| . | RCTs (N = 7) . | Matched Observational (N = 28) . | All Observational (N = 341) . |
|---|---|---|---|
| Funding | |||
| Pharmaceutical | 2 (29%) | 1 (4%) | 16 (5%) |
| Public funding | 5 (71%) | 16 (57%) | 142 (42%) |
| Not funded | 0 (0%) | 10 (36%) | 132 (39%) |
| Not specified | 0 (0%) | 1 (4%) | 51 (15%) |
| Multicenter | 7 (100%) | 13 (46%) | 109 (32%) |
| Resistance profile | |||
| MRSA and MSSA | 2 (29%) | 8 (29%) | 215 (63%) |
| MSSA only | 2 (29%) | 8 (29%) | 36 (11%) |
| MRSA only | 3 (43%) | 12 (43%) | 90 (26%) |
| Sample size, median (IQR) | 116 (98, 367) | 311 (243, 618) | 245 (130, 521) |
| Mean age reported, median (IQR) | 58 (57, 61) | 61 (59, 68) | 61 (57, 65) |
| Female proportion, median (IQR) | 35% (34%, 35%) | 36% (34%, 38%) | 37% (34%, 40%) |
| Median CCI, median (IQR) | 4.0 (2.75, 5.0) | 3.0 (2.0, 5.0) | 3.0 (2.0, 3.0) |
| Median Pitt bacteremia score, median (IQR) | 2.0 (n = 1) | 1.0 (1.0, 1.75) | 1.0 (1.0, 1.5) |
| Proportion of infections with the following characteristics | |||
| Nosocomial, median (IQR) | 27% (23%, 36%) | 36% (31%, 56%) | 50% (33%, 68%) |
| Osteoarticular infections, median (IQR) | 12% (12%, 16%) | 18% (9%, 24%) | 10% (6%, 15%) |
| Skin and soft tissue infections, median (IQR) | 23% (22%, 25%) | 17% (11%, 22%) | 16% (12%, 22%) |
| Lung infections, median (IQR) | 7% (6%, 14%) | 12% (8%, 14%) | 11% (7%, 16%) |
| Infective endocarditis, median (IQR) | 12% (6%, 16%) | 8% (5%, 15%) | 7% (4%, 11%) |
| Complicated bacteremia, median (IQR) | 73% (70%, 76%) | 40% (28%, 86%) | 48% (31%, 62%) |
| Proportion of patients who had the following interventions | |||
| ID consultation, median (IQR) | 97% and 100% (n = 2) | 76% (65%, 90%) | 72% (51%, 82%) |
| Echocardiography, median (IQR) | 100% (97%, 100%) | 67% (54%, 71%) | 54% (43%, 70%) |
| Mortality in studies on all SAB (MRSA and MSSA) | |||
| 1-month pooled mortality (95% CI) | 8.1% (6.5%–10.1%) T2 < 0.0001 | 17.7% (13.1%–23.4%) T2 = 0.2042 | 18.7% (17.5%–19.9%) T2 = 0.1697 |
| 3-month pooled mortality (95% CI) | 14.8% (12.4%–17.5%) Single study | 26.4% (23.1%–30.1%) T2 = 0.0434 | 26.4% (23.2%–29.8%) T2 = 0.3158 |
| 6-month pooled mortality (95% CI) | 21.9% (15.3%–30.2%) Single study | 27.3% (23.2%–31.8%) T2 = 0.0325 | 25.5% (18.8%–33.7%) T2 = 0.3012 |
| Mortality in studies on only MRSA | |||
| 2-week pooled mortality (95% CI) | 7.6% (5.2%–10.9%) Single study | 13.8% (8.2%–22.4%) Single study | 20.7% (15.4%–27.3%) T2 = 0.3082 |
| 1-month pooled mortality (95% CI)a | 21.9% (16.0%–29.2%) T2 < 0.0001 | 26.7% (20.9%–33.5%) T2 = 0.2521 | 26.0% (24.2%–27.9%) T2 = 0.1833 |
| 3-month pooled mortality (95% CI)a | 18.3% (14.8%–22.4%) T2 < 0.0001 | 30.4% (26.8%–34.3%) T2 = 0.0188 | 35.7% (29.9%–41.9%) T2 = 0.1689 |
