Please use this identifier to cite or link to this item:
Title: Combination of Vancomycin and β-Lactam Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Pilot Multicenter Randomized Controlled Trial.
Authors: Davis JS
Sud A
O'Sullivan MVN
Robinson JO
Ferguson PE
Foo H
van Hal SJ
Ralph AP
Howden BP
Binks PM
Kirby A
Tong SYC
Majumdar S
Baird RW
Gordon C
Jeremiah C
Leung G
Brischetto A
Crowe A
Dakh F
Whykes K
Kirkwood M
Menon M
Somerville L
Subedi S
Owen S
Liu E
Zhou F
Robinson O
Coombs G
Pollet S
Davis R
Citation: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2016-01-15; 62(2): 173-180
Abstract: In vitro laboratory and animal studies demonstrate a synergistic role for the combination of vancomycin and antistaphylococcal β-lactams for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Prospective clinical data are lacking. In this open-label, multicenter, clinical trial, adults with MRSA bacteremia received vancomycin 1.5 g intravenously twice daily and were randomly assigned (1:1) to receive intravenous flucloxacillin 2 g every 6 hours for 7 days (combination group) or no additional therapy (standard therapy group). Participants were stratified by hospital and randomized in permuted blocks of variable size. Randomization codes were kept in sealed, sequentially numbered, opaque envelopes. The primary outcome was the duration of MRSA bacteremia in days. We randomly assigned 60 patients to receive vancomycin (n = 29), or vancomycin plus flucloxacillin (n = 31). The mean duration of bacteremia was 3.00 days in the standard therapy group and 1.94 days in the combination group. According to a negative binomial model, the mean time to resolution of bacteremia in the combination group was 65% (95% confidence interval, 41%-102%; P = .06) that in the standard therapy group. There was no difference in the secondary end points of 28- and 90-day mortality, metastatic infection, nephrotoxicity, or hepatotoxicity. Combining an antistaphylococcal β-lactam with vancomycin may shorten the duration of MRSA bacteremia. Further trials with a larger sample size and objective clinically relevant end points are warranted. Australian New Zealand Clinical Trials Registry: ACTRN12610000940077 (
Click to open PubMed article:
Journal title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Publication Date: 2016-01-15
Type: Journal Article
Multicenter Study
Randomized Controlled Trial
DOI: 10.1093/cid/civ808
Appears in Collections:(a) NT Health Research Collection

Files in This Item:
There are no files associated with this item.

Items in ePublications are protected by copyright, with all rights reserved, unless otherwise indicated.

Google Media

Google ScholarTM

Who's citing