The antibiotic most commonly prescribed to treat bloodstream infections in dialysis patients may not always be the best choice, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).
When Staphylococcus aureus bacteria gain access to a patients bloodstream, the infection then becomes life threatening. Antibiotics can often cure this infection, but without any antibiotic treatment, more than 80 percent of patients with bloodstream infections are likely to die. But whats the most appropriate antibiotic to use?
Kevin Chan, MD, of Fresenius Medical Care North America and Massachusetts General Hospital, and his colleagues compared the effectiveness of various antibiotics at preventing hospitalization and death from bloodstream infection. They reviewed more than 500,000 blood culture results from their chronic kidney disease database, looking for methicillin-sensitive strains of S. aureus bloodstream infection. They also identified when physicians used vancomycin or cefazolin to treat these infections. Vancomycin is often perceived as the better antibiotic because it has broad coverage against many strains of bacteria; however, other factors like the antibiotics killing power and tissue penetration are also important factors in selecting the best treatment.
Among the major findings:
- 56 percent of patients remained on vancomycin after blood culture results reported S. aureus bacteria were susceptible to cefazolin, while only 17% were treated with cefazolin.
- Cefazolin-treated patients experienced a 38 percent lower rate of hospitalization and death compared with vancomycin-treated patients.
- Cefazolin-treated patients also had a 48 percent lower rate of sepsis, which is the most serious form of bloodstream infection.
I think the data suggest there is an opportunity to improve outcomes for patients through appropriate antibiotic selection, says Chan.
Study co-authors include H. Shaw Warren, MD, Ravi Thadhani, MD (Massachusetts General Hospital); David J.R. Steele, MD, Jeffrey L. Hymes, MD, Franklin Maddux, MD (Fresenius Medical Care North America); and Raymond Hakim, MD, PhD.
The article, Prevalence and Outcomes of Antimicrobial Treatment for Staphylococcus Aureus Bloodstream Infection in Outpatients with End-Stage Renal Disease, appears online at http://jasn.asnjournals.org/ on Aug. 16, 2012.
Beyond the Surface: Rethinking Environmental Hygiene Validation at Exchange25
June 30th 2025Environmental hygiene is about more than just shiny surfaces. At Exchange25, infection prevention experts urged the field to look deeper, rethink blame, and validate cleaning efforts across the entire care environment, not just EVS tasks.
A Controversial Reboot: New Vaccine Panel Faces Scrutiny, Support, and Sharp Divides
June 26th 2025As the newly appointed Advisory Committee on Immunization Practices (ACIP) met for the first time under sweeping changes by HHS Secretary Robert F. Kennedy Jr, the national spotlight turned to the panel’s legitimacy, vaccine guidance, and whether science or ideology would steer public health policy in a polarized era.
Getting Down and Dirty With PPE: Presentations at HSPA by Jill Holdsworth and Katie Belski
June 26th 2025In the heart of the hospital, decontamination technicians tackle one of health care’s dirtiest—and most vital—jobs. At HSPA 2025, 6 packed workshops led by experts Jill Holdsworth and Katie Belski spotlighted the crucial, often-overlooked art of PPE removal. The message was clear: proper doffing saves lives, starting with your own.