Patient characteristics | β-lactam plus vancomycina (n=153) | β-lactam monotherapya (n=47) | P-value |
---|---|---|---|
Ageb | 51.3 ± 16.9 | 58.7 ± 16.1 | < 0.01 |
Males | 92 (60.1) | 34 (72.3) | 0.17 |
Community-onset | 137 (89.5) | 36 (76.6) | 0.03 |
Hospital-onset | 16 (10.5) | 11 (23.4) | 0.03 |
HIV infection | 18 (11.8) | 2 (4.26) | 0.17 |
Hepatitis C infection | 50 (32.7) | 11 (23.4) | 0.28 |
Immunocompromised | 12 (7.84) | 6 (12.8) | 0.38 |
Alcohol or illicit drug abuse | 68 (44.4) | 14 (29.8) | 0.09 |
Intravenous drug use | 54 (35.3) | 10 (21.3) | 0.08 |
Charlson comorbidity indexc | 3 (1–6) | 3 (1–5) | 0.30 |
Pitt bacteremia scorec | 1 (0–2) | 0 (0–1) | < 0.01 |
Infectious diseases consultation | 120 (78.4) | 30 (63.8) | 0.05 |
Source of bacteremia | |||
Central or peripheral line | 15 (9.80) | 9 (19.1) | 0.12 |
Skin and soft tissue | 25 (16.3) | 11 (23.4) | 0.28 |
Intravenous drug use | 43 (28.1) | 5 (10.6) | 0.02 |
Bone or joint infection | 15 (9.80) | 8 (17.0) | 0.19 |
Lung | 4 (2.61) | 2 (4.26) | 0.63 |
Other | 14 (9.15) | 5 (10.6) | 0.78 |
Unknown | 37 (24.2) | 7 (14.9) | 0.23 |
Infective endocarditis | 40 (26.1) | 5 (10.6) | 0.03 |
Metastatic complications | 66 (43.1) | 7 (14.9) | < 0.001 |
Surgical source control | 31 (20.3) | 12 (25.5) | 0.43 |
Empiric antimicrobials | |||
Cloxacillin or cefazolin | 95 (62.1) | 43 (91.5) | < 0.0001 |
3rd generation cephalosporin | 73 (47.7) | 7 (14.9) | < 0.0001 |
Piperacillin-tazobactam | 65 (42.5) | 4 (8.51) | < 0.0001 |
Ticarcillin-clavulanic acid | 2 (1.31) | 1 (2.13) | 0.55 |
Carbapenem | 7 (4.58) | 1 (2.13) | 0.68 |
Daptomycin | 0 | 2 (4.26) | 0.05 |
Linezolid | 1 (0.65) | 1 (2.13) | 0.42 |
Otherd | 60 (39.2) | 22 (46.8) | 1.00 |
Blood culture time to positivitye | 20.3 (16.3–25.3) | 19.8 (18.0–27) | 0.36 |
Duration of empiric therapye | 55.5 (44.9–73.8) | 54.3 (38.8–64.5) | 0.08 |
Duration of definitive therapyf | 31 (14–43) | 26 (12–40) | 0.18 |
Time to receipt of empiric therapye | 1.6 (0.03–6.17) | 3.95 (0.58–15.5) | 0.08 |
Time to receipt of β-lactame | 2.77 (0.25–13.7) | 3.95 (0.58–16.6) | 0.74 |
Time to receipt of cloxacillin or cefazoline | 34.8 (21.2–58.4) | 13.0 (1.83–23.8) | 0.00 |
Empiric β-lactam exposuree | 52.3 (39.8–73.8) | 51.7 (38.8–64.5) | 0.42 |
Proportional empiric β-lactam exposureg | 100 (86.1–100) | 100 (95.2–100) | 0.01 |
Primary outcome | |||
28-day mortality | 14 (9.15) | 2 (4.26) | 0.37 |
Secondary outcomes | |||
90-day mortality | 21 (13.7) | 4 (8.51) | 0.45 |
Recurrent infection at 6 months | 5 (3.27) | 2 (4.26) | 0.67 |
Duration of bacteremiae,h | 84.8 (52.5–136) | 63.4 (30.5–114) | 0.03 |
≥ 3 daysh | 81 (56.3) | 17 (44.7) | 0.27 |
Hospital length of stayf | 26 (13–45) | 15 (10–30) | < 0.01 |