Abstract：
(1) Background: Ceftriaxone is a potential alternative for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSIs) in acute care and outpatient parenteral antimicrobial therapy (OPAT) settings. We evaluated the effectiveness and safety of ceftriaxone for the treatment of MSSA BSIs. (2) Method: We searched PubMed, Embase, and Cochrane Library from their inception to October 30th 2021. Our outcomes included clinical cure, microbiological cure, 30- and 90-day mortality, 90-day hospital readmission, and adverse drug reactions (ADRs). We compared ceftriaxone against standard of care (SOC) therapy. We used the random-effects model for the meta-analysis, and our estimated effects were reported as odds ratios (ORs) with 95% confidence intervals (CI). (3) Results: Twelve retrospective cohort studies were included, comprising 1037 patients in the ceftriaxone arms and 2088 patients in the SOC arms. The clinical cure rate of the ceftriaxone regimen was not statistically different from SOC: OR 0.65 (95% CI: 0.29-1.45). Ceftriaxone was also not statistically different from SOC in microbiological cure: OR 1.48 (95% CI: 0.29-7.51); 30-day mortality: OR 0.79 (95% CI: 0.14-4.65); 90-day mortality: OR 0.82 (95% CI: 0.38-1.80); 90-day hospital readmission: OR 1.20 (95% CI: 0.92-1.56); and ADRs: OR 0.92 (95% CI: 0.39-2.18). (4) Conclusion: Ceftriaxone could provide an alternative for the treatment of MSSA BSIs in acute care and OPAT settings (except in patients whose BSIs were due to infective endocarditis).
摘要：
（1）背景：头孢曲松是急性护理和门诊肠外抗菌治疗（OPAT）设置中治疗甲氧西林敏感的金黄色葡萄球菌（MSSA）血流感染（BSIs）的潜在替代品。我们评估了头孢曲松治疗MSSABSIs的有效性和安全性。(2)方法：我们搜索PubMed，Embase,和Cochrane图书馆从成立到2021年10月30日。我们的结果包括临床治愈，微生物治疗，30天和90天死亡率，90天再次住院，药物不良反应（ADR）。我们比较了头孢曲松与标准治疗（SOC）治疗。我们使用随机效应模型进行荟萃分析，我们的估计效果报告为比值比(ORs)和95%置信区间(CI).(3)结果:共纳入12项回顾性队列研究,包括头孢曲松组的1037名患者和SOC组的2088名患者。头孢曲松方案的临床治愈率与SOC无统计学差异：OR0.65（95％CI：0.29-1.45）。头孢曲松在微生物学治疗方面也与SOC无统计学差异：OR1.48（95％CI：0.29-7.51）；30天死亡率：OR0.79（95％CI：0.14-4.65）；90天死亡率：OR0.82（95％CI：0.38-1.80）；90天再入院：OR1.20（95％CI：0.92-1.56）；和ADR39：95-CI：0.92（4）结论：头孢曲松可以为急性护理和OPAT设置中MSSABSIs的治疗提供替代方案（BSIs是由于感染性心内膜炎引起的患者除外）。
