Volume 14 Supplement 1

30th International Symposium on Intensive Care and Emergency Medicine

Open Access

Bacteremic nosocomial pneumonia cases from the ATTAIN studies

  • E Rubinstein1,
  • SL Barriere2,
  • FC Genter2,
  • GR Corey3,
  • C Luna4,
  • A Lentnek5 and
  • ME Stryjewski6
Critical Care201014(Suppl 1):P79

DOI: 10.1186/cc8311

Published: 1 March 2010


Bacteremic pneumonia is associated with worse outcome including higher mortality. The ATTAIN program compared telavancin (TLV), a lipoglycopeptide antibiotic, with vancomycin (VAN) for treatment of nosocomial pneumonia (NP) due to Gram-positive pathogens including MRSA. This subgroup analysis examined the baseline characteristics and clinical outcomes in bacteremic HAP cases.


ATTAIN 1 and 2 were methodologically identical, randomized, double-blind, phase 3 studies. Adult patients with NP due to presumed or confirmed Gram-positive pathogens were randomized (1:1) to TLV 10 mg/kg intravenously every 24 hours or VAN 1 g intravenously every 12 hours (adjusted per site-specific guidelines) for 7 to 21 days. The modified all-treated (MAT) population consisted of patients who received ≥1 dose of study medication and who had a respiratory pathogen recovered from baseline cultures. Bacteremic NP was defined by the identification of a pneumonia-causing pathogen in the blood or of the same pathogen in lung and blood with identical susceptibility profiles. Clinical outcomes were assessed at test-of-cure (TOC) 7 to 14 days after end of study treatment.


All MAT patients with bacteremic NP (n = 73) were included in this analysis. At baseline, more TLV patients than VAN patients were in the ICU (TLV 74%, VAN 62%) and had ventilator-associated pneumonia (TLV 59%, VAN 44%); APACHE II scores were similar between groups (mean ± SD, TLV 16 ± 6, VAN 17 ± 6). S. aureus was the most common pathogen (TLV 76%, VAN 69%) and included MRSA (TLV 41%, VAN 49%). Cure rates for TLV and VAN were 44% and 36%, respectively (difference TLV - VAN (95% CI) = 7.3% (-15.9%, 30.5%)). On-study mortality was similar, 41% in each treatment group. Incidences of adverse events (AE) were similar between groups, except for nausea (TLV 21%, VAN 3%) and vomiting (TLV 15%, VAN, 0%). Proportions of patients who discontinued the study medication due to AEs were similar (TLV 12%, VAN 13%).


TLV and VAN had similar cure rates in a subgroup of ATTAIN patients with bacteremic NP. The safety profiles of TLV and VAN were mostly comparable in these patients.

Authors’ Affiliations

University of Manitoba
Theravance, Inc.
University of Buenos Aires
Wellstar Infectious Disease


© BioMed Central Ltd. 2010