Thomas Glück, MD reviewing Osthoff M et al. Crit Care Med 2016 Jan 6.
Low-dose ASA use, initiated before BSI onset, was associated with lower mortality in patients with Staphylococcus aureus, but not Escherichia coli, infection.
Mortality from Staphylococcus aureus bloodstream infection (BSI) is high despite use of appropriate antibiotics and removal of infectious foci. Previous studies suggested a possible antistaphylococcal effect of low-dose (<300 mg/day) acetylsalicylic acid (ASA), coupled with adequate antibiotic therapy. Now, researchers in Switzerland have identified 689 patients treated for a first S. aureus BSI episode at their institution from 2001 through 2013, including 157 who were taking low-dose ASA at BSI onset. In a propensity-matched analysis, they compared the 157 ASA users with another 157 patients from the same S. aureus BSI cohort who were not taking ASA (controls).
Although ASA users were significantly more likely than nonusers to be on statins (61% vs. 20%), the two groups' other characteristics were similar, including length of hospital stay after BSI onset, time to adequate antibiotic therapy, and antimicrobial treatment duration. All-cause mortality was significantly lower among ASA users than matched controls, both at 30 days (12.1% vs. 27.4%) and in the hospital (14.6% vs. 27.4%). In multivariate analyses, low-dose ASA use, but not statin use, was independently associated with lower 30-day mortality. Low-dose ASA use was also associated with reduced mortality in the overall 689-person cohort.
Among 602 patients treated for Escherichia coli BSI at the same institution from 2008 through 2013, the researchers compared 134 ASA users with 134 propensity-matched non–ASA-using controls. That analysis identified no association between low-dose ASA use and mortality.
Citation(s):
Osthoff M et al. Low-dose acetylsalicylic acid treatment and impact on short-term mortality in Staphylococcus aureus bloodstream infection: A propensity score–matched cohort study. Crit Care Med 2016 Jan 6; [e-pub].
JWatch
