What question did this study set out to answer?

To determine the quantitative relationship between the vancomycin AUC24/MIC ratio and attributable mortality in patients hospitalized with MRSA complicated bacteremia and infective endocarditis.

November 30, 2011Antimicrobial Agents and ChemotherapyOpen Access

Vancomycin AUC ₂₄ /MIC Ratio in Patients with Complicated Bacteremia and Infective Endocarditis Due to Methicillin-Resistant Staphylococcus aureus and Its Association with Attributable Mortality during Hospitalization

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Authors

JBJack BrownNational Institute for Health Research KBKristen BrownUniversity of Colorado Anschutz Medical Campus AFAlan ForrestRoyal Botanic Garden Edinburgh

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Implication

Retrospective study reveals a vancomycin AUC24/MIC ratio below 211 increases attributable mortality in MRSA bacteremia, highlighting the critical role of adequate dosing.

Key Points

To determine the quantitative relationship between the vancomycin AUC24/MIC ratio and attributable mortality in patients hospitalized with MRSA complicated bacteremia and infective endocarditis.
Retrospectively analyzed 50 hospitalized patients (32 with complicated bacteremia and 18 with infective endocarditis) treated for MRSA between July 2006 and June 2008.
Determined bacterial MICs by Etest and calculated vancomycin AUC24 using a maximum a posteriori probability-Bayesian estimator.
Applied classification and regression tree (CART) analysis to establish the predictive cutoff for attributable mortality, with multivariate logistic regression to adjust for confounders.
A CART-derived vancomycin AUC24/MIC ratio breakpoint of <211 was associated with significantly higher attributable mortality compared to a ratio of ≥211 (38% vs. 8%, P = 0.02).
Multivariate logistic regression demonstrated that an AUC24/MIC ratio <211 (odds ratio, 10.4; P = 0.01) and baseline APACHE-II score (odds ratio, 1.24; P = 0.04) were independent predictors of attributable mortality.

Cite This Study

Brown et al. (2011) studied this question.

synapsesocial.com/papers/6a7357ec8317ef39e84e55da https://doi.org/10.1128/aac.05609-11

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Implication

Retrospective study reveals a vancomycin AUC24/MIC ratio below 211 increases attributable mortality in MRSA bacteremia, highlighting the critical role of adequate dosing.

Vancomycin AUC ₂₄ /MIC Ratio in Patients with Complicated Bacteremia and Infective Endocarditis Due to Methicillin-Resistant Staphylococcus aureus and Its Association with Attributable Mortality during Hospitalization

Discussion

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Implication

Key Points

Cite This Study

Vancomycin AUC ₂₄ /MIC Ratio in Patients with Complicated Bacteremia and Infective Endocarditis Due to Methicillin-Resistant Staphylococcus aureus and Its Association with Attributable Mortality during Hospitalization

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