Staphylococcus aureus bacteraemia treatment outcomes in patients receiving ticagrelor vs a propensity-matched cohort receiving clopidogrel

• Published in: International journal of antimicrobial agents 2023-04, Vol.61 (4), p.106743-106743, Article 106743
• Main Authors: Gentry, Chris A., Williams, Riley J., Whitman, Charles M., Thind, Sharanjeet K., Kliewer, Brian S.
• Format: Article
• Language: English
• Subjects: Bacteremia - drug therapy; Bloodstream infection; Clopidogrel; Clopidogrel - adverse effects; Clopidogrel - therapeutic use; Humans; Platelet Aggregation Inhibitors - therapeutic use; Retrospective Studies; Staphylococcal Infections - drug therapy; Staphylococcus aureus; Ticagrelor; Ticagrelor - adverse effects; Ticagrelor - therapeutic use; Treatment Outcome
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2023.106743

•P2Y12 inhibitors may be protective against the development of Staphylococcus aureus bacteraemia (SAB).•Clinical outcomes for patients with SAB while taking a P2Y12 inhibitor remain limited.•A retrospective analysis was conducted characterizing clinical outcomes for patients with SAB while on ticagrelor vs clopidogrel.•Overall, 30-day mortality between the two groups was low and not significantly different. Ticagrelor may improve the outcomes in Staphylococcus aureus bacteraemia (SAB). However, treatment outcome data for these patients remain limited. The primary objective of this study was to characterize the outcomes of patients with SAB who received ticagrelor compared with a cohort who received clopidogrel. This was a retrospective, nationwide propensity-matched analysis of patients with SAB who were prescribed ticagrelor or clopidogrel concomitantly with antistaphylococcal therapy. The primary outcome was the comparative all-cause 30-day mortality rate between propensity-matched groups. In total, 1509 patients were prescribed concomitantly with ticagrelor or clopidogrel during treatment of S. aureus bacteraemia; of these, 194 patients were excluded from this study due to an inadequate number of antiplatelet doses within the first week of therapy (n=171) or non-admission to hospital (n=23). Of the remaining 1315 patients, 74 patients received ticagrelor and 1241 patients received clopidogrel. There was no significant difference in all-cause 30-day mortality between the groups [6/74 (8.1%) in the ticagrelor group vs 10/74 (13.5%) in the clopidogrel group; P=0.29]. Multi-variate logistic regression demonstrated that elevated aspartate aminotransferase, systolic blood pressure