Penicillin Against Flucloxacillin Treatment Evaluation

Launched by THE UNIVERSITY OF QUEENSLAND · Aug 12, 2018

Keywords

ClinConnect Summary

Background and rationale:

Resistance to penicillin was discovered in Staphylococcus aureus in the mid-1940s, soon after the introduction of penicillin as a therapeutic agent into clinical practice. The emergence of penicillin resistant S. aureus (PRSA) was widely encountered in hospitals thereafter, with some reports finding rates of PRSA rising from 14% to 38% in less than 1 year. Two mechanisms are known that result in resistance to penicillin in staphylococci. The most common, and earliest described, was by the production of a serine β-lactamase, known as penicillinase (PC1), which hydr...

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Eligibility criteria

• Inclusion Criteria:
• • Bloodstream infection with Staphylococcus aureus susceptible to penicillin and negative for penicillinase by phenotypic methods.
• • No more than 72 hours has elapsed since the first positive blood culture was drawn
• • Patient is aged 18 years and over
• • The patient or approved proxy is able to provide informed consent
• Exclusion Criteria:
• * Patient with a recorded allergy to penicillin including:
• • 1. Hypersensitivity type reaction
• • 2. Stephens-Johnson syndrome
• • 3. Rash
• • 4. Urticaria
• • Contraindications based upon other recorded allergies, such as gastrointestinal upset, will be at the discretion of the treating clinician
• • Patient with significant polymicrobial bacteraemia (skin contaminants excepted)
• • Treated with non-curative intent
• • Pregnancy or breast-feeding
• • Patient currently receiving concomitant antimicrobials with activity against S. aureus which cannot be ceased or substituted.