{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:15:28Z","timestamp":1788974128642,"version":"build-2803163510"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with high rates of mortality and morbidity. Vancomycin is widely used for the treatment of pneumonia and bacteremia due to MRSA, despite treatment failure rates between 21% and 50%. Given the high rates of treatment failure with vancomycin, it is hypothesized that such failure may add a substantial burden to the health care system.\nObjectives: To estimate the hospital costs for patients treated with vancomycin for MRSA pneumonia and\/or bacteremia, comparing costs between those who experienced treatment failure and those who experienced treatment success.\nMethods: This retrospective cohort study involved patients admitted to a Canadian hospital between 2014 and 2018 with MRSA pneumonia and\/or bacteremia who were treated with vancomycin. Direct and indirect hospital costs and additional clinical data were obtained from the hospital database. All costs were inflated to 2024 Canadian dollars using the Consumer Price Index. A generalized linear model was used to estimate the adjusted difference in hospital costs between patients with and without treatment failure.\nResults: A total of 128 patients were included in the cohort, of whom 43 (34%) were identified as having treatment failure. Treatment failure was associated with significantly higher costs than treatment success, with an adjusted mean difference in total cost of $43 082 (95% confidence interval $2065 to $84 098). Those with treatment failure had higher rates of vasopressor use, greater need for intensive care, higher sequential organ failure assessment scores, greater need for mechanical ventilation, and higher rates of nephrotoxicity.\nConclusions: Failure of vancomycin treatment for MRSA pneumonia and\/or bacteremia significantly increased hospital costs.\nKeywords: methicillin-resistant Staphylococcus aureus (MRSA), MRSA pneumonia, MRSA bacteremia, treatment failure, hospital costs, pharmacoeconomic analysis\nR\u00c9SUM\u00c9\nContexte : Les infections \u00e0 Staphylococcus aureus r\u00e9sistant \u00e0 la m\u00e9ticilline (SARM) sont associ\u00e9es \u00e0 des taux \u00e9lev\u00e9s de mortalit\u00e9 et de morbidit\u00e9. La vancomycine est largement utilis\u00e9e pour le traitement des pneumonies et des bact\u00e9ri\u00e9mies \u00e0 SARM, malgr\u00e9 des taux d\u2019\u00e9chec th\u00e9rapeutique compris entre 21 % et 50 %. \u00c9tant donn\u00e9 les taux \u00e9lev\u00e9s d\u2019\u00e9chec th\u00e9rapeutique par la vancomycine, l\u2019hypoth\u00e8se est \u00e9mise que ces \u00e9checs pourraient constituer une charge importante pour le syst\u00e8me de sant\u00e9.\nObjectifs : Estimer les co\u00fbts hospitaliers associ\u00e9s aux patients trait\u00e9s par vancomycine pour une pneumonie ou une bact\u00e9ri\u00e9mie \u00e0 SARM, en comparant les co\u00fbts associ\u00e9s aux patients dont le traitement a fonctionn\u00e9 et ceux chez qui il n\u2019a pas fonctionn\u00e9.\nM\u00e9thodologie : Cette \u00e9tude de cohorte r\u00e9trospective incluait des patients admis dans un h\u00f4pital canadien entre 2014 et 2018 qui \u00e9taient atteints de pneumonie ou de bact\u00e9ri\u00e9mie \u00e0 SARM et qui \u00e9taient trait\u00e9s par vancomycine. Les co\u00fbts hospitaliers directs et indirects ainsi que des donn\u00e9es cliniques suppl\u00e9mentaires ont \u00e9t\u00e9 obtenus \u00e0 partir de la base de donn\u00e9es hospitali\u00e8re. Tous les co\u00fbts ont \u00e9t\u00e9 exprim\u00e9s en dollars canadiens de 2024 en utilisant l\u2019indice des prix \u00e0 la consommation. Un mod\u00e8le lin\u00e9aire g\u00e9n\u00e9ralis\u00e9 a \u00e9t\u00e9 utilis\u00e9 afin d\u2019estimer la diff\u00e9rence ajust\u00e9e des co\u00fbts hospitaliers entre les patients avec et sans \u00e9chec th\u00e9rapeutique.\nR\u00e9sultats : Au total, 128 patients ont \u00e9t\u00e9 inclus dans la cohorte, dont 43 (34 %) ont connu un \u00e9chec th\u00e9rapeutique. Celui-ci \u00e9tait associ\u00e9 \u00e0 des co\u00fbts significativement plus \u00e9lev\u00e9s qu\u2019en cas de r\u00e9ussite du traitement, avec une diff\u00e9rence moyenne ajust\u00e9e du co\u00fbt total de 43 082 $ (intervalle de confiance \u00e0 95 %: 2065 $ \u2013 84 098 $). Les taux de recours plus \u00e9lev\u00e9s aux vasopresseurs et aux soins intensifs, des scores plus \u00e9lev\u00e9s sur l\u2019\u00e9chelle SOFA (Sequential Organ Failure Assessment, un outil m\u00e9dical qui sert \u00e0 \u00e9valuer et suivre la gravit\u00e9 de la d\u00e9faillance des organes), un recours plus fr\u00e9quent \u00e0 la ventilation m\u00e9canique, ainsi que des taux plus \u00e9lev\u00e9s de n\u00e9phrotoxicit\u00e9 ont \u00e9t\u00e9 observ\u00e9s chez les patients ayant connu un \u00e9chec th\u00e9rapeutique.\nConclusions : L\u2019\u00e9chec du traitement par vancomycine dans les cas de pneumonie ou de bact\u00e9ri\u00e9mie \u00e0 SARM entra\u00eenait une augmentation significative des co\u00fbts hospitaliers.\nMots-cl\u00e9s : Staphylococcus aureus r\u00e9sistant \u00e0 la m\u00e9ticilline (SARM), pneumonie \u00e0 SARM, bact\u00e9ri\u00e9mie \u00e0 SARM, \u00e9chec th\u00e9rapeutique, co\u00fbts hospitaliers, analyse pharmaco\u00e9conomique<\/jats:p>","DOI":"10.4212\/cjhp.3860","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:51:55Z","timestamp":1788972715000},"source":"Crossref","is-referenced-by-count":0,"title":["Costs Associated with Failure of Vancomycin Treatment for Pneumonia and Bacteremia Due to Methicillin-Resistant Staphylococcus aureus"],"prefix":"10.4212","volume":"79","author":[{"given":"Maria","family":"Josey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Marko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie","family":"Gauthier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letissia","family":"Fadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kednapa","family":"Thavorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salmaan","family":"Kanji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2732","published-online":{"date-parts":[[2026,9,9]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3860\/5948","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3860\/5955","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3860\/5948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:51:57Z","timestamp":1788972717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,9]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3860","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"e3860"}}