Empiric Guideline-Recommended Weight-Based Vancomycin Dosing and Mortality in Methicillin-Resistant Staphylococcus Aureus Bacteremia: A Retrospective Cohort Study

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dc.contributor.utaustinauthorFrei, Chistopher R.en_US
dc.contributor.utaustinauthorForcade, Nicolas A.en_US
dc.creatorHall, Ronald G., IIen_US
dc.creatorGiuliano, Christopher A.en_US
dc.creatorHaase, Krystal K.en_US
dc.creatorHazlewood, Kathleen A.en_US
dc.creatorFrei, Chistopher R.en_US
dc.creatorForcade, Nicolas A.en_US
dc.creatorBrouse, Sara D.en_US
dc.creatorBell, Todden_US
dc.creatorBedimo, Roger J.en_US
dc.creatorAlvarez, Carlos A.en_US
dc.date.accessioned2016-10-28T19:49:15Z
dc.date.available2016-10-28T19:49:15Z
dc.date.issued2012-04en_US
dc.description.abstractNo studies have evaluated the effect of guideline-recommended weight-based dosing on in-hospital mortality of patients with methicillin-resistant Staphylococcus aureus bacteremia. Methods: This was a multicenter, retrospective, cohort study of patients with methicillin-resistant Staphylococcus aureus bacteremia receiving at least 48 hours of empiric vancomycin therapy between 01/07/2002 and 30/06/2008. We compared in-hospital mortality for patients treated empirically with weight-based, guideline-recommended vancomycin doses (at least 15 mg/kg/dose) to those treated with less than 15 mg/kg/dose. We used a general linear mixed multivariable model analysis with variables identified a priori through a conceptual framework based on the literature. Results: A total of 337 patients who were admitted to the three hospitals were included in the cohort. One-third of patients received vancomycin empirically at the guideline-recommended dose. Guideline-recommended dosing was not associated with in-hospital mortality in the univariable (16% vs. 13%, OR 1.26 [95% CI 0.67-2.39]) or multivariable (OR 0.71, 95% CI 0.33-1.55) analysis. Independent predictors of in-hospital mortality were ICU admission, Pitt bacteremia score of 4 or greater, age 53 years or greater, and nephrotoxicity. Conclusions: Empiric use of weight-based, guideline-recommended empiric vancomycin dosing was not associated with reduced mortality in this multicenter study.en_US
dc.description.departmentPharmaceutical Sciencesen_US
dc.description.sponsorshipNorth and Central Texas Clinical and Translational Science Initiative from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) KL2RR024983en_US
dc.description.sponsorshipNIH Roadmap for Medical Researchen_US
dc.description.sponsorshipNIH grant KL2RR025766en_US
dc.identifierdoi:10.15781/T2ST7F06D
dc.identifier.citationHall, Ronald G., Christopher A. Giuliano, Krystal K. Haase, Kathleen A. Hazlewood, Chistopher R. Frei, Nicolas A. Forcade, Sara D. Brouse, Todd Bell, Roger J. Bedimo, and Carlos A. Alvarez. "Empiric guideline-recommended weight-based vancomycin dosing and mortality in methicillin-resistant Staphylococcus aureus bacteremia: a retrospective cohort study." BMC infectious diseases, Vol. 12, No. 1 (Apr., 2012): 1.en_US
dc.identifier.doi10.1186/1471-2334-12-104en_US
dc.identifier.issn1471-2334en_US
dc.identifier.urihttp://hdl.handle.net/2152/43139
dc.language.isoEnglishen_US
dc.relation.ispartofen_US
dc.relation.ispartofserialBMC Infectious Diseasesen_US
dc.rightsAdministrative deposit of works to Texas ScholarWorks: This works author(s) is or was a University faculty member, student or staff member; this article is already available through open access or the publisher allows a PDF version of the article to be freely posted online. The library makes the deposit as a matter of fair use (for scholarly, educational, and research purposes), and to preserve the work and further secure public access to the works of the University.en_US
dc.rights.restrictionOpenen_US
dc.subjectweighten_US
dc.subjectobesityen_US
dc.subjectefficacyen_US
dc.subjectmrsaen_US
dc.subjectvancomycinen_US
dc.subjectbacteremiaen_US
dc.subjecttherapyen_US
dc.subjectpharmacokineticsen_US
dc.subjectpredictionen_US
dc.subjectinfectious diseasesen_US
dc.titleEmpiric Guideline-Recommended Weight-Based Vancomycin Dosing and Mortality in Methicillin-Resistant Staphylococcus Aureus Bacteremia: A Retrospective Cohort Studyen_US
dc.typeArticleen_US

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