| Mortality in studies on only MSSA | |||
| 1-month pooled mortality (95% CI) | 13.8% (11.0%–17.2%) T2 < 0.0001 | 17.4% (14.7%–20.5%) T2 = 0.0597 | 17.1% (15.5%–18.8%) T2 = 0.1680 |
| 3-month pooled mortality (95% CI) | 19.0% (15.7%–22.7%) T2 < 0.0001 | 24.0% (20.2%–28.3%) T2 = 0.0624 | 23.9% (20.0%–28.4%) T2 = 0.2260 |
| . | RCTs (N = 7) . | Matched Observational (N = 28) . | All Observational (N = 341) . |
|---|---|---|---|
| Funding | |||
| Pharmaceutical | 2 (29%) | 1 (4%) | 16 (5%) |
| Public funding | 5 (71%) | 16 (57%) | 142 (42%) |
| Not funded | 0 (0%) | 10 (36%) | 132 (39%) |
| Not specified | 0 (0%) | 1 (4%) | 51 (15%) |
| Multicenter | 7 (100%) | 13 (46%) | 109 (32%) |
| Resistance profile | |||
| MRSA and MSSA | 2 (29%) | 8 (29%) | 215 (63%) |
| MSSA only | 2 (29%) | 8 (29%) | 36 (11%) |
| MRSA only | 3 (43%) | 12 (43%) | 90 (26%) |
| Sample size, median (IQR) | 116 (98, 367) | 311 (243, 618) | 245 (130, 521) |
| Mean age reported, median (IQR) | 58 (57, 61) | 61 (59, 68) | 61 (57, 65) |
| Female proportion, median (IQR) | 35% (34%, 35%) | 36% (34%, 38%) | 37% (34%, 40%) |
| Median CCI, median (IQR) | 4.0 (2.75, 5.0) | 3.0 (2.0, 5.0) | 3.0 (2.0, 3.0) |
| Median Pitt bacteremia score, median (IQR) | 2.0 (n = 1) | 1.0 (1.0, 1.75) | 1.0 (1.0, 1.5) |
| Proportion of infections with the following characteristics | |||
| Nosocomial, median (IQR) | 27% (23%, 36%) | 36% (31%, 56%) | 50% (33%, 68%) |
| Osteoarticular infections, median (IQR) | 12% (12%, 16%) | 18% (9%, 24%) | 10% (6%, 15%) |
| Skin and soft tissue infections, median (IQR) | 23% (22%, 25%) | 17% (11%, 22%) | 16% (12%, 22%) |
| Lung infections, median (IQR) | 7% (6%, 14%) | 12% (8%, 14%) | 11% (7%, 16%) |
| Infective endocarditis, median (IQR) | 12% (6%, 16%) | 8% (5%, 15%) | 7% (4%, 11%) |
| Complicated bacteremia, median (IQR) | 73% (70%, 76%) | 40% (28%, 86%) | 48% (31%, 62%) |
| Proportion of patients who had the following interventions | |||
| ID consultation, median (IQR) | 97% and 100% (n = 2) | 76% (65%, 90%) | 72% (51%, 82%) |
| Echocardiography, median (IQR) | 100% (97%, 100%) | 67% (54%, 71%) | 54% (43%, 70%) |
| Mortality in studies on all SAB (MRSA and MSSA) | |||
| 1-month pooled mortality (95% CI) | 8.1% (6.5%–10.1%) T2 < 0.0001 | 17.7% (13.1%–23.4%) T2 = 0.2042 | 18.7% (17.5%–19.9%) T2 = 0.1697 |
| 3-month pooled mortality (95% CI) | 14.8% (12.4%–17.5%) Single study | 26.4% (23.1%–30.1%) T2 = 0.0434 | 26.4% (23.2%–29.8%) T2 = 0.3158 |
| 6-month pooled mortality (95% CI) | 21.9% (15.3%–30.2%) Single study | 27.3% (23.2%–31.8%) T2 = 0.0325 | 25.5% (18.8%–33.7%) T2 = 0.3012 |
| Mortality in studies on only MRSA | |||
