Table 2.
Clinical Outcomes of 3 Strategies for Management of Methicillin-Sensitive Staphylococcus aureus Bacteremia and Reported Penicillin Allergy
| Outcome | Vanc | Hx-Cefaz | ST-Cefaz |
|---|---|---|---|
| Cure, % | 67.3 | 83.4 | 84.5 |
| Recurrence, % | 14.8 | 9.3 | 8.9 |
| Death, % | 17.9 | 7.3 | 6.6 |
| Allergic reactionsa, total, % | 3.0 | 2.4 | 1.7 |
| Major, % | 0.3 | 0.1 | 0.1 |
| Minor, % | 2.8 | 2.2 | 1.6 |
| Iatrogenic allergic reactionsb, % | 0.8 | 2.1 | 1.6 |
| Adverse drug reactions, % | 5.2 | 4.6 | 4.7 |
| Composite outcome valuec (strategy rank) | 21.3 (3) | 35.9 (2) | 36.8 (1) |
Abbreviations: Hx-Cefaz, allergy history-guided treatment: if history excludes anaphylactic features, give cefazolin; PCN, penicillin; ST-Cefaz, complete allergy evaluation with PCN skin testing, give cefazolin if negative; Vanc, no allergy evaluation, give vancomycin.
a Major and minor reactions do not sum to total due to rounding.
b Reactions from cefazolin in a patient with reported PCN allergy.
c Composite outcome weights: cure, +50; recurrence of infection, −20; death, −50; major allergic reactions, −10; minor allergic reactions, −2; adverse drug reactions, −6.