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Predictors of Clinical Success in the Treatment of Patients with Methicillin-Resistant Staphylococcus aureus (MRSA) Nosocomial Pneumonia (NP).

MedStar author(s):

Citation: PLoS ONE [Electronic Resource]. 10(7):e0131932, 2015.PMID: 26196695Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Randomized Controlled Trial | Research Support, Non-U.S. Gov'tSubject headings: *Cross Infection/dt [Drug Therapy] | *Linezolid/ad [Administration & Dosage] | *Methicillin-Resistant Staphylococcus aureus | *Pneumonia, Staphylococcal/dt [Drug Therapy] | *Vancomycin/ad [Administration & Dosage] | Adult | Aged | Aged, 80 and over | Cross Infection/pp [Physiopathology] | Double-Blind Method | Female | Humans | Male | Middle Aged | Pneumonia, Staphylococcal/pp [Physiopathology]Year: 2015 Local holdings: Available online through MWHC library: 2006 - presentISSN:

1932-6203

Name of journal: PloS oneAbstract: Methicillin-resistant Staphylococcus aureus (MRSA) remains an important pathogen in nosocomial pneumonia and is associated with significant morbidity and mortality. Clinical outcomes for nosocomial pneumonia are dependent on patient age, co-morbidities, severity of illness and appropriate antibiotic therapy. The objective of this secondary analysis was to identify baseline clinical variables that are associated with clinical success at the end of the study observation period. Data from a randomized blinded trial (NCT00084266) comparing linezolid (600-mg twice daily) to vancomycin (15-mg/kg twice daily, dose-adjusted) for the treatment of culture-proven MRSA pneumonia were analyzed to evaluate baseline clinical and demographic factors that may predict clinical success at end of study (EOS) (7-30 days after end of treatment). A multivariate logistic regression was conducted to identify baseline factors that are associated with clinical success. Patients treated with linezolid (OR 1.55 95% CI: 1.013, 2.355), no vasopressor receipt (OR 2.30, 95% CI: 1.303, 4.069), unilateral involvement (OR 1.70, 95% CI: 1.078, 2.681) and normal renal function (eGFR 30-80 vs >80 OR 0.48, 95% CI: 0.303, 0.750) were more likely to have clinical success. From a clinical standpoint, identifying reliable predictors of outcome and who might benefit more from one therapy versus another can help inform treatment decisions.All authors: Biswas P, Niederman MS, Puzniak LA, Shorr AFFiscal year: FY2016Digital Object Identifier:

http://dx.doi.org/10.1371/journal.pone.0131932

Date added to catalog: 2016-05-24

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26196695	Available		26196695

Available online through MWHC library: 2006 - present

Methicillin-resistant Staphylococcus aureus (MRSA) remains an important pathogen in nosocomial pneumonia and is associated with significant morbidity and mortality. Clinical outcomes for nosocomial pneumonia are dependent on patient age, co-morbidities, severity of illness and appropriate antibiotic therapy. The objective of this secondary analysis was to identify baseline clinical variables that are associated with clinical success at the end of the study observation period. Data from a randomized blinded trial (NCT00084266) comparing linezolid (600-mg twice daily) to vancomycin (15-mg/kg twice daily, dose-adjusted) for the treatment of culture-proven MRSA pneumonia were analyzed to evaluate baseline clinical and demographic factors that may predict clinical success at end of study (EOS) (7-30 days after end of treatment). A multivariate logistic regression was conducted to identify baseline factors that are associated with clinical success. Patients treated with linezolid (OR 1.55 95% CI: 1.013, 2.355), no vasopressor receipt (OR 2.30, 95% CI: 1.303, 4.069), unilateral involvement (OR 1.70, 95% CI: 1.078, 2.681) and normal renal function (eGFR 30-80 vs >80 OR 0.48, 95% CI: 0.303, 0.750) were more likely to have clinical success. From a clinical standpoint, identifying reliable predictors of outcome and who might benefit more from one therapy versus another can help inform treatment decisions.

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