WALTHAM, Mass.—The antibiotic most commonly prescribed for some bloodstream infections in dialysis patients may not be the best choice, reported MedPage Today.
Nearly 60 percent of a large cohort with bacteremia caused by methicillin-susceptible Staphylococcus aureus (MSSA) was treated with vancomycin (Vancocin), according to Kevin Chan, MD, of Fresenius Medical Care North America (FMCNA) in Waltham, Mass., and colleagues.
Only one in six patients was treated with cefazolin (Ancef), although the drug was associated with a markedly lower risk of hospital admission or death, Chan and colleagues reported online in the Journal of the American Society of Nephrology.
"The data suggest there is an opportunity to improve outcomes for patients through appropriate antibiotic selection," Chan said in a statement.
S. aureus bacteremia is increasingly common in the general population, and without appropriate antibiotic therapy it will kill about 80 percent of affected patients, the researchers noted; even with antibiotics, mortality is more than 20 percent.
Annual incidence of S. aureus bloodstream infection in patients with end-stage renal disease (ESRD) has been estimated to be very high, accounting for up to 26 percent of all S. aureus bacteremia, the researchers added.
To see how those patients were treated, Chan and colleagues looked at blood culture specimens collected from 293,094 hemodialysis outpatients in the FMCNA network of outpatient clinics from January 1, 2006 to December 31, 2010.