Intravenous to oral switch therapy in cancer patients with catheter-related bloodstream infection due to methicillin-sensitive Staphylococcus aureus: A single-center retrospective observational study

The most common complication in cancer patients is catheter-related bloodstream infection (CRBSI), of which Staphylococcus aureus is a common pathogen. Although S. aureus CRBSI patients are recommended for prolonged intravenous therapy, this is often not feasible. We assessed the effectiveness of sw...

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Bibliographic Details
Published in:PloS one 2018-11, Vol.13 (11), p.e0207413-e0207413
Main Authors: Itoh, Naoya, Hadano, Yoshiro, Saito, Sho, Myokai, Michiko, Nakamura, Yasunobu, Kurai, Hanako
Format: Article
Language:English
Subjects:
Administration, Intravenous
Administration, Oral
Aged
Anti-Bacterial Agents - administration & dosage
Antibiotics
Antimicrobial agents
Biology and Life Sciences
Cancer
Cancer patients
Cancer research
Cancer therapies
Cancer treatment
Catheter-Related Infections - drug therapy
Catheter-Related Infections - mortality
Catheterization
Catheters
Chemotherapy
Complications and side effects
Confidence intervals
Disease-Free Survival
Endocarditis
Evidence-based medicine
Feasibility studies
Female
Health aspects
Hospitals
Humans
Infection
Infections
Infectious diseases
Intravenous administration
Intravenous therapy
Male
Medical instruments
Medical research
Medicine and Health Sciences
Methicillin
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Mortality
Neoplasms - drug therapy
Neoplasms - mortality
Nosocomial infections
Observational studies
Parenteral nutrition
Patients
Regression analysis
Regression models
Retrospective Studies
Staphylococcal infections
Staphylococcal Infections - drug therapy
Staphylococcal Infections - mortality
Staphylococcus aureus
Staphylococcus aureus infections
Staphylococcus infections
Statistical analysis
Survival Rate
Therapy
Time Factors
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Summary:The most common complication in cancer patients is catheter-related bloodstream infection (CRBSI), of which Staphylococcus aureus is a common pathogen. Although S. aureus CRBSI patients are recommended for prolonged intravenous therapy, this is often not feasible. We assessed the effectiveness of switching from intravenous to oral antimicrobial therapy in cancer patients with CRBSI due to methicillin-sensitive S. aureus (MSSA). We conducted a retrospective observational study of 60 patients at one tertiary-care cancer center between April 2005 and March 2016. Patients who received effective intravenous (IV) antibiotics for at least 10 days (IV group) were compared to the IV group of patients who had switched to effective oral (PO) antibiotics after IV treatment for at least 10 days (IV + PO group). The primary endpoint was all-cause mortality within 90 days. Univariate and propensity score-adjusted multivariate logistic regression analyses using variables likely to influence the outcomes were performed. Of the 60 patients, 32 (53.3%) and 28 (46.7%) were in the IV and IV + PO groups, respectively. The median antibiotic treatment durations in the IV and IV + PO groups were 17 (13-31) and 33 (26-52) days, respectively (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0207413