Longer-term Mortality and Kidney Outcomes of Participants in the Combination Antibiotics for Methicillin-Resistant Staphylococcus aureus (CAMERA2) Trial : A Post Hoc Analysis
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
Background: The Combination Antibiotic Therapy for Methicillin-Resistant Staphylococcus aureus (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard therapy (monotherapy) arm. We analyzed the long-term outcomes of participants in CAMERA2 to understand the impact of combination antibiotic therapy and AKI.
Methods: Trial sites obtained additional follow-up data. The primary outcome was all-cause mortality, censored at death or the date of last known follow-up. Secondary outcomes included kidney failure or a reduction in kidney function (a 40% reduction in estimated glomerular filtration rate to <60 mL/minute/1.73 m2). To determine independent predictors of mortality in this cohort, adjusted hazard ratios were calculated using a Cox proportional hazards regression model.
Results: This post hoc analysis included extended follow-up data for 260 patients. Overall, 123 of 260 (47%) of participants died, with a median population survival estimate of 3.4 years (235 deaths per 1000 person-years). Fifty-five patients died within 90 days after CAMERA2 trial randomization; another 68 deaths occurred after day 90. Using univariable Cox proportional hazards regression, mortality was not associated with either the assigned treatment arm in CAMERA2 (hazard ratio [HR], 0.84 [95% confidence interval [CI], .59-1.19]; P = .33) or experiencing an AKI (HR at 1 year, 1.04 [95% CI, .64-1.68]; P = .88).
Conclusions: In this cohort of patients hospitalized with methicillin-resistant S aureus bacteremia, we found no association between either treatment arm of the CAMERA2 trial or AKI (using CAMERA2 trial definition) and longer-term mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Open forum infectious diseases - 10(2023), 7 vom: 22. Juli, Seite ofad337 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Legg, Amy [VerfasserIn] |
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| Links: |
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| Themen: |
Acute kidney injury |
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| Anmerkungen: |
Date Revised 28.07.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ofid/ofad337 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Legg, Amy |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Longer-term Mortality and Kidney Outcomes of Participants in the Combination Antibiotics for Methicillin-Resistant Staphylococcus aureus (CAMERA2) Trial |b A Post Hoc Analysis |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a Background: The Combination Antibiotic Therapy for Methicillin-Resistant Staphylococcus aureus (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard therapy (monotherapy) arm. We analyzed the long-term outcomes of participants in CAMERA2 to understand the impact of combination antibiotic therapy and AKI | ||
| 520 | |a Methods: Trial sites obtained additional follow-up data. The primary outcome was all-cause mortality, censored at death or the date of last known follow-up. Secondary outcomes included kidney failure or a reduction in kidney function (a 40% reduction in estimated glomerular filtration rate to <60 mL/minute/1.73 m2). To determine independent predictors of mortality in this cohort, adjusted hazard ratios were calculated using a Cox proportional hazards regression model | ||
| 520 | |a Results: This post hoc analysis included extended follow-up data for 260 patients. Overall, 123 of 260 (47%) of participants died, with a median population survival estimate of 3.4 years (235 deaths per 1000 person-years). Fifty-five patients died within 90 days after CAMERA2 trial randomization; another 68 deaths occurred after day 90. Using univariable Cox proportional hazards regression, mortality was not associated with either the assigned treatment arm in CAMERA2 (hazard ratio [HR], 0.84 [95% confidence interval [CI], .59-1.19]; P = .33) or experiencing an AKI (HR at 1 year, 1.04 [95% CI, .64-1.68]; P = .88) | ||
| 520 | |a Conclusions: In this cohort of patients hospitalized with methicillin-resistant S aureus bacteremia, we found no association between either treatment arm of the CAMERA2 trial or AKI (using CAMERA2 trial definition) and longer-term mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Staphylococcus aureus bacteremia | |
| 650 | 4 | |a acute kidney injury | |
| 650 | 4 | |a nephrotoxicity | |
| 700 | 1 | |a Roberts, Matthew A |e verfasserin |4 aut | |
