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Clinical Outcomes of an Innovative Cefazolin Delivery Program for MSSA Infections in OPAT
Laura Herrera-Hidalgo1,2,3, Rafael Luque-Márquez2,3,4, Aristides de Alarcon2,3,4
1Unidad de Farmacia, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain.
Abstract:
Cefazolin is a recommended treatment for methicillin-susceptible Staphylococcus aureus (MSSA) infections that has been successfully used in outpatient parenteral antibiotic therapy (OPAT) programs. The aim of this study was to assess the clinical outcomes of cefazolin delivered each day (Group 24) vs. every two days (Group 48) for MSSA infections in OPAT programs. It was a prospective observational study with retrospective analysis of a cohort of MSSA infections attended in OPAT. The primary outcome was treatment success, defined as completing the antimicrobial regimen without death, treatment discontinuation, or readmission during treatment and follow-up. A univariate and multivariate logistic regression model was built. A two-sided p < 0.05 was considered statistically significant. Of the 149 MSSA infections treated with cefazolin 2 g/8 h in OPATs, 94 and 55 patients were included in the delivery Group 24 and Group 48, respectively. Treatment failure and unplanned readmission rates were similar in both groups (11.7% vs. 7.3% p = 0.752 and 8.5% vs. 5.5% p = 0.491). There was a significant increase in vascular access complications in Group 24 (33.0%) with respect to Group 48 (7.3%) (p < 0.001). Treating uncomplicated MSSA infection with cefazolin home-delivered every two days through an OPAT program is not associated with an increased risk of treatment failure and entails a significant reduction in resource consumption compared to daily delivery.
Insights
Administering cefazolin every two days for methicillin-susceptible Staphylococcus aureus (MSSA) infections in outpatient parenteral antibiotic therapy (OPAT) is as effective as daily dosing. This approach reduces vascular access complications and resource use in OPAT programs.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Pharmacy
Background:
- Cefazolin is a key antibiotic for methicillin-susceptible Staphylococcus aureus (MSSA) infections.
- Outpatient parenteral antibiotic therapy (OPAT) programs utilize cefazolin effectively.
- Optimizing cefazolin delivery schedules in OPAT is crucial for patient outcomes and resource management.
Purpose of the Study:
- To compare clinical outcomes of daily (Group 24) versus every-two-day (Group 48) cefazolin administration in OPAT for MSSA infections.
- To evaluate treatment success rates, failure, readmissions, and vascular access complications between the two dosing groups.
Main Methods:
- Prospective observational study with retrospective analysis of 149 patients with MSSA infections in OPAT.
- Patients received cefazolin 2 g/8 h, with analysis divided into daily (Group 24) and every-two-day (Group 48) delivery.
- Univariate and multivariate logistic regression models were used to assess outcomes. Statistical significance was set at p < 0.05.
Main Results:
- Treatment failure and unplanned readmission rates were similar between Group 24 (11.7%, 8.5%) and Group 48 (7.3%, 5.5%).
- Vascular access complications were significantly higher in Group 24 (33.0%) compared to Group 48 (7.3%) (p < 0.001).
Conclusions:
- Administering cefazolin every two days for uncomplicated MSSA infections in OPAT is not linked to increased treatment failure.
- Every-two-day cefazolin delivery in OPAT significantly reduces vascular access complications and resource consumption compared to daily administration.
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