamics of four intravenous antimicrobial regimens-ceftriaxone 1 g, gatifloxacin 400 mg, levofloxacin 500 mg, and levofloxacin 750 mg, each every 24 hours-against recent Streptococcus pneumoniae isolates. DESIGN:Pharmacodynamic analysis using Monte Carlo simulation. DATA SOURC...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.2005.25.9.1161
更新日期:2005-09-01 00:00:00
abstract::Exenatide is an incretin mimetic indicated for the treatment of type 2 diabetes mellitus in combination with a sulfonylurea, a thiazolidinedione, metformin, or metformin plus a sulfonylurea or thiazolidinedione. Exenatide lowers postprandial blood glucose levels by stimulating glucose-dependent insulin secretion, inhi...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.27.10.1449
更新日期:2007-10-01 00:00:00
abstract::We conducted a retrospective analysis to evaluate the relationship between anxiolytic or hypnotic therapy and maintenance of therapy with selective serotonin reuptake inhibitors (SSRIs). Subjects were 654 patients who received anxiolytics or hypnotics early in SSRI therapy (study group ) and 15,172 patients who did no...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the level of agreement between two sets of criteria, the Thrombolysis in Myocardial Infarction (TIMI) criteria and investigator-developed criteria, for identifying bleeding events in patients who had undergone a percutaneous coronary intervention (PCI) and to measure length of hospital stay ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.27.1.36
更新日期:2007-01-01 00:00:00
abstract::A 63-year-old man with ventricular tachycardia (VT) refractory to drug therapy was admitted for surgical ablation of the VT with coronary artery bypass graft surgery. He developed increased theophylline concentrations with decreased calculated theophylline clearance after propafenone therapy for recurrent VT was initi...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Decades of overuse and misuse of antibiotics have turned the resistance problem into a crisis. Preventive and corrective measures are urgently needed. This article presents a broad overview of the status of antimicrobial resistance. Resistance in key bacterial pathogens such as enterococci, staphylococci, pneumococci,...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.24.18.203S.52236
更新日期:2004-12-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy and safety of a new combination product, enalapril-diltiazem ER, when administered over the long term. DESIGN:Open-label, titration to response, with treatment lasting 46 weeks after a 6-week, double-blind phase. SETTING:Medical clinics in the private and academic sectors. PA...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1997-01-01 00:00:00
abstract:STUDY OBJECTIVES:To compare the cost-effectiveness of intravenous plus oral amiodarone, atrial septal pacing, and both strategies combined to prevent atrial fibrillation after open heart surgery. Secondary objectives were to compare the cost-effectiveness of amiodarone versus no amiodarone and of pacing versus no pacin...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1592/phco.24.11.1013.36132
更新日期:2004-08-01 00:00:00
abstract::Recombinant human erythropoietin reverses the severe anemia associated with end-stage renal disease. Mean half-life values after a single intravenous bolus dose range from 4-13 hours. Renal clearance is not a significant route of elimination. Dosing schedules in chronic renal failure involve a single intravenous bolus...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::The pharmacokinetic disposition of numerous antimicrobial agents is altered in critically ill patients. Pharmacokinetics of trovafloxacin, a fluoroquinolone indicated specifically for severe, life-threatening infections in the intensive care unit, have not been well studied in this population. We characterized the pha...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1592/phco.20.5.400.35056
更新日期:2000-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the bioavailability and renal elimination of para-aminosalicylic acid (PAS) and its inactive metabolite acetyl-para-aminosalicylic acid (AcPAS) from a new PAS formulation. DESIGN:(a) Single-dose pharmacokinetic study in healthy volunteers; (b) Day-1 and day-8 pharmacokinetic comparison in ...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章
doi:10.1002/j.1875-9114.1994.tb02787.x
更新日期:1994-01-01 00:00:00
abstract::3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are a frequently prescribed class of drugs that are generally well tolerated by most patients. A rare, yet serious side effect associated with these drugs is rhabdomyolysis. Although all HMG-CoA reductase inhibitors can cause this adverse effect, pre...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.22.7.533.33674
更新日期:2002-04-01 00:00:00
abstract::Methotrexate, administered for treatment of pediatric and adult malignancies, is a direct renal toxin, which can lead to renal dysfunction, decreased methotrexate clearance, elevated methotrexate concentrations, and systemic toxicity. Although plasma methotrexate concentrations have been shown to decline precipitously...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.30.1.111
更新日期:2010-01-01 00:00:00
abstract::Clinical trials continue to evaluate the pharmacologic management of myocardial infarction for benefits in mortality, degree of infarct artery patency, and frequency of reocclusion. The discovery of thrombus formation in the development of the myocardial infarction renewed interest in thrombolytic therapy. In appropri...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-01 00:00:00
abstract::Carbamazepine is a potent anticonvulsant agent with proven efficacy in the treatment of partial and tonic-clonic seizures. An epileptic child treated with therapeutic dosages of carbamazepine developed severe hepatitis and hepatic insufficiency. She had a positive response to withdrawal of the drug and administration ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.19.3.252.30918
更新日期:1999-02-01 00:00:00
abstract::Therapeutic goals for atrial fibrillation (AF) include ventricular rate control, stroke prevention, conversion to normal sinus rhythm, and maintenance of normal sinus rhythm. The optimal strategy of rate versus rhythm control for acute management of patients with AF is a continuing debate. However, selected patients m...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.24.8.792.36065
更新日期:2004-06-01 00:00:00
abstract::Graves' disease is an autoimmune process in which the thyroid gland is stimulated by autoantibodies, leading to hyperthyroidism. Graves' disease is the most common cause of hyperthyroid function, primarily affecting women in their 40s and 50s. Treatment may involve oral radioiodine, which is taken up by the follicular...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.2005.25.7.1017
更新日期:2005-07-01 00:00:00
abstract::Apixaban, a direct factor Xa inhibitor, is a novel oral anticoagulant (NOAC) indicated for prevention of embolic events in patients with nonvalvular atrial fibrillation. The agent is associated with a lower risk of bleeding compared with vitamin K antagonists such as warfarin. Hemopericardium is a life-threatening ble...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1602
更新日期:2015-07-01 00:00:00