Influence of Reported Penicillin Allergy on Mortality in MSSA Bacteremia.
Repository Usage Stats
Penicillin allergy frequently impacts antibiotic choice. As beta-lactams are superior to vancomycin in treating methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, we examined the effect of reported penicillin allergy on clinical outcomes in patients with MSSA bacteremia.In this retrospective cohort study of adults with MSSA bacteremia admitted to a large tertiary care hospital, outcomes were examined according to reported penicillin allergy. Primary outcomes included 30-day and 90-day mortality rates. Multivariable regression models were developed to quantify the effect of reported penicillin allergy on mortality while adjusting for potential confounders.From 2010 to 2015, 318 patients with MSSA bacteremia were identified. Reported penicillin allergy had no significant effect on adjusted 30-day mortality (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.29-1.84; P = .51). Patients with reported penicillin allergy were more likely to receive vancomycin (38% vs 11%, P < .01), but a large number received cefazolin regardless of reported allergy (29 of 66, 44%). Mortality rates were highest among nonallergic patients receiving vancomycin (22.6% vs 7.4% for those receiving beta-lactams regardless of reported allergy, P < .01). In multivariable analysis, beta-lactam receipt was most strongly associated with survival (OR, 0.26; 95% CI, 0.12-0.54).Reported penicillin allergy had no significant effect on 30- or 90-day mortality. Non-penicillin-allergic patients receiving vancomycin for treatment of MSSA bacteremia had the highest mortality rates overall. Receipt of a beta-lactam was the strongest predictor of survival. These results underscore the importance of correct classification of patients with penicillin allergy and appropriate treatment with a beta-lactam when tolerated.
Published Version (Please cite this version)10.1093/ofid/ofy042
Publication InfoTurner, Nicholas A; Moehring, Rebekah; Sarubbi, Christina; Wrenn, Rebekah H; Drew, Richard H; Cunningham, Coleen K; ... Anderson, Deverick J (2018). Influence of Reported Penicillin Allergy on Mortality in MSSA Bacteremia. Open forum infectious diseases, 5(3). 10.1093/ofid/ofy042. Retrieved from https://hdl.handle.net/10161/16481.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Professor of Medicine
Hospital epidemiology, infection control, antibiotic stewardship, multidrug-resistant organisms, device-related infections, surgical site infections, catheter-associated bloodstream infections, cost of infections, infections in community hospitals
Adjunct Professor in the Department of Pediatrics
Dr. Cunningham is a pediatric infectious diseases physician who has focused her research on the prevention and treatment of HIV infection in children. She has also played important roles in evaluation of vaccines for other infectious diseases and recently has worked on Ebola virus treatment studies. She is currently working on studies of active and passive immunization to prevent HIV transmission in neonates born to HIV infected women.
Professor in Medicine
Pharmacokinetics/pharmacodynamics of antimicrobials, antifungal use in compromised hosts, antimicrobial stewardship, prediction and therapy of multidrug-resistant pathogens, aerosolized antimicrobials
Florence McAlister Distinguished Professor of Medicine
Determinants of Outcome in Patients with Staphylococcus aureus Bacteremia Antibacterial ResistancePathogenesis of Bacterial Infections Tropical medicine/International Health
Associate Professor of Medicine
Assistant Professor of Medicine
Alphabetical list of authors with Scholars@Duke profiles.