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Title: Longer-term mortality and kidney outcomes of participants in the combination antibiotics for methicillin-resistant Staphylococcus aureus (CAMERA2) trial: a post hoc analysis
Authors: Legg, Amy
Roberts, Matthew A.
Davies, Jane
Cass, Alan
Meagher, Niamh
Sud, Archana
Daitch, Vered
Dishon Benattar, Yael
Yahav, Dafna
Paul, Mical
Chen, Xinxin
Yeo, He Ping
Lye, David C.
Lee, Russel
Robinson, J. Owen
Foo, Hong
Tramontana, Adrian R.
Bak, Narin
Grenfell, Adelaide
Rogers, Benjamin
Li, Ying
Joshi, Neela
O'Sullivan, Matthew
McKew, Genevieve
Ghosh, Niladri
Schneider, Kellie
Holmes, Natasha E.
Dotel, Ravindra
Chia, Timothy
Archuleta, Sophia
Smith, Simon
Warner, Morgyn S.
Titin, Christina
Kalimuddin, Shirin
Roberts, Jason A.
Tong, Steven Y. C.
Davis, Joshua S.
Keywords: Science::Medicine
Issue Date: 2023
Source: Legg, A., Roberts, M. A., Davies, J., Cass, A., Meagher, N., Sud, A., Daitch, V., Dishon Benattar, Y., Yahav, D., Paul, M., Chen, X., Yeo, H. P., Lye, D. C., Lee, R., Robinson, J. O., Foo, H., Tramontana, A. R., Bak, N., Grenfell, A., ...Davis, J. S. (2023). 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 Infectious Diseases, 10(7), ofad337-.
Journal: Open Forum Infectious Diseases 
Abstract: Background: The Combination Antibiotic Therapy for Methicillin-Resistant Staphylococcus aureus (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard therapy (monotherapy) arm. We analyzed the long-term outcomes of participants in CAMERA2 to understand the impact of combination antibiotic therapy and AKI. Methods: Trial sites obtained additional follow-up data. The primary outcome was all-cause mortality, censored at death or the date of last known follow-up. Secondary outcomes included kidney failure or a reduction in kidney function (a 40% reduction in estimated glomerular filtration rate to <60 mL/minute/1.73 m2). To determine independent predictors of mortality in this cohort, adjusted hazard ratios were calculated using a Cox proportional hazards regression model. Results: This post hoc analysis included extended follow-up data for 260 patients. Overall, 123 of 260 (47%) of participants died, with a median population survival estimate of 3.4 years (235 deaths per 1000 person-years). Fifty-five patients died within 90 days after CAMERA2 trial randomization; another 68 deaths occurred after day 90. Using univariable Cox proportional hazards regression, mortality was not associated with either the assigned treatment arm in CAMERA2 (hazard ratio [HR], 0.84 [95% confidence interval [CI],. 59-1.19]; P =. 33) or experiencing an AKI (HR at 1 year, 1.04 [95% CI,. 64-1.68]; P =. 88). Conclusions: In this cohort of patients hospitalized with methicillin-resistant S aureus bacteremia, we found no association between either treatment arm of the CAMERA2 trial or AKI (using CAMERA2 trial definition) and longer-term mortality.
ISSN: 2328-8957
DOI: 10.1093/ofid/ofad337
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: National Centre for Infectious Diseases, Singapore 
Tan Tock Seng Hospital 
Yong Loo Lin School of Medicine, NUS 
Rights: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons. org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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