SHM Converge Scientific Abstract ePoster Gallery-Effect of Empiric Antibiotics Against Mrsa: Systematic Review and Meta-Analysis

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This systematic review and meta-analysis examined whether empiric antibiotics active against MRSA reduce mortality in hospitalized patients who ultimately had culture-proven MRSA infection. The authors searched seven databases through April 2022 and included 37 observational studies involving 11,661 patients. Most studies were at moderate to critical risk of bias, mainly due to confounding.<br /><br />The main outcome was adjusted mortality risk with active empiric MRSA therapy. Among the 15 studies that reported adjusted estimates, the pooled adjusted odds ratio for mortality was 0.64 (95% CI, 0.48–0.84), suggesting a benefit overall. However, the effect varied by infection type. There was no evidence of mortality benefit in MRSA pneumonia. For the three most common infectious syndromes in non-critically ill patients, the absolute mortality reduction was 0.1% or less, indicating little to no meaningful benefit in typical hospital presentations.<br /><br />In contrast, larger absolute benefits, generally 1% or more, were seen in syndromes with higher MRSA prevalence and/or higher baseline mortality risk. This suggests empiric MRSA coverage is most useful when the chance of MRSA infection or the severity of illness is greater.<br /><br />Overall, the authors conclude that empiric MRSA-active antibiotics are unlikely to provide a mortality benefit for most hospitalized patients with common infectious syndromes, though selected higher-risk groups may benefit.

Asset Subtitle

Craig Gunderson

Meta Tag

Author List Alyssa A. Grimshaw, Craig Gunderson, George Carey, Jurgen Holleck, Kirsha Gordon, Ritujith Jayakrishnan, Samer Ein Alshaeba

Category Research

Concept Empiric Anti-MRSA Antibiotics

Concept Methicillin-Resistant Staphylococcus aureus

Concept Mortality

Concept Adjusted Odds Ratio

Concept Hospitalized Patients

Distinguished Non-Finalist

Presenter Organization Va

Presenting Author Craig Gunderson

Track Value in Hospital Medicine

Keywords

MRSA

empiric antibiotics

mortality

systematic review

meta-analysis

hospitalized patients

culture-proven infection

adjusted odds ratio

MRSA pneumonia

observational studies

Empiric Anti-MRSA Antibiotics

Methicillin-Resistant Staphylococcus aureus

Mortality

Adjusted Odds Ratio

Hospitalized Patients