Death, long hospital stays, and treatment failures are more likely when vancomycin is used for MRSA bacteremia with minimum inhibitory concentrations (MIC) > 1 mcg/mL. Lubin et al propose a clinical prediction rule to predict relative vancomycin resistance, based on a retrospective analysis of 272 patients with MRSA bacteremia at Tufts. Oversimplifying slightly: Having less than two risk factors (age > 50; prior receipt of vanco; prior MRSA bacteremia; chronic liver disease, or a nontunneled venous catheter) had a 91% negative predictive value for having an MRSA strain with MIC > 1 (relative vancomycin resistance). Having 2 or more factors had a positive predictive value of only 30%, though. There was no prospective validation cohort.
Predicing vancomycin failure in MRSA bacteremia
Predicing vancomycin failure in MRSA…
Predicing vancomycin failure in MRSA bacteremia
Death, long hospital stays, and treatment failures are more likely when vancomycin is used for MRSA bacteremia with minimum inhibitory concentrations (MIC) > 1 mcg/mL. Lubin et al propose a clinical prediction rule to predict relative vancomycin resistance, based on a retrospective analysis of 272 patients with MRSA bacteremia at Tufts. Oversimplifying slightly: Having less than two risk factors (age > 50; prior receipt of vanco; prior MRSA bacteremia; chronic liver disease, or a nontunneled venous catheter) had a 91% negative predictive value for having an MRSA strain with MIC > 1 (relative vancomycin resistance). Having 2 or more factors had a positive predictive value of only 30%, though. There was no prospective validation cohort.