CAMERA2
Combination Antibiotic Therapy for MRSA Bacteraemia
Patient / Population Intervention / Exposure Comparison Outcome
In 352 patients with MRSA bacteraemia, standard therapy plus an anti-staphylococcal β-lactam did not improve a composite of mortality, persistent bacteraemia and relapse versus standard therapy alone — and acute kidney injury increased.
N
352
Design
Open-label RCT, stopped early for safety
Endpoint
Composite of mortality, persistent bacteraemia, relapse or treatment failure
Relevance
2
Result35% vs 39% — no benefit (absolute difference -4.2%; 95% CI -14.3% to 6.0%). Acute kidney injury 23% vs 6%.
Tong SYC, et al. JAMA. 2020;323(6):527-537. 10.1001/jama.2020.0103
Discussion & critique
Routine upfront β-lactam combination is harmful in MRSA bacteraemia without benefit — vancomycin or daptomycin monotherapy remains standard.