A multicenter study of the real-world use of ceftaroline versus vancomycin for acute bacterial skin and skin structure infections.
Antimicrob Agents Chemother. 2019 Aug 12;:
Authors: Trinh TD, Jorgensen SCJ, Zasowski EJ, Claeys KC, Lagnf AM, Estrada SJ, Delaportes DJ, Huang V, Klinker KP, Kaye KS, Davis SL, Rybak MJ
Objective: To determine if real-world ceftaroline treatment in adults hospitalized for acute bacterial skin and skin structure infections (ABSSSI) is associated with decreased infection-related length of stay (LOSInf ) compared to vancomycin.Design: Retrospective, multicenter, cohort study from 2012 to 2017. Cox proportional hazard regression, propensity score matching and inverse probability of treatment weighting (IPTW) were used to determine the independent effect of treatment group on LOSInf. Setting: Four academic medical centers and two community hospitals in Arizona, Florida, Michigan, and West Virginia, United States.Patients: Adults hospitalized with ABSSSI and treated with ceftaroline or vancomycin for ≥72 hours within 120 hours of diagnosis.Results: A total of 724 patients were included (325 ceftaroline and 399 vancomycin). In general, ceftaroline patients had characteristics consistent with a higher risk of poor outcomes. The unadjusted median LOSinf was 5 (3, 7) days and 6 (4, 8) days in the vancomycin and ceftaroline group, respectively (HR, 0.866, 95% CI 0.747, 1.002). The Cox proportional hazard model, propensity score matched and IPTW analyses demonstrated no significant difference in LOSInf between groups (aHR, 0.891; 95% CI 0.748, 1.060; aHR 0.955, 95% CI 0.786, 1.159; aHR 0.918, 95% CI 0.793, 1.063, respectively). Patients treated with ceftaroline were significantly more likely to meet criteria for discharge readiness at day three in unadjusted and adjusted analyses.Conclusions: Although discharge readiness at day three was higher in ceftaroline treated patients, LOSInf was similar between treatment groups. Clinical and non-clinical factors were associated with LOSInf.
PMID: 31405859 [PubMed - as supplied by publisher]