Comparative outcomes of cefazolin versus nafcillin for methicillin-susceptible Staphylococcus aureus bacteraemia: a prospective multicentre cohort study in Korea
| Autor: | S. Lee, K.-H. Song, S.-I. Jung, W.B. Park, S.H. Lee, Y.-S. Kim, Y.G. Kwak, Y.K. Kim, S.M. Kiem, H.-I. Kim, E.S. Kim, K.-H. Park, N.J. Kim, H.-C. Jang, H.B. Kim, S.-M. Choi, K.U. Park, C.J. Kim, J.E. Cho, Y.J. Choi, J. In Park, T.S. Kim, P.G. Choe, N.-H. Kim, M.J. Lee, S.J. Choi, J.H. Jeon, D.-K. Kim, S.-A. Song, M.J. Kang, J.G. Shin, J. Yi, S. Park, H.K. Choi, M.S. Han, C.R. Cho, H.S. Song, Y.S. Lee, S.-J. Kang, H.-J. Hwang, S. Cheon, J.H. Hwang, S.J. Yun, K.T. Kwon, S.M. Shin |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.drug_class 030106 microbiology Antibiotics Cefazolin Bacteremia Nafcillin Sepsis Methicillin 03 medical and health sciences Republic of Korea polycyclic compounds medicine Humans Prospective Studies Adverse effect Aged business.industry General Medicine Middle Aged Staphylococcal Infections biochemical phenomena metabolism and nutrition bacterial infections and mycoses medicine.disease Anti-Bacterial Agents Discontinuation Infectious Diseases Anesthesia Propensity score matching Drug Therapy Combination Female business medicine.drug Cohort study |
| Zdroj: | Clinical Microbiology and Infection. 24:152-158 |
| ISSN: | 1198-743X |
| DOI: | 10.1016/j.cmi.2017.07.001 |
| Popis: | Objectives No randomized controlled trials have evaluated the comparative outcomes of cefazolin versus nafcillin for methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia. Methods A prospective observational cohort study including all S. aureus bacteraemia was conducted at 10 hospitals. Patients (≥15 years) with MSSA bacteraemia who received cefazolin or nafcillin as definitive antibiotics were included. The rates of treatment failure (premature discontinuation of antibiotics because of adverse effects, switching of antibiotics because of clinical failure, all-cause mortality within 1 month, or recurrence) were compared between the cefazolin and nafcillin groups. Propensity score matching analyses were performed to balance the factors influencing the selection of antibiotics. Results Among the 242 included cases, the bones and joints (36.8%) were the most common sites of infection and 60.7% of the patients had sepsis. The overall treatment failure rate was 43.8% (106/242). All-cause mortality within 1 month was 6.2% (15/242). After propensity score matching, the treatment failure rate of cefazolin was lower than that of nafcillin (30.4% (24/79) vs. 49.4% (39/79), p 0.015) because of a higher rate of discontinuation caused by adverse events. When the data were limited to patients with sepsis, the treatment failure rates of both groups were not significantly different. Approximately 22% (24/110) of MSSA isolates exhibited a cefazolin-inoculum effect (CIE) that had significant impact on the failure rate and mortality of the cefazolin group. Conclusions Cefazolin might be recommended as an adequate and better-tolerated treatment for MSSA bacteraemia in the absence of CIE. |
| Databáze: | OpenAIRE |
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