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Objectives: Examine the characteristics and outcomes associated with a switch in antibiotic therapy for the treatment of appropriate empiric treatment of MRSA pneumonia.
Study Design: Retrospective cohort analysis.
Methods: A retrospective data analysis was conducted using an electronic data repository to identify patients 18 years of age or older with respiratory cultures positive for MRSA and started on anti-MRSA antibiotics. The primary results were the description of and the discharge disposition of patients treated with a single and those who required a switch anti-MRSA antibiotics. Descriptive and inferential statistics were utilized where appropriate.
Results: From January 1, 2008 to December 31, 2014, 674 patients were admitted with culture-positive MRSA pneumonia, of which 420 patients received a single antibiotic while 209 patients required a switch in initial antibiotics. The majority of the patients received vancomycin as the initial antibiotic regardless of whether subsequent switch in antibiotic was needed. Patients who received a single antibiotic were predominately discharged home or to a nursing facility while those who required a switch in antibiotics predominately did not survive or were discharged to a long-term care facility (p=0.0001). The APACHE II score and average length of stay were 16.3 ± 6 and 21.8 ± 20 days for those with no switch in initial antibiotics and 17.7 ± 6 and 34.7 ± 28 days for those who required a switch (p=0.003 and p<0.001), respectively.
Conclusions: Our study suggests that patients who required a switch in initial anti-MRSA antibiotics were sicker and hence have worse outcomes then those who did not required a switch.