TABLE 1.
Demographic and clinical characteristics of the two treatment groupsa
| Variable | Value for the group |
P valueb | |
|---|---|---|---|
| Combo (n = 50) | VAN alone (n = 30) | ||
| Mean age (yr [±SD]) | 51.6 ± 15.0 | 50.5 ± 16.8 | 0.772 |
| Median LOS (days [IQR]) | 20.5 (10.0–41.0) | 12.0 (7.8–28.8) | 0.027c |
| Median VAN therapy duration (days [IQR]) | 23.5 (11.0–34.0) | 30.0 (11.0–44.0) | 0.281c |
| Median VAN serum level (mg/liter [IQR])d | 20.2 (16.2–23.2) | 17.5 (14.1–24.4) | 0.067c |
| No. of male participants (%) | 37 (74.0) | 17 (56.7) | 0.112 |
| Race (no. of patients [%]) | 0.531 | ||
| Caucasian | 18 (36.0) | 14 (46.7) | |
| Hispanic | 19 (38.0) | 8 (26.7) | |
| Othere | 13 (26.0) | 8 (26.7) | |
| Comorbidities (no. of patients [%]) | |||
| Alcoholism | 7 (14.0) | 1 (3.3) | 0.097 |
| Cancer | 11 (22.0) | 4 (13.3) | 0.327 |
| Chronic lung disease | 4 (8.0) | 4 (13.3) | 0.448 |
| Congestive heart failure | 6 (12.0) | 2 (6.7) | 0.429 |
| Diabetes mellitus | 25 (50.0) | 13 (43.3) | 0.563 |
| Liver disease | 6 (12.0) | 6 (20.0) | 0.338 |
| MRSA bacteremia risk factors (no. of patients [%]) | |||
| Cellulitis on admission | 2 (4.0) | 4 (13.3) | 0.190f |
| Central venous catheter | 5 (10.0) | 5 (16.7) | 0.389 |
| Hemodialysis | 6 (12.0) | 6 (20.0) | 0.338 |
| Homelessness | 1 (2.0) | 0 (0.0) | >0.999f |
| Immunosuppression | 9 (18.0) | 3 (10.0) | 0.320 |
| Injection drug use | 9 (18.0) | 7 (23.3) | 0.566 |
| MRSA colonizationg | 10 (20.0) | 8 (26.7) | 0.493 |
| Previous health care exposure | 22 (44.0) | 12 (40.0) | 0.726 |
| Prior antibiotic exposureh | 4 (8.0) | 2 (6.7) | >0.999f |
| Skin ulcers on admission | 9 (18.0) | 1 (3.3) | 0.037 |
| Origin of bacteremia (no. of patients [%]) | |||
| Endocarditis | 11 (22.0) | 11 (36.7) | 0.159 |
| Osteomyelitis | 11 (22.0) | 4 (13.3) | 0.327 |
| Skin and soft tissue infection | 5 (10.0) | 1 (3.3) | 0.402f |
| Otheri | 20 (40.0) | 13 (43.3) | 0.770 |
| More than one source | 3 (6.0) | 1 (3.3) | >0.999f |
| Source control (no. of patients [%]) | |||
| Removable source of infection | 11 (22.0) | 8 (26.7) | 0.637 |
| Removable source of infection retainedj | 2 (4.0) | 2 (6.7) | 0.602 |
| Severity of illness markers | |||
| ICU admission (no. of patients [%]) | 21 (42.0) | 6 (20.0) | 0.039 |
| Ventilator use (no. of patients [%]) | 13 (26.0) | 4 (13.3) | 0.169 |
| Median Pitt bacteremia score (IQR) | 1 (1–3) | 1 (0–2) | 0.238c |
| Pitt bacteremia score of ≥4 (no. of patients [%]) | 9 (18.0) | 4 (13.3) | 0.580 |
LOS, length of stay; IQR, interquartile range; ICU, intensive care unit.
P values were calculated by the likelihood ratio χ2 test, except where otherwise noted.
Wilcoxon rank sum test.
One patient in each treatment group did not have a vancomycin serum level documented in the electronic medical record. Both patients experienced microbiological eradication.
Comprised of African American, Asian American/Pacific Islander and Native American/Alaskan Native, two or more races and unknown/declined to answer.
Fisher's exact test.
History of an MRSA infection or being a known MRSA carrier.
Exposure to a β-lactam, fluoroquinolone, or VAN for ≥7 days within 30 days prior to infection.
Comprised of catheter-related bloodstream infection, urinary tract infection, pneumonia, prosthesis, or bacteremia of unknown origin.
Of the four patients for whom a removable source of infection was retained, none experienced microbiological failure.