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Possibility of Poor Outcomes after Treatment Using Teicoplanin at the Minimum Inhibitory Concentration of > 2 mu g/mL in Methicillin-resistant Staphylococcus aureus Bacteremia

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Title: Possibility of Poor Outcomes after Treatment Using Teicoplanin at the Minimum Inhibitory Concentration of > 2 mu g/mL in Methicillin-resistant Staphylococcus aureus Bacteremia
Authors: Kagami, Keisuke Browse this author
Imai, Shungo Browse this author
Tazawa, Yuki Browse this author
Iwasaki, Sumio Browse this author
Fukumoto, Tatsuya Browse this author
Akizawa, Koji Browse this author
Yamada, Takehiro Browse this author
Ishiguro, Nobuhisa Browse this author
Iseki, Ken Browse this author →KAKEN DB
Keywords: teicoplanin
methicillin-resistant Staphylococcus aureus
bacteremia
Issue Date: Sep-2018
Publisher: The Pharmaceutical Society of Japan
Journal Title: 薬学雑誌
Journal Title(alt): Journal of the pharmaceutical society of Japan
Volume: 138
Issue: 9
Start Page: 1181
End Page: 1189
Publisher DOI: 10.1248/yakushi.18-00011
PMID: 30175762
Abstract: Only minimal information exists regarding the treatment outcomes of patients suffering from methicillin-resistant Staphylococcus aureus (MRSA) bacteremia treated with teicoplanin (TEIC) when the TEIC minimum inhibitory concentration (MIC) is close to the upper limit of the "susceptibility range" according to the Clinical Laboratory Standards Institute (CLSI) . We investigated the outcome of TEIC-treated patients in MRSA bacteremia, focusing on TEIC MIC against MRSA. A retrospective cohort study was conducted on patients with MRSA bacteremia. TEIC treatment failure was defined as any of the following: (1) all-cause 60-day mortality, (2) persistent bacteremia until the end of TEIC treatment, or (3) 30-day recurrence of MRSA bacteremia. Nineteen patients were enrolled, of whom 15 exhibited TEIC MICs <= 2 mu g/mL and the remaining 4 exhibited >2 mu g/mL. The rate of treatment failure and all-cause 60-day mortality in patients with MIC >2 mu g/mL were significantly higher than those in patients with MIC <= 2 mu g/mL [4 patients (100%) versus 4 patients (26.7 %) (p=0.018) and 4 patients (100%) versus 2 patients (13.3%) (p=0.004) , respectively] . Three of four patients (75%) with MIC >2 mu g/mL had persistent bacteremia, which was quantitatively higher than in patients with MIC <= 2 mu g/mL (1 of 7 patients, 14.3%) . Our finding suggests that TEIC MIC >2 mu g/mL may be related to poor treatment outcome in MRSA bacteremia, and that TEIC should not be used in this case.
Rights: Copyright 2018 The Pharmaceutical Society of Japan
Type: article
URI: http://hdl.handle.net/2115/71741
Appears in Collections:薬学研究院 (Faculty of Pharmaceutical Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 井関 健

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