Improved Outcome with Early Rifampicin Combination Treatment in Methicillin-Sensitive Staphylococcus aureus Bacteraemia with a Deep Infection Focus - A Retrospective Cohort Study

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Forsblom , E , Ruotsalainen , E & Jarvinen , A 2015 , ' Improved Outcome with Early Rifampicin Combination Treatment in Methicillin-Sensitive Staphylococcus aureus Bacteraemia with a Deep Infection Focus - A Retrospective Cohort Study ' , PLoS One , vol. 10 , no. 4 , 0122824 . https://doi.org/10.1371/journal.pone.0122824

Title: Improved Outcome with Early Rifampicin Combination Treatment in Methicillin-Sensitive Staphylococcus aureus Bacteraemia with a Deep Infection Focus - A Retrospective Cohort Study
Author: Forsblom, Erik; Ruotsalainen, Eeva; Jarvinen, Asko
Contributor: University of Helsinki, Clinicum
University of Helsinki, Infektiosairauksien yksikkö
University of Helsinki, Department of Medicine
Date: 2015-04-13
Language: eng
Number of pages: 13
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/166045
Abstract: Introduction Rifampicin has been used as adjunctive therapy in Staphylococcus aureus bacteraemia (SAB) with a deep infection focus. However, data for prognostic impact of rifampicin therapy is unestablished including the optimal initiation time point. We studied the impact of rifampicin therapy and the optimal initiation time for rifampicin treatment on prognosis in methicillin-sensitive S. aureus bacteraemia with a deep infection. Methods Retrospective, multicentre study in Finland including 357 SAB patients with a deep infection focus. Patients with alcoholism, liver disease or patients who died within 3 days were excluded. Patients were categorised according to duration of rifampicin therapy and according to whether rifampicin was initiated early (within 7 days) or late (7 days after) after the positive blood cultures. Primary end point was 90 days mortality. Results Twenty-seven percent of patients received no rifampicin therapy, 14% received rifampicin for 1-13 days whereas 59% received rifampicin >= 14 days. The 90 day mortality was; 26% for patients treated without rifampicin, 16% for rifampicin therapy of any length and 10% for early onset rifampicin therapy >= 14 days. Lack of rifampicin therapy increased (OR 1.89, p=0.026), rifampicin of any duration decreased (OR 0.53, p=0.026) and rifampicin therapy >= 14 days with early onset lowered the risk for a fatal outcome (OR 0.33, p Conclusion Rifampicin adjunctive therapy for at least 14 days and initiated within 7 days of positive blood culture associated with improved outcome among SAB patients with a deep infection.
Subject: PROSTHETIC JOINT INFECTIONS
RANDOMIZED CLINICAL-TRIAL
ANTIBIOTIC-TREATMENT
DRUG-USERS
ENDOCARDITIS
RESISTANT
THERAPY
VANCOMYCIN
MORTALITY
OSTEOMYELITIS
3121 General medicine, internal medicine and other clinical medicine
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