Intermountain Health Care, Inc.
The purpose of this study is to see if, in selected patients with a serious bacterial infection of the bloodstream, treating the bacterial infection with a combination of antibiotics is more effective than treating the infection with a single antibiotic. Participants must have blood cultures which are positive for a certain type of bacteria.
Staphyloccocus aureus bacteremia (SAB) is a common infectious disease condition in hospitalized patients which is associated with significant morbidity, excessive costs, and high mortality, despite effective antibiotic therapy. This pragmatic study is designed to test the hypothesis that outcomes in adults hospitalized with SAB will be improved by using combination antibiotic therapy (CAT) as early, targeted therapy in a high-risk subgroup. A group of patients identified early in their course as meeting at least one high-risk criterion who have no contraindications will be treated with one of…
Inclusion Criteria: * Age ≥18 years * Alive and admitted to an Intermountain Health (IH) hospital acute care unit at enrollment * Initial positive blood culture with either methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-susceptible Staphylococcus aureus (MSSA), collected: 1. on or during the index admission to an IH hospital, or 2. in an ambulatory setting (laboratory, clinic or emergency department) within 48 hours of the index admission, or 3. at a non-IH network hospital within 24 hours of subsequent transfer to an IH hospital Exclusion Criteria: * Patient r…
Intravenous anti-staphylococcal beta-lactam, either cefazolin or nafcillin, per the discretion of the treating physician.
Vancomycin or daptomycin, per discretion of the treating physician
Patients with methicillin-sensitive S. aureus bacteremia (MSSAB) and no contraindications will receive an anti-staphylococcal beta-lactam, either cefazolin or nafcillin, plus ertapenem
Daptomycin plus ceftaroline