Contemporary use of cefazolin for MSSA infective endocarditis : analysis of a national prospective cohort
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP).
METHODS: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately.
RESULTS: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors.
CONCLUSION: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:137 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 137(2023) vom: 25. Dez., Seite 134-143 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 04.12.2023 Date Revised 04.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2023.10.019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364180544 |
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| 024 | 7 | |a 10.1016/j.ijid.2023.10.019 |2 doi | |
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| 041 | |a eng | ||
| 100 | 1 | |a Herrera-Hidalgo, Laura |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Contemporary use of cefazolin for MSSA infective endocarditis |b analysis of a national prospective cohort |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 04.12.2023 | ||
| 500 | |a Date Revised 04.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP) | ||
| 520 | |a METHODS: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately | ||
| 520 | |a RESULTS: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors | ||
| 520 | |a CONCLUSION: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antistaphylococcal penicillin | |
| 650 | 4 | |a Cefazolin | |
| 650 | 4 | |a Infective endocarditis | |
| 650 | 4 | |a Methicillin-susceptible Staphylococcus aureus | |
| 650 | 7 | |a Cefazolin |2 NLM | |
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| 650 | 7 | |a Cloxacillin |2 NLM | |
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| 700 | 1 | |a Muñoz, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Álvarez-Uría, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Alonso-Menchén, David |e verfasserin |4 aut | |
| 700 | 1 | |a Luque-Marquez, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Gutiérrez-Carretero, Encarnación |e verfasserin |4 aut | |
| 700 | 1 | |a Fariñas, María Del Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Miró, Jose Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Goenaga, Miguel Angel |e verfasserin |4 aut | |
| 700 | 1 | |a López-Cortés, Luis Eduardo |e verfasserin |4 aut | |
| 700 | 1 | |a Angulo-Lara, Basilio |e verfasserin |4 aut | |
| 700 | 1 | |a Boix-Palop, Lucia |e verfasserin |4 aut | |
| 700 | 1 | |a de Alarcón, Arístides |e verfasserin |4 aut | |
| 700 | 0 | |a Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) Cohort Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez, Fernando Fernández |e investigator |4 oth | |
| 700 | 1 | |a de Lomas, José Mª García |e investigator |4 oth | |
| 700 | 1 | |a Rosas, Gabriel |e investigator |4 oth | |
| 700 | 1 | |a de la Torre Lima, Javier |e investigator |4 oth | |
| 700 | 1 | |a Bereciartua, Elena |e investigator |4 oth | |
| 700 | 1 | |a Vidal, María José Blanco |e investigator |4 oth | |
| 700 | 1 | |a Blanco, Roberto |e investigator |4 oth | |
| 700 | 1 | |a Boado, María Victoria |e investigator |4 oth | |
| 700 | 1 | |a Lázaro, Marta Campaña |e investigator |4 oth | |
| 700 | 1 | |a Crespo, Alejandro |e investigator |4 oth | |
| 700 | 1 | |a Carrión, Laura Guio |e investigator |4 oth | |
| 700 | 1 | |a Del Álamo Martínez de Lagos, Mikel |e investigator |4 oth | |
| 700 | 1 | |a Ugarte, Gorane Euba |e investigator |4 oth | |
| 700 | 1 | |a Goikoetxea, Ane Josune |e investigator |4 oth | |
| 700 | 1 | |a Hierro, Marta Ibarrola |e investigator |4 oth | |
| 700 | 1 | |a Iruretagoyena, José Ramón |e investigator |4 oth | |
| 700 | 1 | |a Zuazabal, Josu Irurzun |e investigator |4 oth | |
| 700 | 1 | |a López-Soria, Leire |e investigator |4 oth | |
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| 700 | 1 | |a Nieto, Javier |e investigator |4 oth | |
| 700 | 1 | |a Rodrigo, David |e investigator |4 oth | |
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| 700 | 1 | |a Vitoria, Yolanda |e investigator |4 oth | |
| 700 | 1 | |a Voces, Roberto |e investigator |4 oth | |
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| 700 | 1 | |a Odriozola, Mª Jesús Bustinduy |e investigator |4 oth | |
| 700 | 1 | |a Del Bosque Martín, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Echeverría, Tomás |e investigator |4 oth | |
| 700 | 1 | |a Yarza, Alberto Eizaguirre |e investigator |4 oth | |
| 700 | 1 | |a Fuentes, Ana |e investigator |4 oth | |
| 700 | 1 | |a Goenaga, Miguel Ángel |e investigator |4 oth | |
| 700 | 1 | |a Del Río, Muskilda Goyeneche |e investigator |4 oth | |
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