Patient characteristics | β-lactama (n=200) | Vancomycina (n=200) | P-value |
---|---|---|---|
Ageb | 53.0 ± 16.9 | 57.9 ± 18.4 | 0.01 |
Males | 126 (63.0) | 132 (66.0) | 0.53 |
Community-onset | 173 (86.5) | 158 (79.0) | 0.05 |
Hospital-onset | 27 (13.5) | 42 (21.0) | 0.05 |
HIV infection | 20 (10.0) | 16 (8.0) | 0.48 |
Hepatitis C infection | 61 (30.5) | 55 (27.5) | 0.51 |
Immunocompromised | 18 (9.0) | 16 (8.0) | 0.72 |
Alcohol or illicit drug abuse | 82 (41.0) | 71 (35.5) | 0.26 |
Intravenous drug use | 64 (32.0) | 56 (28.0) | 0.38 |
Charlson comorbidity indexc | 3 (1.0–6.0) | 4 (1.0–7.0) | 0.01 |
Pitt bacteremia scorec | 1 (0–2) | 1 (0–2) | 0.18 |
Infectious diseases consultation | 150 (75.0) | 132 (66.0) | 0.05 |
Source of bacteremia | |||
Central or peripheral line | 24 (12.0) | 37 (18.5) | 0.09 |
Skin and soft tissue | 36 (18.0) | 24 (12.0) | 0.12 |
Intravenous drug use | 48 (24.0) | 39 (19.5) | 0.33 |
Bone or joint infection | 23 (11.5) | 13 (6.5) | 0.11 |
Lung | 6 (3.0) | 7 (3.5) | 1.00 |
Other | 19 (9.5) | 20 (10.0) | 1.00 |
Unknown | 44 (22.0) | 60 (30.0) | 0.09 |
Infective endocarditis | 45 (22.5) | 23 (11.5) | < 0.01 |
Metastatic complications | 73 (36.5) | 53 (26.5) | 0.03 |
Surgical source control | 43 (21.5) | 26 (13.0) | 0.02 |
Empiric antimicrobials | |||
β-lactam | 200 (100) | 75 (37.5) | < 0.0001 |
Cloxacillin or cefazolin | 138 (69.0) | 10 (5.0) | < 0.0001 |
3rd generation cephalosporin | 80 (40.0) | 35 (17.5) | < 0.0001 |
Piperacillin-tazobactam | 69 (34.5) | 35 (17.5) | < 0.001 |
Ticarcillin-clavulanic acid | 3 (1.5) | 1 (0.5) | 0.62 |
Carbapenem | 8 (4.0) | 4 (2.0) | 0.24 |
Vancomycin | 153 (76.5) | 197 (98.5) | < 0.0001 |
Daptomycin | 2 (1.0) | 1 (0.5) | 1.00 |
Linezolid | 2 (1.0) | 2 (1.0) | 1.00 |
Otherd | 82 (41.0) | 97 (48.5) | 0.13 |
Blood culture time to positivitye | 20.2 (16.6–25.5) | 18.5 (16.2–23.3) | 0.02 |
Duration of empiric therapye | 55.4 (44.2–72.5) | 52.1 (39.2–75.7) | 0.55 |
Duration of definitive therapyf | 28 (13.0–42.0) | 26.5 (11.0–42.0) | 0.14 |
Time to receipt of empiric therapye | 1.92 (0.1–6.9) | 10.8 (1.4–24.1) | < 0.0001 |
Time to receipt of β-lactame | 2.92 (0.3–13.8) | 50.5 (4.8–75.5) | < 0.0001 |
Time to receipt of cloxacillin or cefazoline | 31.0 (13.8–50.8) | 67.8 (50.3–88.0) | < 0.0001 |
Empiric β-lactam exposure | 52.3 (39.8–71.9)e 60.6 ± 39.9g | 0 (0–16.2)e 9.5 ± 38.5g | < 0.0001 |
Proportional empiric β-lactam exposure | 100 (100–100)h 94.5 ± 46.9i | 0 (0–24.5)h 14.0 ± 44.8i | < 0.0001 |
Primary outcome | |||
28-day mortality | 16 (8.0) | 18 (9.0) | 0.72 |
Secondary outcomes | |||
90-day mortality | 25 (12.5) | 32 (16.0) | 0.32 |
Recurrent infection at 6 months | 7 (3.5) | 8 (4.0) | 0.79 |
Duration of bacteremiae,j | 74.4 (48.3–130) | 89.7 (56.7–132) | 0.20 |
≥ 3 daysj | 98 (53.8) | 111 (60.0) | 0.25 |
Hospital length of stayf | 22.5 (12.5–43.0) | 22 (13.0–45.0) | 0.59 |