PMID- 33511221
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220420
IS  - 2328-8957 (Print)
IS  - 2328-8957 (Electronic)
IS  - 2328-8957 (Linking)
VI  - 8
IP  - 1
DP  - 2021 Jan
TI  - Clinical Outcomes of Ceftriaxone vs Penicillin G for Complicated Viridans Group 
      Streptococci Bacteremia.
PG  - ofaa542
LID - 10.1093/ofid/ofaa542 [doi]
LID - ofaa542
AB  - BACKGROUND: Ceftriaxone (CTX) and penicillin G (PCN G) are considered reasonable 
      treatment options for viridans group streptococci (VGS) bloodstream infections, 
      but comparisons between these agents are limited. We evaluated clinical outcomes 
      among patients treated with these agents for complicated VGS bacteremia. METHODS: 
      This was a single-center retrospective study of adult patients with >/=1 positive 
      VGS blood culture who were treated with either CTX or PCN G/ampicillin (both 
      included in the PCN arm) between January 2013 and June 2019. The primary outcome 
      was a composite of safety end points, including hospital readmission due to VGS 
      bacteremia or adverse events (AEs) from therapy, Clostridioides difficile 
      infections, treatment modification or discontinuation due to AEs from therapy, 
      and development of extended-spectrum beta-lactamase resistance. Secondary 
      outcomes included individual safety end points, VGS bacteremia recurrence, 
      hospital readmission, and all-cause mortality. RESULTS: Of 328 patients screened, 
      94 met eligibility criteria (CTX n = 64, PCN n = 30). Streptococcus mitis was the 
      most common isolate, and infective endocarditis was the predominant source of 
      infection. CTX was not significantly associated with increased risk of the 
      primary composite safety outcome (CTX 14% vs PCN 27%; P = .139). The driver of 
      the composite outcome was hospital readmission due to VGS bacteremia or therapy 
      complications. No secondary end points differed significantly between groups. On 
      multivariate analysis, source removal was a protective factor of the primary 
      composite safety outcome. CONCLUSIONS: Despite potential safety concerns with the 
      prolonged use of CTX in complicated VGS bacteremia, this study did not 
      demonstrate higher rates of treatment failure, adverse events, or resistance.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of 
      Infectious Diseases Society of America.
FAU - Wo, Stephanie
AU  - Wo S
AD  - Department of Pharmacy, NYU Langone Health, New York, New York, USA.
FAU - Dubrovskaya, Yanina
AU  - Dubrovskaya Y
AD  - Department of Pharmacy, NYU Langone Health, New York, New York, USA.
AD  - Department of Medicine, New York University School of Medicine, New York, New 
      York, USA.
FAU - Siegfried, Justin
AU  - Siegfried J
AD  - Department of Pharmacy, NYU Langone Health, New York, New York, USA.
FAU - Papadopoulos, John
AU  - Papadopoulos J
AD  - Department of Pharmacy, NYU Langone Health, New York, New York, USA.
AD  - Department of Medicine, New York University School of Medicine, New York, New 
      York, USA.
FAU - Jen, Shin-Pung
AU  - Jen SP
AD  - Department of Pharmacy, Newark Beth Israel Medical Center, Newark, New Jersey, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20201107
PL  - United States
TA  - Open Forum Infect Dis
JT  - Open forum infectious diseases
JID - 101637045
PMC - PMC7817077
OTO - NOTNLM
OT  - antimicrobial stewardship
OT  - bacteremia
OT  - ceftriaxone
OT  - penicillin
OT  - viridans group streptococci
EDAT- 2021/01/30 06:00
MHDA- 2021/01/30 06:01
PMCR- 2020/11/07
CRDT- 2021/01/29 05:57
PHST- 2020/08/07 00:00 [received]
PHST- 2020/11/03 00:00 [accepted]
PHST- 2021/01/29 05:57 [entrez]
PHST- 2021/01/30 06:00 [pubmed]
PHST- 2021/01/30 06:01 [medline]
PHST- 2020/11/07 00:00 [pmc-release]
AID - ofaa542 [pii]
AID - 10.1093/ofid/ofaa542 [doi]
PST - epublish
SO  - Open Forum Infect Dis. 2020 Nov 7;8(1):ofaa542. doi: 10.1093/ofid/ofaa542. 
      eCollection 2021 Jan.