Prolonged cefazolin course for treatment of methicillin susceptible staphylococcus species infections and the impact on the emergence of multidrug-resistant bacteria during cloxacillin shortage - 28/04/21
, Amaury Barret a, Camille Vinclair c, d, Brice Guerpillon a, d, David Leyssene b, Anne-Christine Jaouen b, Laure Alleman a, Heidi Wille aBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | Cefazolin is a cloxacillin alternative for methicillin resistant staphylococcus sp. |
• | Cefazolin is the alternative recommended by health authorities during a cloxacillin shortage. |
• | Efficacy and tolerance data compare favorably with cloxacillin, although a risk of coagulation anomalies has arisen. |
• | The ecological impact and risks of multidrug-resistant bacteria selection (Methicillin resistant Staphylococcus aureus, β-lactamase producing extended spectrum Enterobacterales, Clostridium difficile) under prolonged treatment is not known. |
Abstract |
Objectives |
To describe the efficacy and safety of prolonged cefazolin course for Staphylococcus infection and the emergence of multidrug-resistant bacteria carriage after treatment.
Methods |
Monocentric retrospective cohort study of patients hospitalized for blood stream infections (BSI) and osteoarticular infections (OAI) by methicillin susceptible staphylococcal species treated with cefazolin from January 2015 to July 2017. Rectal and nasal swabs were performed at cefazolin initiation and end of treatment to detect respectively methicillin resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing bacteria.
Results |
Fifty-eight patients were included, 41 had a bacteremia including 22 endocarditis and 22 OAI. Mean duration of treatment was 21.5 days at a mean daily dose of 6.5g/d. Fifty-five (94.5%) received combination therapy. Fifty-two (89.7%) of patients achieved bacteriological cure. Four patients were ESBL carriers at inclusion. No additional ESBL or MRSA were detected by end of treatment.
Conclusion |
Cefazolin appears as an effective and safe treatment for BSI or osteoarticular infection and does not appear to select MRSA or ESBL.
Le texte complet de cet article est disponible en PDF.Keywords : Cefazolin, Multidrug resistance, Staphylococcus aureus
Plan
| ☆ | Presentation at the 28th ECCMID Congress, Madrid, Spain 21–24 April 2018. |
Vol 51 - N° 3
P. 304-307 - mai 2021 Retour au numéro
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