| 2-week pooled mortality (95% CI) | 7.6% (5.2%–10.9%) Single study | 13.8% (8.2%–22.4%) Single study | 20.7% (15.4%–27.3%) T2 = 0.3082 |
| 1-month pooled mortality (95% CI)a | 21.9% (16.0%–29.2%) T2 < 0.0001 | 26.7% (20.9%–33.5%) T2 = 0.2521 | 26.0% (24.2%–27.9%) T2 = 0.1833 |
| 3-month pooled mortality (95% CI)a | 18.3% (14.8%–22.4%) T2 < 0.0001 | 30.4% (26.8%–34.3%) T2 = 0.0188 | 35.7% (29.9%–41.9%) T2 = 0.1689 |
| Mortality in studies on only MSSA | |||
| 1-month pooled mortality (95% CI) | 13.8% (11.0%–17.2%) T2 < 0.0001 | 17.4% (14.7%–20.5%) T2 = 0.0597 | 17.1% (15.5%–18.8%) T2 = 0.1680 |
| 3-month pooled mortality (95% CI) | 19.0% (15.7%–22.7%) T2 < 0.0001 | 24.0% (20.2%–28.3%) T2 = 0.0624 | 23.9% (20.0%–28.4%) T2 = 0.2260 |
Baseline characteristics of RCT and matched observational studies are presented as dot plots in Supplementary Materials 1, Supplementary Figure 1–7.
Abbreviations: CCI, Charlson comorbidity index; CI, confidence interval; ID, infectious diseases; IQR, interquartile range; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus; RCT, randomized controlled trials.
The pooled mortality 3-month mortality was lower than the 1-month mortality because the estimates were based on different RCTs. One RCT reported 1-month mortality but not 3-month mortality, whereas 2 other RCTs reported 3-month mortality but not 1-month mortality.
| . | RCTs (N = 7) . | Matched Observational (N = 28) . | All Observational (N = 341) . |
|---|---|---|---|
| Funding | |||
| Pharmaceutical | 2 (29%) | 1 (4%) | 16 (5%) |
| Public funding | 5 (71%) | 16 (57%) | 142 (42%) |
| Not funded | 0 (0%) | 10 (36%) | 132 (39%) |
| Not specified | 0 (0%) | 1 (4%) | 51 (15%) |
| Multicenter | 7 (100%) | 13 (46%) | 109 (32%) |
| Resistance profile | |||
| MRSA and MSSA | 2 (29%) | 8 (29%) | 215 (63%) |
| MSSA only | 2 (29%) | 8 (29%) | 36 (11%) |
| MRSA only | 3 (43%) | 12 (43%) | 90 (26%) |
| Sample size, median (IQR) | 116 (98, 367) | 311 (243, 618) | 245 (130, 521) |
| Mean age reported, median (IQR) | 58 (57, 61) | 61 (59, 68) | 61 (57, 65) |
| Female proportion, median (IQR) | 35% (34%, 35%) | 36% (34%, 38%) | 37% (34%, 40%) |
| Median CCI, median (IQR) | 4.0 (2.75, 5.0) | 3.0 (2.0, 5.0) | 3.0 (2.0, 3.0) |
| Median Pitt bacteremia score, median (IQR) | 2.0 (n = 1) | 1.0 (1.0, 1.75) | 1.0 (1.0, 1.5) |
| Proportion of infections with the following characteristics | |||
| Nosocomial, median (IQR) | 27% (23%, 36%) | 36% (31%, 56%) | 50% (33%, 68%) |
| Osteoarticular infections, median (IQR) | 12% (12%, 16%) | 18% (9%, 24%) | 10% (6%, 15%) |
| Skin and soft tissue infections, median (IQR) | 23% (22%, 25%) | 17% (11%, 22%) | 16% (12%, 22%) |
| Lung infections, median (IQR) | 7% (6%, 14%) | 12% (8%, 14%) | 11% (7%, 16%) |
