Vancomycin not the best for MSSA

Link: Outcome of Vancomycin Treatment in Patients with Methicillin-susceptible Staphylococcus aureus Bacteremia -- Kim et al., 10.1128/AAC.00700-07 -- Antimicrobial Agents and Chemotherapy.

The cases for the case-control study were defined as patients who received vancomycin treatment for MSSA-B; the controls, who were patients that received beta-lactam treatment for MSSA-B, were selected with 1: 2 ratio according to the objective matching scoring system and the propensity score system. In the cohort study, SAB-related mortality in patients with vancomycin treatment (37%, 10/27) was significantly higher than that in those with beta-lactam treatment (18%, 47/267) (P = 0.02). In addition, multivariate analysis revealed that vancomycin treatment was associated with SAB-related mortality when independent predictors for SAB-related mortality and the propensity score were considered (adjusted OR 3.3, 95% CI 1.2-9.5). In the case-control study using the objective matching scoring system and the propensity score system, SAB-related mortality in case-patients was 37% (10/27) and in control-patients 11% (6/54), respectively (P < 0.01, respectively). Our data suggest that vancomycin is inferior to beta-lactam in the treatment of MSSA-B.