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Title

Effect of vancomycin therapy for osteomyelitis on colonization by methicillin-resistant Staphylococcus aureus: lack of emergence of glycopeptide resistance

Authors
Vuagnat, Albert
Published in Infection Control and Hospital Epidemiology. 2003, vol. 24, no. 9, p. 650-654
Abstract BACKGROUND: In treating orthopedic infections, the long-term impact of vancomycin therapy on colonization by methicillin-resistant Staphylococcus aureus (MRSA) and the emergence of vancomycin-intermediate S. aureus is unknown. DESIGN: Prospective surveillance of the effect of long-term vancomycin therapy on colonization by MRSA and the emergence of vancomycin-intermediate S. aureus. METHODS: Thirty-four patients with MRSA osteomyelitis that was microbiologically documented were longitudinally observed for the emergence of vancomycin-intermediate S. aureus at 3 body sites (wound, anterior nares, and groin) during the initial period of vancomycin therapy and at the 2-month follow-up. Twenty patients received the standard dose (20 mg/kg/d) for 34 +/- 6 days and 14 patients received a high dose (40 mg/kg/d) of vancomycin for 37 +/- 9 days. RESULTS: During vancomycin treatment, global MRSA carriage (all body sites) fell from 100% to 25% in the group of patients receiving the standard dose of vancomycin, and from 100% to 40% in the group receiving the high dose. During the 2-month follow-up period after vancomycin therapy, global MRSA carriage increased from 25% to 55% in the group receiving the standard dose and decreased from 43% to 36% in the group receiving the high dose. CONCLUSION: Therapy with a high dose of vancomycin contributes to the sustained eradication of MRSA carriage without promoting the emergence of glycopeptide resistance.
Keywords AdultAgedAnti-Bacterial Agents/administration & dosage/ pharmacology/ therapeutic useCarrier StateDose-Response Relationship, DrugDrug Administration ScheduleFemaleHumansMaleMethicillin ResistanceMiddle AgedOsteomyelitis/ drug therapyPopulation SurveillanceProspective StudiesStaphylococcal Infections/ drug therapy/pathologyStaphylococcus aureus/ drug effects/ pathogenicityVancomycin/administration & dosage/pharmacology/ therapeutic use
Identifiers
PMID: 14510246
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Article - document accessible for UNIGE members only Limited access to UNIGE
Other version: http://www.journals.uchicago.edu/doi/abs/10.1086/502268
Structures
Research groups Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
Chirurgie orthopédique et traumatologique (98)
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(ISO format)
BERNARD, Louis et al. Effect of vancomycin therapy for osteomyelitis on colonization by methicillin-resistant Staphylococcus aureus: lack of emergence of glycopeptide resistance. In: Infection Control and Hospital Epidemiology, 2003, vol. 24, n° 9, p. 650-654. https://archive-ouverte.unige.ch/unige:7104

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Deposited on : 2010-06-21

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