| Infective endocarditis, median (IQR) | 12% (6%, 16%) | 8% (5%, 15%) | 7% (4%, 11%) |
| Complicated bacteremia, median (IQR) | 73% (70%, 76%) | 40% (28%, 86%) | 48% (31%, 62%) |
| Proportion of patients who had the following interventions | |||
| ID consultation, median (IQR) | 97% and 100% (n = 2) | 76% (65%, 90%) | 72% (51%, 82%) |
| Echocardiography, median (IQR) | 100% (97%, 100%) | 67% (54%, 71%) | 54% (43%, 70%) |
| Mortality in studies on all SAB (MRSA and MSSA) | |||
| 1-month pooled mortality (95% CI) | 8.1% (6.5%–10.1%) T2 < 0.0001 | 17.7% (13.1%–23.4%) T2 = 0.2042 | 18.7% (17.5%–19.9%) T2 = 0.1697 |
| 3-month pooled mortality (95% CI) | 14.8% (12.4%–17.5%) Single study | 26.4% (23.1%–30.1%) T2 = 0.0434 | 26.4% (23.2%–29.8%) T2 = 0.3158 |
| 6-month pooled mortality (95% CI) | 21.9% (15.3%–30.2%) Single study | 27.3% (23.2%–31.8%) T2 = 0.0325 | 25.5% (18.8%–33.7%) T2 = 0.3012 |
| Mortality in studies on only MRSA | |||
| 2-week pooled mortality (95% CI) | 7.6% (5.2%–10.9%) Single study | 13.8% (8.2%–22.4%) Single study | 20.7% (15.4%–27.3%) T2 = 0.3082 |
| 1-month pooled mortality (95% CI)a | 21.9% (16.0%–29.2%) T2 < 0.0001 | 26.7% (20.9%–33.5%) T2 = 0.2521 | 26.0% (24.2%–27.9%) T2 = 0.1833 |
| 3-month pooled mortality (95% CI)a | 18.3% (14.8%–22.4%) T2 < 0.0001 | 30.4% (26.8%–34.3%) T2 = 0.0188 | 35.7% (29.9%–41.9%) T2 = 0.1689 |
| Mortality in studies on only MSSA | |||
| 1-month pooled mortality (95% CI) | 13.8% (11.0%–17.2%) T2 < 0.0001 | 17.4% (14.7%–20.5%) T2 = 0.0597 | 17.1% (15.5%–18.8%) T2 = 0.1680 |
| 3-month pooled mortality (95% CI) | 19.0% (15.7%–22.7%) T2 < 0.0001 | 24.0% (20.2%–28.3%) T2 = 0.0624 | 23.9% (20.0%–28.4%) T2 = 0.2260 |
| . | RCTs (N = 7) . | Matched Observational (N = 28) . | All Observational (N = 341) . |
|---|---|---|---|
| Funding | |||
| Pharmaceutical | 2 (29%) | 1 (4%) | 16 (5%) |
| Public funding | 5 (71%) | 16 (57%) | 142 (42%) |
| Not funded | 0 (0%) | 10 (36%) | 132 (39%) |
| Not specified | 0 (0%) | 1 (4%) | 51 (15%) |
| Multicenter | 7 (100%) | 13 (46%) | 109 (32%) |
| Resistance profile | |||
| MRSA and MSSA | 2 (29%) | 8 (29%) | 215 (63%) |
| MSSA only | 2 (29%) | 8 (29%) | 36 (11%) |
| MRSA only | 3 (43%) | 12 (43%) | 90 (26%) |
| Sample size, median (IQR) | 116 (98, 367) | 311 (243, 618) | 245 (130, 521) |
| Mean age reported, median (IQR) | 58 (57, 61) | 61 (59, 68) | 61 (57, 65) |
| Female proportion, median (IQR) | 35% (34%, 35%) | 36% (34%, 38%) | 37% (34%, 40%) |
| Median CCI, median (IQR) | 4.0 (2.75, 5.0) | 3.0 (2.0, 5.0) | 3.0 (2.0, 3.0) |
| Median Pitt bacteremia score, median (IQR) | 2.0 (n = 1) | 1.0 (1.0, 1.75) | 1.0 (1.0, 1.5) |
| Proportion of infections with the following characteristics | |||
