title: Staphylococcus aureus bacteraemia--Nationwide assessment of treatment adequacy and outcome.
abstract: OBJECTIVE
  To assess the treatment adequacy for Staphylococcus aureus bacteraemia (SAB) and its association with outcome on a whole population basis.
  
  
  METHODS
  All individuals ≥18 years old diagnosed with SAB in Iceland between December 1 2003 and November 30 2008 were retrospectively identified. Clinical data was collected from medical records and adequacy of antibiotic treatment based on antibiotic choice, dose, administration route and treatment duration.
  
  
  RESULTS
  Empirical therapy was considered adequate in 262 of 325 (81%) SAB episodes, with no correlation to outcome. The complete antibiotic treatment was deemed adequate in 147 of 279 (53%) episodes. Among patients with complicated SAB median duration of active intravenous therapy was 14 days in those experiencing relapse compared to 30 days in patients without relapse (p = 0.03). No patient died after completing adequate treatment compared to 4 (3.0%) following inadequate therapy (p = 0.01). Despite no overall change being seen in antibiotic treatment, 30-day mortality decreased from 25.0 to 6.8% from first to last year of study (p = 0.001).
  
  
  CONCLUSIONS
  Appropriate antibiotic therapy for SAB was associated with lower relapse rates and mortality. Although treatment adequacy was regarded as insufficient in half of cases, mortality of SAB in Iceland is amongst the lowest recorded.
  
  
  CONCLUSIONS
  In a national study of S. aureus bacteraemia the antibiotic treatment was judged inadequate in 53% of episodes, while appropriate treatment was associated with lower relapse rate and mortality. Despite this, the mortality in Iceland is among the lowest reported.
authors.affiliation: Department of Infectious Diseases, Landspitali University Hospital, Fossvogi, IS-108 Reykjavik, Iceland.
authors.forename: Hilmir
authors.initials: H
authors.lastname: Asgeirsson
authors.forename: Mar
authors.initials: M
authors.lastname: Kristjansson
authors.forename: Karl G
authors.initials: KG
authors.lastname: Kristinsson
authors.forename: Olafur
authors.initials: O
authors.lastname: Gudlaugsson
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007055:Iceland; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents