Resident
Vahid, Sepideh, RPh, MSc
Residency Program
LMPS
Project Title
Use of Daptomycin Plus Beta-lactams as Part of MRSA Salvage Regimens in Two Large Tertiary Teaching Hospitals (PERSIST)
Investigators
Gnyra, Michelle, B.Sc. Pharm, ACPR; Lee, Colin, B.Sc. Pharm, ACPR, PharmD, MSc; Lau, Tim, B.Sc. Pharm, ACPR, PharmD, Nishi, Cesilia, B.Sc. Pharm, ACPR, PharmD; Grant, Jennifer, MD CM, FRCPC; Leung, Victor,MD, FRCPC; Stefanovic, Aleksandra, MD, FRCPC; Romney, MD, FRCPC, DTM&H
Abstract
Persistent Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is defined as positive cultures despite 7 days of guideline-recommended antibiotics. There is no standard approach in choosing salvage regimens. Through a retrospective chart review of MRSA bacteremia cases at Vancouver’s 2 large hospitals, we evaluated the prevalence of persistent cases. Characterizing the alternatives, we observed that high-dose daptomycin + beta-lactam (specifically 5th generation cephalosporins with anti-MRSA activity) was the most common salvage regimen used. There was no difference in length of stay, recurrence, or adverse events among different regimens. Although confounded by severity, salvage therapy was associated with increased time to microbiological clearance.
