Reply to Fries et al . and Valentin

TO THE EDITOR—We thank Fries et al [1] and Valentin et al [2] for their comments about our study [3] and for providing their data. Although their results did not control for confounders, their experience adds to previous work showing that consultation with an infectious diseases specialist improves the management and prognosis of Staphylococcus aureus bacteremia (SAB), as reviewed in our article. Valentin et al [1] asked for information about adherence to the whole bundle of management parameters during the preintervention and intervention periods in our study. This information could not be calculated, because not all of the specific indicators included in the bundle were feasible for all patients, which is why we provided adherence to each specific indicator during the preintervention and intervention periods. They also asked about the impact of the bundle on specific highrisk populations, because they did not find a significant reduction in mortality among elderly patients and those with a high Pitt score or Charlson index. Because older age, a high Pitt score, and a high Charlson index in themselves are associated with an increased risk of death, much bigger sample sizes would be needed to demonstrate the impact of any