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Outcome of Staphylococcus aureus bacteremia according to compliance with recommendations of infectious diseases specialists: experience with 244 patients.

Publication ,  Journal Article
Fowler, VG; Sanders, LL; Sexton, DJ; Kong, L; Marr, KA; Gopal, AK; Gottlieb, G; McClelland, RS; Corey, GR
Published in: Clin Infect Dis
September 1998

To determine whether recommendations of infectious diseases specialists affect outcome for patients, we evaluated 244 hospitalized patients with Staphylococcus aureus bacteremia. We offered our management recommendations to each patient's physicians and then assessed the clinical outcome for both patients for whom our consultative advice was followed and those for whom our advice was not heeded. All patients were followed up for 12 weeks after their first positive blood culture. Our management advice was followed for 112 patients (45.9%) and partially or completely ignored for 132 patients (54.1%). Patients for whom our recommendations were followed were more likely to be cured of their S. aureus infection and less likely to relapse (P < .01), despite having significantly more metastatic infections (P < .01) at the outset of therapy, than were those for whom our recommendations were not followed. Failure to follow recommendations to remove an infected intravascular device was the most important risk for treatment failure. After controlling for other factors, logistic regression analysis revealed that patients whose intravascular device was not removed were 6.5 times more likely to relapse or die of their infection than were those whose device was removed. Our findings suggest that patient-specific management advice by infectious diseases consultants can improve the clinical outcome for patients with S. aureus bacteremia.

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Published In

Clin Infect Dis

DOI

ISSN

1058-4838

Publication Date

September 1998

Volume

27

Issue

3

Start / End Page

478 / 486

Location

United States

Related Subject Headings

  • Vancomycin
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Regression Analysis
  • Penicillins
  • Outcome and Process Assessment, Health Care
  • Nafcillin
  • Middle Aged
  • Microbiology
  • Male
 

Citation

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Fowler, V. G., Sanders, L. L., Sexton, D. J., Kong, L., Marr, K. A., Gopal, A. K., … Corey, G. R. (1998). Outcome of Staphylococcus aureus bacteremia according to compliance with recommendations of infectious diseases specialists: experience with 244 patients. Clin Infect Dis, 27(3), 478–486. https://doi.org/10.1086/514686
Fowler, V. G., L. L. Sanders, D. J. Sexton, L. Kong, K. A. Marr, A. K. Gopal, G. Gottlieb, R. S. McClelland, and G. R. Corey. “Outcome of Staphylococcus aureus bacteremia according to compliance with recommendations of infectious diseases specialists: experience with 244 patients.Clin Infect Dis 27, no. 3 (September 1998): 478–86. https://doi.org/10.1086/514686.
Fowler VG, Sanders LL, Sexton DJ, Kong L, Marr KA, Gopal AK, et al. Outcome of Staphylococcus aureus bacteremia according to compliance with recommendations of infectious diseases specialists: experience with 244 patients. Clin Infect Dis. 1998 Sep;27(3):478–86.
Fowler, V. G., et al. “Outcome of Staphylococcus aureus bacteremia according to compliance with recommendations of infectious diseases specialists: experience with 244 patients.Clin Infect Dis, vol. 27, no. 3, Sept. 1998, pp. 478–86. Pubmed, doi:10.1086/514686.
Fowler VG, Sanders LL, Sexton DJ, Kong L, Marr KA, Gopal AK, Gottlieb G, McClelland RS, Corey GR. Outcome of Staphylococcus aureus bacteremia according to compliance with recommendations of infectious diseases specialists: experience with 244 patients. Clin Infect Dis. 1998 Sep;27(3):478–486.

Published In

Clin Infect Dis

DOI

ISSN

1058-4838

Publication Date

September 1998

Volume

27

Issue

3

Start / End Page

478 / 486

Location

United States

Related Subject Headings

  • Vancomycin
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Regression Analysis
  • Penicillins
  • Outcome and Process Assessment, Health Care
  • Nafcillin
  • Middle Aged
  • Microbiology
  • Male