PDF(Pubmed)
Abstract：
BACKGROUND: First-line treatments for methicillin-susceptible S. aureus (MSSA) bacteraemia are nafcillin, oxacillin, or cefazolin. Regional shortages of these antibiotics force clinicians to use other options like dicloxacillin and cephalotin. This study aims to describe and compare the safety and efficacy of cephalotin and dicloxacillin for the treatment of MSSA bacteraemia.
METHODS: This retrospective study was conducted in a referral centre in Mexico City. We identified MSSA isolates in blood cultures from 1 January 2012 to 31 December 2022. Patients ≥ 18 years of age, with a first episode of MSSA bacteraemia, who received cephalotin or dicloxacillin as the definitive antibiotic treatment, were included. The primary outcome was in-hospital all-cause mortality.
RESULTS: We included 202 patients, of which 48% (97/202) received cephalotin as the definitive therapy and 52% (105/202) received dicloxacillin. In-hospital all-cause mortality was 20.7% (42/202). There were no differences in all-cause in-hospital mortality between patients receiving cephalotin or dicloxacillin (20% vs. 21%, p = 0.43), nor in 30-day all-cause mortality (14% vs. 18%, p = 0.57) or 90-day all-cause mortality (24% vs. 22%, p = 0.82). No severe adverse reactions were associated with either antibiotic.
CONCLUSIONS: Cephalotin and dicloxacillin were equally effective for treating MSSA bacteraemia, and both showed an adequate safety profile.
METHODS: This retrospective study was conducted in a referral centre in Mexico City. We identified MSSA isolates in blood cultures from 1 January 2012 to 31 December 2022. Patients ≥ 18 years of age, with a first episode of MSSA bacteraemia, who received cephalotin or dicloxacillin as the definitive antibiotic treatment, were included. The primary outcome was in-hospital all-cause mortality.
RESULTS: We included 202 patients, of which 48% (97/202) received cephalotin as the definitive therapy and 52% (105/202) received dicloxacillin. In-hospital all-cause mortality was 20.7% (42/202). There were no differences in all-cause in-hospital mortality between patients receiving cephalotin or dicloxacillin (20% vs. 21%, p = 0.43), nor in 30-day all-cause mortality (14% vs. 18%, p = 0.57) or 90-day all-cause mortality (24% vs. 22%, p = 0.82). No severe adverse reactions were associated with either antibiotic.
CONCLUSIONS: Cephalotin and dicloxacillin were equally effective for treating MSSA bacteraemia, and both showed an adequate safety profile.
摘要：
背景：甲氧西林敏感型金黄色葡萄球菌（MSSA）菌血症的一线治疗方法是纳夫西林，苯唑西林,或者头孢唑啉.这些抗生素的区域性短缺迫使临床医生使用其他选择，例如双氯西林和头孢洛汀。本研究旨在描述和比较头孢洛素和双氯西林治疗MSSA菌血症的安全性和有效性。
方法：这项回顾性研究在墨西哥城的一个转诊中心进行。我们在2012年1月1日至2022年12月31日的血液培养物中鉴定了MSSA分离株。年龄≥18岁的患者，第一次出现MSSA菌血症，接受头孢洛素或双氯西林作为最终抗生素治疗的人，包括在内。主要结局是院内全因死亡率。
结果：我们包括202名患者，其中48%(97/202)接受头孢洛汀作为确定性治疗,52%(105/202)接受双氯西林治疗.住院全因死亡率为20.7%(42/202)。接受头孢洛汀或双氯西林的患者之间的全因住院死亡率没有差异（20％与21%,p=0.43)，在30天全因死亡率中也没有(14%与18%,p=0.57)或90天全因死亡率(24%与22%,p=0.82）。两种抗生素均无严重不良反应。
结论：头孢洛汀和双氯西林对治疗MSSA菌血症同样有效，两者都显示出足够的安全性。
方法：这项回顾性研究在墨西哥城的一个转诊中心进行。我们在2012年1月1日至2022年12月31日的血液培养物中鉴定了MSSA分离株。年龄≥18岁的患者，第一次出现MSSA菌血症，接受头孢洛素或双氯西林作为最终抗生素治疗的人，包括在内。主要结局是院内全因死亡率。
结果：我们包括202名患者，其中48%(97/202)接受头孢洛汀作为确定性治疗,52%(105/202)接受双氯西林治疗.住院全因死亡率为20.7%(42/202)。接受头孢洛汀或双氯西林的患者之间的全因住院死亡率没有差异（20％与21%,p=0.43)，在30天全因死亡率中也没有(14%与18%,p=0.57)或90天全因死亡率(24%与22%,p=0.82）。两种抗生素均无严重不良反应。
结论：头孢洛汀和双氯西林对治疗MSSA菌血症同样有效，两者都显示出足够的安全性。
