Researchers from Massachusetts General Hospital discovered that vancomycin, the most commonly prescribed antibiotic to treat bloodstream infections in dialysis patients, may not be as effective in resolving these problems as cefazolin. The findings may have implications for the pharmaceutical marketing of these medications to doctors who care for individuals undergoing dialysis.
This conclusion is based on a study of more than 500,000 blood culture results from a database of chronic kidney disease patients. Specifically, the researchers were scanning for cases of methicillin-sensitive strains of S. aureus bloodstream infections, which were treated with either vancomycin or cefazolin.
Vancomycin tended to be prescribed more because of its killing power, ability to pervade through the body's tissues and range of target bacteria.
According to the results, patients who received cefazolin were 38 percent less likely to be hospitalized or die when compared to those were taking vancomycin. Furthermore, the rate of sepsis in the former group was 48 percent lower.
However, even after blood cultures came back positive for S. aureus, 56 percent of patients still had prescriptions for vancomycin, compared to 17 percent for cefazolin.
"I think the data suggest there is an opportunity to improve outcomes for patients through appropriate antibiotic selection," said researcher Kevin Chan, M.D.
Bloodstream infections are a significant problem in medicine. Every year, almost one in 20 hospitalized patients in the U.S. acquires a healthcare associated infection, according to the Centers for Disease Control and Prevention (CDC). Central line-associated bloodstream infections, such as the ones that may occur during hemodialysis, have a mortality rate between 12 and 25 percent.
In 2008 alone, the CDC recorded 37,000 bloodstream infections among patients undergoing central line hemodialysis. Since 1993, the rate of hospitalization for hemodialysis patients with these illnesses increased by 47 percent.
This new study may help inform physicians' treatment decisions.