CAMERA2 (post-hoc analysis)
Trial question
What is the role of combination antibiotic therapy in patients hospitalized for MRSA bacteremia?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
35.0% female
65.0% male
N = 260
260 patients (91 female, 169 male).
Inclusion criteria: adult patients hospitalized for MRSA bacteremia.
Key exclusion criteria: receipt of chronic hemodialysis or peritoneal dialysis before enrollment.
Interventions
N=129 combination therapy (intravenous vancomycin or daptomycin plus intravenous flucloxacillin, cloxacillin, or cefazolin).
N=131 standard monotherapy (intravenous vancomycin or daptomycin).
Primary outcome
All-cause mortality
50%
44%
50.0 %
37.5 %
25.0 %
12.5 %
0.0 %
Combination
therapy
Standard
monotherapy
No significant
difference ↔
No significant difference in all-cause mortality (50% vs. 44%; HR 1.2, 95% CI 0.84 to 1.7).
Secondary outcomes
No significant difference in AKI at 1 year (29% vs. 9%; HR 1.03, 95% CI 0.64 to 1.68).
Conclusion
In adult patients hospitalized for MRSA bacteremia, combination therapy was not superior to standard monotherapy with respect to all-cause mortality.
Reference
Amy Legg, Matthew A Roberts, Jane Davies et al. Longer-term Mortality and Kidney Outcomes of Participants in the Combination Antibiotics for Methicillin-Resistant Staphylococcus aureus (CAMERA2) Trial: A Post Hoc Analysis. Open Forum Infect Dis. 2023 Jul 3;10(7):ofad337.
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