Common Antibiotics Are Not Always Best

Editor's Choice
Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Blood / Hematology
Article Date: 17 Aug 2012 - 13:00 PST


A new study, appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN), has evidence that the most commonly used antibiotic treating bloodstream infections in dialysis patients, vancomycin, might not be the best choice.

A bloodstream infection, also known as bacteremia, occurs when bacteria enters the bloodstream either by infection, wound, injection or a surgical procedure. Symptoms include high fever, rapid heart rate, chills, vomiting, and nausea. This infection becomes life threatening when a bacteria called Staphylococcus aureus is found.

Fortunately, medicine can often cure this infection. Over 80% of people are likely to die from bloodstream infections if they do not receive any antibiotic treatment.

In order to determine which was the best prescription drug to use, Kevin Chan, MD (Fresenius Medical Care North America and Massachusetts General Hospital) and his colleagues examined the differences between various antibiotics, analyzing the effectiveness of each drug at preventing hospitalization and death.

Searching for methicillin-sensitive strains of S. aureus bloodstream infection, authors observed over 500,000 blood culture results from their chronic kidney database, while checking if they took vancomycin or cefazolin to treat these infections.

Most experts have considered vancomycin as the better antibiotic because it can protect against many strains of bacteria. However there are other factors that need to be considered when choosing the best drug, such as the medication's killing power and tissue penetration.

Results showed:

• 56% of patients still took vancomycin even after blood culture showed that S. aureus bacteria were susceptible to cefazolin, and only 17% used cefazolin
• A 38% lower rate of hospitalization and death was seen in patients who took cefazolin when compared with those who used vancomycin
• A 48% lower rate of sepsis, the most severe form of bloodstream infection, was seen in the cefazolin-treated patients
  
  

Dr. Chan concluded:

"I think the data suggest there is an opportunity to improve outcomes for patients through appropriate antibiotic selection."

Written by Sarah Glynn


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