| Nosocomial, median (IQR) | 27% (23%, 36%) | 36% (31%, 56%) | 50% (33%, 68%) |
| Osteoarticular infections, median (IQR) | 12% (12%, 16%) | 18% (9%, 24%) | 10% (6%, 15%) |
| Skin and soft tissue infections, median (IQR) | 23% (22%, 25%) | 17% (11%, 22%) | 16% (12%, 22%) |
| Lung infections, median (IQR) | 7% (6%, 14%) | 12% (8%, 14%) | 11% (7%, 16%) |
| Infective endocarditis, median (IQR) | 12% (6%, 16%) | 8% (5%, 15%) | 7% (4%, 11%) |
| Complicated bacteremia, median (IQR) | 73% (70%, 76%) | 40% (28%, 86%) | 48% (31%, 62%) |
| Proportion of patients who had the following interventions | |||
| ID consultation, median (IQR) | 97% and 100% (n = 2) | 76% (65%, 90%) | 72% (51%, 82%) |
| Echocardiography, median (IQR) | 100% (97%, 100%) | 67% (54%, 71%) | 54% (43%, 70%) |
| Mortality in studies on all SAB (MRSA and MSSA) | |||
| 1-month pooled mortality (95% CI) | 8.1% (6.5%–10.1%) T2 < 0.0001 | 17.7% (13.1%–23.4%) T2 = 0.2042 | 18.7% (17.5%–19.9%) T2 = 0.1697 |
| 3-month pooled mortality (95% CI) | 14.8% (12.4%–17.5%) Single study | 26.4% (23.1%–30.1%) T2 = 0.0434 | 26.4% (23.2%–29.8%) T2 = 0.3158 |
| 6-month pooled mortality (95% CI) | 21.9% (15.3%–30.2%) Single study | 27.3% (23.2%–31.8%) T2 = 0.0325 | 25.5% (18.8%–33.7%) T2 = 0.3012 |
| Mortality in studies on only MRSA | |||
| 2-week pooled mortality (95% CI) | 7.6% (5.2%–10.9%) Single study | 13.8% (8.2%–22.4%) Single study | 20.7% (15.4%–27.3%) T2 = 0.3082 |
| 1-month pooled mortality (95% CI)a | 21.9% (16.0%–29.2%) T2 < 0.0001 | 26.7% (20.9%–33.5%) T2 = 0.2521 | 26.0% (24.2%–27.9%) T2 = 0.1833 |
| 3-month pooled mortality (95% CI)a | 18.3% (14.8%–22.4%) T2 < 0.0001 | 30.4% (26.8%–34.3%) T2 = 0.0188 | 35.7% (29.9%–41.9%) T2 = 0.1689 |
| Mortality in studies on only MSSA | |||
| 1-month pooled mortality (95% CI) | 13.8% (11.0%–17.2%) T2 < 0.0001 | 17.4% (14.7%–20.5%) T2 = 0.0597 | 17.1% (15.5%–18.8%) T2 = 0.1680 |
| 3-month pooled mortality (95% CI) | 19.0% (15.7%–22.7%) T2 < 0.0001 | 24.0% (20.2%–28.3%) T2 = 0.0624 | 23.9% (20.0%–28.4%) T2 = 0.2260 |
Baseline characteristics of RCT and matched observational studies are presented as dot plots in Supplementary Materials 1, Supplementary Figure 1–7.
Abbreviations: CCI, Charlson comorbidity index; CI, confidence interval; ID, infectious diseases; IQR, interquartile range; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus; RCT, randomized controlled trials.
The pooled mortality 3-month mortality was lower than the 1-month mortality because the estimates were based on different RCTs. One RCT reported 1-month mortality but not 3-month mortality, whereas 2 other RCTs reported 3-month mortality but not 1-month mortality.
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