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WEDNESDAY, Oct. 24, 2018 (HealthDay News) — For patients with staphylococcal bacteremia, an algorithm that defines treatment duration results in a non-inferior rate of clinical success compared with usual care, according to a study published in the Sept. 25 issue of the Journal of the American Medical Association<\/i>.<\/p>\n
Thomas L. Holland, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues conducted a randomized trial involving adults with staphylococcal bacteremia at 16 medical centers. Follow-up was for 42 days beyond end of therapy for those with Staphylococcus aureus<\/i> and 28 days for those with coagulase-negative staphylococcal bacteremia. Participants were randomized to algorithm-based therapy (255 patients) or usual practice (254 patients). For the algorithm group, diagnostic evaluation, antibiotic selection, and therapy duration were predefined.<\/p>\n
The researchers found that clinical success was documented in 82.0 and 81.5 percent of patients assigned to algorithm-based therapy and usual practice, respectively (difference, 0.5 percent; one-sided 97.5 percent confidence interval, \u22126.2 to \u221e). Serious adverse events were reported in 32.5 and 28.3 percent of algorithm-based therapy and usual practice patients, respectively (difference, 4.2 percent; 95 percent confidence interval, \u22123.8 to 12.2 percent). The mean duration of therapy was 4.4 days for algorithm-based therapy versus 6.2 days for usual practice among per-protocol patients with simple or uncomplicated bacteremia (difference, \u22121.8 days; 95 percent confidence interval, \u22123.1 to \u22120.6).<\/p>\n
“The use of an algorithm to guide testing and treatment compared with usual care resulted in a non-inferior rate of clinical success; although there was not a significant difference in serious adverse events, interpretation is limited by wide confidence intervals,” the authors write.<\/p>\n
Several authors disclosed financial ties to the biopharmaceutical industry.<\/p>\n
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