- Title
- Longer-term Mortality and Kidney Outcomes of Participants in the Combination Antibiotics for Methicillin-Resistant Staphylococcus aureus (CAMERA2) Trial: A Post Hoc Analysis
- Creator
- Legg, Amy; Roberts, Matthew A.; Xinxin, Chen; Ping, Yeo He; Lye, David; Lee, Russel; Robinson, J. Owen; Foo, Hong; Tramontana, Adrian R.; Bak, Narin; Grenfell, Adelaide; Rogers, Benjamin; Davies, Jane; Li, Ying; Joshi, N; O’Sullivan, M; McKew, G; Ghosh, N; Schneider, K; Holmes, NE; Dotel, R; Chia, T; Archuleta, S; Cass, Alan; Smith, S; Warner, MS; Titin, C; Kalimuddin, S; Roberts, JA; Tong, SYC; Davis, JS; Lye, DC; Yahav, D; Meagher, Niamh; Sud, A; Robinson, JO; Nelson, J; Roberts, MA; Cass, A; Paterson, DL; Foo, H; Paul, M; Guy, SD; Sud, Archana; Tramontana, AR; Walls, GB; McBride, S; Bak, N; Rogers, BA; Ralph, AP; Davies, J; Ferguson, PE; Daitch, Vared; McKew, GL; Gray, TJ; Young, BE; Runnegar, N; Andresen, DN; Anagnostou, NA; Dishon Benattar, Yael; Johnson, SA; Chatfield, MD; Cheng, AC; Fowler, VG; Howden, BP; Meagher, N; Price, DJ; van Hal, SJ; Gill, S; Rofe, A; Yahav, Dafna; O'Sullivan, M; Davis, Joshua S.; Paul, Mical
- Relation
- Open Forum Infectious Diseases Vol. 10, Issue 7, no. ofad337
- Publisher Link
- http://dx.doi.org/10.1093/ofid/ofad337
- Publisher
- Oxford University Press (OUP)
- Resource Type
- journal article
- Date
- 2023
- Description
- 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.
- Subject
- acute kidney injury; nephrotoxicity; Staphylococcus aureus bacteremia; patients; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1497909
- Identifier
- uon:54430
- Identifier
- ISSN:2328-8957
- Rights
- x
- Language
- eng
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