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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA

Published on: February 9, 2011

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A large retrospective cohort study of cefazolin compared with flucloxacillin for methicillin-susceptible

J S Davis1, J Turnidge2, Syc Tong3

  • 1Global and Tropical Health Division, Menzies School of Health Research, Darwin, NT, Australia; Department of Infectious Diseases, John Hunter Hospital, Newcastle, NSW Australia.

International Journal of Antimicrobial Agents
|March 3, 2018
PubMed
Abstract

Insights

For methicillin-susceptible Staphylococcus aureus (MSSA) infections, cefazolin showed similar 30-day mortality outcomes compared to flucloxacillin. This large observational study in Australasia supports cefazolin as an effective treatment option for MSSA bacteremia.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Antistaphylococcal penicillins (ASPs) are standard treatment for invasive methicillin-susceptible Staphylococcus aureus (MSSA) infections.
  • Cefazolin is an alternative, but concerns exist regarding MSSA strains producing beta-lactamases that may reduce its efficacy.

Purpose of the Study:

  • To compare treatment outcomes between flucloxacillin and cefazolin for patients with MSSA infections.
  • To evaluate 30-day all-cause mortality in MSSA bacteremia patients treated with either flucloxacillin or cefazolin.

Main Methods:

  • Retrospective analysis of prospectively collected data from the Australia and New Zealand Co-operative Outcomes of Staphylococcal Sepsis (ANZCOSS) study.
  • Inclusion of consecutive unique episodes of Staphylococcus aureus bacteremia from January 2007 to September 2013.
  • Comparison of 30-day all-cause mortality between patients treated with flucloxacillin versus cefazolin.

Main Results:

  • Data from 7312 episodes of MSSA bacteremia were analyzed.
  • No significant difference in 30-day mortality was observed between flucloxacillin (11.2%) and cefazolin (10.7%) groups.
  • Propensity-adjusted analysis also showed non-significantly lower mortality in the cefazolin group (aOR 0.86).

Conclusions:

  • This study, the largest to date from Australasia, supports previous findings on cefazolin's efficacy for MSSA bacteremia.
  • Observational data suggest cefazolin offers equivalent or superior outcomes compared to ASPs for MSSA bacteremia.
  • A randomized controlled trial is recommended to definitively confirm cefazolin's effectiveness.
Keywords:
Antistaphylococcal penicillinsBacteraemiaCefazolinFlucloxacillinStaphylococcus aureus

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