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https://hdl.handle.net/2440/133148
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Type: | Journal article |
Title: | Benzylpenicillin versus flucloxacillin for penicillin-susceptible Staphylococcus aureus bloodstream infections from a large retrospective cohort study |
Author: | Henderson, A. Harris, P. Hartel, G. Paterson, D. Turnidge, J. Davis, J.S. Tong, S.Y.C. |
Citation: | International Journal of Antimicrobial Agents, 2019; 54(4):491-495 |
Publisher: | Elsevier |
Issue Date: | 2019 |
ISSN: | 0924-8579 1872-7913 |
Statement of Responsibility: | A. Henderson, P. Harris, G. Hartel, D. Paterson, J. Turnidge, J. S. Davis, S. Y. C. Tong |
Abstract: | In clinical practice, differing opinions exists regarding the optimal management of patients with penicillin-susceptible Staphylococcus aureus (PSSA) bloodstream infection (BSI). The aim of this study was to compare the 30-day mortality of patients treated with benzylpenicillin or flucloxacillin for PSSA BSI from a large prospectively collected data set from Australia and New Zealand. A logistic regression model and propensity score treatment analysis using inverse probability of treatment weighting were used. A total of 915 patients were included in the study, with an overall mortality rate of 12.9% (118/915) [benzylpenicillin 10.5% (33/315) and flucloxacillin 14.2% (85/600)]. Endocarditis was associated with benzylpenicillin treatment choice, whereas skin and soft-tissue infection was associated with flucloxacillin treatment choice. In the multivariate analysis, increased 30-day mortality was associated with flucloxacillin compared with benzylpenicillin [odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.0-2.5; P = 0.05). When adjusted for treatment choice in the propensity score analysis, flucloxacillin was again associated with increased 30-day mortality (OR = 1.06, 95% CI 1.01-1.1; P = 0.03). An increase in 30-day mortality associated with flucloxacillin use suggests a potential benefit for benzylpenicillin therapy in patients with PSSA BSI. |
Keywords: | Bacteraemia Benzylpenicillin Bloodstream infection Flucloxacillin Penicillin-susceptible Staphylococcus aureus |
Rights: | Crown Copyright © 2019 Published by Elsevier B.V. All rights reserved. |
DOI: | 10.1016/j.ijantimicag.2019.05.020 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1083105 http://purl.org/au-research/grants/nhmrc/1065736 |
Published version: | http://dx.doi.org/10.1016/j.ijantimicag.2019.05.020 |
Appears in Collections: | Medicine publications |
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