Combination of Antistaphylococcal β-Lactam With Standard Therapy Compared to Standard Therapy Alone for the Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia: A Post Hoc Analysis of the CAMERA2 Trial Using a Desirability of Outcome Ranking Approach
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Le résumé fourni par la source
Abstract Background Desirability of outcome ranking (DOOR) is an emerging approach to clinical trial outcome measurement using an ordinal scale to incorporate efficacy and safety endpoints. Methods We applied a previously validated DOOR endpoint to a cohort of CAMERA2 trial participants with methicillin-resistant Staphylococcus aureus bacteremia (MRSAB). Participants were randomly assigned to standard therapy, or to standard therapy plus an antistaphylococcal β-lactam (combination therapy). Each participant was assigned a DOOR category, within which they were further ranked according to their hospital length of stay (LOS) and duration of intravenous antibiotic treatment. We calculated the probability and the generalized odds ratio of participants receiving combination therapy having worse outcomes than those receiving standard therapy. Results Participants assigned combination therapy had a 54.5% (95% confidence interval [CI], 48.9%–60.1%; P = .11) probability and a 1.2-fold odds (95% CI, .95–1.50; P = .12) of having a worse outcome than participants on standard therapy. When further ranked according to LOS and duration of antibiotic treatment, participants in the combination group had a 55.6% (95% CI, 49.5%–61.7%) and 55.3% (95% CI, 49.2%–61.4%) probability of having a worse outcome than participants in the standard treatment group, respectively. Conclusions When considering both efficacy and safety, treatment of MRSAB with a combination of standard therapy and a β-lactam likely results in a worse clinical outcome than standard therapy. However, a small benefit of combination therapy cannot be excluded. Most likely the toxicity of combination therapy outweighed any benefit from faster clearance of bacteremia.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé, mais le titre doit être comparé manuellement.
- Titre Crossref
- Combination of Antistaphylococcal β-Lactam With Standard Therapy Compared to Standard Therapy Alone for the Treatment of Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Post Hoc Analysis of the CAMERA2 Trial Using a Desirability of Outcome Ranking Approach
- Date Crossref
- 25/04/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The Royal Melbourne Hospital pays non établi dans la noticeOrganisme public
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The University of Melbourne . Department of Infectious Diseases pays non établi dans la noticeUniversité ou école supérieure
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Peter Doherty Institute Department of Infectious Diseases pays non établi dans la noticeStructure de recherche
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John Hunter Hospital Department of Infectious Diseases pays non établi dans la noticeÉtablissement de santé
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Charles Darwin University Devision of Global and Tropical Health pays non établi dans la noticeUniversité ou école supérieure
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Menzies School of Health Research pays non établi dans la noticeOrganisation à but non lucratif
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Melbourne School of Population and Global Health Centre for Epidemiology and Biostatistics pays non établi dans la noticeUniversité ou école supérieure
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Melbourne School of Population & Global Health . Centre for Epidemiology and Biostatistics pays non établi dans la noticeUniversité ou école supérieure
The Royal Melbourne Hospital, . Department of Infectious Diseases — The University of Melbourne et Department of Infectious Diseases — Peter Doherty Institute, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.