115 Global differences in SAB management 6 Results A total of 2229 individual survey responses were obtained. The URL link was opened 5679 times (response rate 39%). Nine percent (198/2229) of records were removed from the analyses because of completion of ≤1 questions (88/2229, 4%) or not entering the country of practice (110/2229, 5%). No non-targeted responses were identified. The remaining survey records of 2031 respondents from 71 different countries on 6 continents (North America [701, 35%], Europe [573, 28%], Asia [409, 20%], Oceania [182, 9%], South America [124, 6%], and Africa [42, 2%]) were included in the analysis (Figure 1). Respondents stated they were physicians in adult infectious diseases (74%), clinical microbiology (10%), internal medicine (6%), and pediatric infectious diseases (5%). Thirteen percent of respondents were still in training, and 44% had been registered as a consultant for more than 10 years. Antimicrobial management of SAB Antibiotic treatment for SAB differed significantly between continents (Figure 2). For MSSA bacteremia, cefazolin was the first-choice antibiotic treatment in North America (78% of respondents), whereas anti-staphylococcal penicillins were preferred in all other continents (51%–82%; P < .01) (Figure 2A). For MRSA bacteremia, vancomycin was the preferred first-choice antibiotic agent in all continents, but with a broad range of 53%–97% of respondents. Daptomycin was identified as the first-choice antibiotic agent for MRSA bacteremia in 23% of European respondents but in <10% of respondents of all other continents (Figure 2B; P < .01 for all comparisons above.) Adjunctive rifampin The practice of adding adjunctive rifampin in cases of SAB associated with infected prosthetic material was most frequently reported in Europe: 94% of European respondents would add it in at least 1 of the listed prosthetic material infections (cardiac device, endovascular device, joint prosthesis, prosthetic heart valve, and/ or spondylodesis material infection). In Oceania and Africa rifampin was least often used in SAB patients with infected prosthetic material: 26% and 38% never added rifampin for this indication, respectively (Figure 2C). Oral switch therapy The estimated percentage of SAB patients in whom oral therapy was used was lowest in North America, where 76% of physicians indicated that they never or uncommonly used oral switch antibiotic therapy. Acceptance of oral therapy was highest in Europe, where 55% of physicians indicated that they used it frequently in their SAB patients
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