A randomized clinical trial to compare fleroxacin-rifampicin with flucloxacillin or vancomycin for the treatment of staphylococcal infection

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Serval ID
serval:BIB_BFC47D7BCC54
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A randomized clinical trial to compare fleroxacin-rifampicin with flucloxacillin or vancomycin for the treatment of staphylococcal infection
Journal
Clinical Infectious Diseases
Author(s)
Schrenzel  J., Harbarth  S., Schockmel  G., Genne  D., Bregenzer  T., Flueckiger  U., Petignat  C., Jacobs  F., Francioli  P., Zimmerli  W., Lew  D. P.
ISSN
1537-6591 (Electronic)
Publication state
Published
Issued date
11/2004
Volume
39
Number
9
Pages
1285-92
Notes
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Nov 1
Abstract
BACKGROUND: Oral combination therapy with fluoroquinolones plus rifampicin is a promising alternative to standard parenteral therapy for staphylococcal infections. METHODS: In a multicenter, randomized trial, we compared the efficacy, safety, and length of hospital stay for patients with staphylococcal infections treated either with an oral combination of a fluoroquinolone (fleroxacin) plus rifampicin or with standard parenteral treatment (flucloxacillin or vancomycin). Patients were included if cultures showed the presence of bacteremia or deep-seated infections with Staphylococcus aureus (104 patients) or catheter-related bacteremia due to drug-susceptible, coagulase-negative staphylococci (23 patients). RESULTS: The cure rate in the intention-to-treat analysis was 78% for the fleroxacin-rifampicin group (68 patients) and 75% for the standard therapy group (59 patients; 47 received flucloxacillin, and 12 received vancomycin); in the population of clinically evaluable patients (n=119), the cure rate was 82% and 80%, respectively; and in the population of microbiologically evaluable patients (n=103), the cure rate was 86% and 84%, respectively. Clinical and bacteriological failures after S. aureus infections were documented in similar proportions of patients. The median length of hospital stay after study entry was 12 days in the fleroxacin-rifampicin group, compared with 23 days in the standard treatment group (P=.006). More adverse events probably related to the study drug were reported in the fleroxacin-rifampicin group than in the standard therapy group (15 of 68 vs. 5 of 59 patients; P=.05). CONCLUSIONS: This study suggests that an oral regimen containing a fluoroquinolone plus rifampicin may be effective for treating staphylococcal infections, allowing earlier discharge from the hospital.
Keywords
Administration, Oral Adult Aged Bacteremia/drug therapy Catheters, Indwelling/microbiology Drug Therapy, Combination Female Fleroxacin/administration & dosage/adverse effects/*therapeutic use Floxacillin/administration & dosage/adverse effects/*therapeutic use Humans Male Methicillin Resistance/drug effects Middle Aged Prospective Studies Rifampin/administration & dosage/adverse effects/*therapeutic use Safety Staphylococcal Infections/diagnosis/*drug therapy/metabolism Staphylococcus/drug effects/isolation & purification Staphylococcus aureus/drug effects/isolation & purification Treatment Outcome Vancomycin/administration & dosage/adverse effects/*therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 18:07
Last modification date
25/09/2019 7:10
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