| 700 | 1 | |a Davies, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Cass, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Meagher, Niamh |e verfasserin |4 aut | |
| 700 | 1 | |a Sud, Archana |e verfasserin |4 aut | |
| 700 | 1 | |a Daitch, Vered |e verfasserin |4 aut | |
| 700 | 1 | |a Dishon Benattar, Yael |e verfasserin |4 aut | |
| 700 | 1 | |a Yahav, Dafna |e verfasserin |4 aut | |
| 700 | 1 | |a Paul, Mical |e verfasserin |4 aut | |
| 700 | 1 | |a Xinxin, Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Ping, Yeo He |e verfasserin |4 aut | |
| 700 | 1 | |a Lye, David |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Russel |e verfasserin |4 aut | |
| 700 | 1 | |a Robinson, J Owen |e verfasserin |4 aut | |
| 700 | 1 | |a Foo, Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Tramontana, Adrian R |e verfasserin |4 aut | |
| 700 | 1 | |a Bak, Narin |e verfasserin |4 aut | |
| 700 | 1 | |a Grenfell, Adelaide |e verfasserin |4 aut | |
| 700 | 1 | |a Rogers, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Joshi, Neela |e verfasserin |4 aut | |
| 700 | 1 | |a O'Sullivan, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a McKew, Genevieve |e verfasserin |4 aut | |
| 700 | 1 | |a Ghosh, Niladri |e verfasserin |4 aut | |
| 700 | 1 | |a Schneider, Kellie |e verfasserin |4 aut | |
| 700 | 1 | |a Holmes, Natasha E |e verfasserin |4 aut | |
| 700 | 1 | |a Dotel, Ravindra |e verfasserin |4 aut | |
| 700 | 1 | |a Chia, Timothy |e verfasserin |4 aut | |
| 700 | 1 | |a Archuleta, Sophia |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Warner, Morgyn S |e verfasserin |4 aut | |
| 700 | 1 | |a Titin, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Kalimuddin, Shirin |e verfasserin |4 aut | |
| 700 | 1 | |a Roberts, Jason A |e verfasserin |4 aut | |
| 700 | 1 | |a Tong, Steven Y C |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Joshua S |e verfasserin |4 aut | |
| 700 | 0 | |a Combination Antibiotics for Methicillin-Resistant Staphylococcus aureus (CAMERA2) Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Tong, Steven Y C |e investigator |4 oth | |
| 700 | 1 | |a Lye, David C |e investigator |4 oth | |
| 700 | 1 | |a Yahav, Dafna |e investigator |4 oth | |
| 700 | 1 | |a Sud, Archana |e investigator |4 oth | |
| 700 | 1 | |a Robinson, J Owen |e investigator |4 oth | |
| 700 | 1 | |a Nelson, Jane |e investigator |4 oth | |
| 700 | 1 | |a Archuleta, Sophia |e investigator |4 oth | |
| 700 | 1 | |a Roberts, Matthew A |e investigator |4 oth | |
| 700 | 1 | |a Cass, Alan |e investigator |4 oth | |
| 700 | 1 | |a Paterson, David L |e investigator |4 oth | |
| 700 | 1 | |a Foo, Hong |e investigator |4 oth | |
| 700 | 1 | |a Paul, Mical |e investigator |4 oth | |
| 700 | 1 | |a Guy, Stephen D |e investigator |4 oth | |
| 700 | 1 | |a Tramontana, Adrian R |e investigator |4 oth | |
| 700 | 1 | |a Walls, Genevieve B |e investigator |4 oth | |
| 700 | 1 | |a McBride, Stephen |e investigator |4 oth | |
| 700 | 1 | |a Bak, Narin |e investigator |4 oth | |
| 700 | 1 | |a Ghosh, Niladri |e investigator |4 oth | |
| 700 | 1 | |a Rogers, Benjamin A |e investigator |4 oth | |
| 700 | 1 | |a Ralph, Anna P |e investigator |4 oth | |
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| 700 | 1 | |a Ferguson, Patricia E |e investigator |4 oth | |
| 700 | 1 | |a Dotel, Ravindra |e investigator |4 oth | |
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| 700 | 1 | |a Gray, Timothy J |e investigator |4 oth | |
| 700 | 1 | |a Holmes, Natasha E |e investigator |4 oth | |
| 700 | 1 | |a Smith, Simon |e investigator |4 oth | |
| 700 | 1 | |a Warner, Morgyn S |e investigator |4 oth | |
| 700 | 1 | |a Kalimuddin, Shirin |e investigator |4 oth | |
| 700 | 1 | |a Young, Barnaby E |e investigator |4 oth | |
| 700 | 1 | |a Runnegar, Naomi |e investigator |4 oth | |
| 700 | 1 | |a Andresen, David N |e investigator |4 oth | |
| 700 | 1 | |a Anagnostou, Nicholas A |e investigator |4 oth | |
| 700 | 1 | |a Johnson, Sandra A |e investigator |4 oth | |
| 700 | 1 | |a Chatfield, Mark D |e investigator |4 oth | |
| 700 | 1 | |a Cheng, Allen C |e investigator |4 oth | |
| 700 | 1 | |a Fowler, Vance G |c Jr |e investigator |4 oth | |
| 700 | 1 | |a Howden, Benjamin P |e investigator |4 oth | |
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| 700 | 1 | |a van Hal, Sebastiaan J |e investigator |4 oth | |
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| 700 | 1 | |a Rofe, Alexander |e investigator |4 oth | |
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| 700 | 1 | |a Davis, Joshua S |e investigator |4 oth | |
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