An Unbiased Peek At LY294002
The type of beta-lactam was forced into each model. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported. The fit of the model was tested using the Hosmer-Lemeshow goodness of fit test and its prediction using the area under the ROC curve (AUC) generated by predicted probabilities. Analyses were conducted using pasw statistics 17.0 (SPSS, Inc). Out of 771 clinically significant episodes of MSSA bacteraemia, 541 episodes could be evaluated for empirical treatment and 498 patients alive on day 7 were evaluated for definitive treatment (Fig.?1). Patient http://www.selleckchem.com/products/Lapatinib-Ditosylate.html characteristics are detailed in Table?1. Infections were rarely acquired in the community without contact with the healthcare setting. More than 50% of patients died within 1?year following the bacteraemia. There were significant differences in baseline patient S6 Kinase characteristics between patients treated empirically with targeted therapy against MSSA (oxacillin or cefazolin) and those given broader-spectrum beta-lactams (data not shown). Mortality at 30?days without adjustment for these differences was 22.1% (29/131) for empirical treatment with cloxacillin or cefazolin compared with 34.7% (34/98) with cefuroxime, 50.5% (98/194) with ceftriaxone/cefotaxime, 41% (25/61) with beta-lactam-beta-lactamase combinations and 28.1% (16/57) with other beta-lactams (p?click here treatment, beta-lactams other than cloxacillin or cefazolin were associated with higher 30-day mortality (Table?2). The adjusted OR for empirical treatment with cefuroxime was 1.98 (95% CI 0.98�C4.01), for ceftriaxone or cefotaxime 2.24 (95% CI 1.23�C4.08) and for beta-lactam-beta-lactamase combinations 2.68 (95% CI 1.23�C5.85). For other beta-lactams (mainly ceftazidime) mortality was not significantly different from cloxacillin/cefazolin, but most patients were treated in combination with vancomycin and confidence intervals were wide. Other risk factors for 30-day mortality are shown in Table?2. The model��s calibration and predictive performance were adequate. Considering definitive antibiotic treatment, there were no statistically significant differences in 90-day mortality with different beta-lactams in the unadjusted analysis: 32.4% (91/281) with cloxacillin, 40.3% (29/72) with cefazolin and 42.1% (61/145) with other beta-lactams. There was no significant difference in 90-day mortality between definitive treatment with cefazolin vs. cloxacillin in the adjusted analysis; OR 0.91 for all 498 patients evaluated and OR 0.81 for the subgroup of 204 patients treated with cefazolin or cloxacillin both empirically and definitively (Table?3).
