@article{10902/30886,
year = {2023},
url = {https://hdl.handle.net/10902/30886},
abstract = {Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP).
Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately.
Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors.
Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective.},
organization = {Funding: The authors received no financial support for the research, authorship, and/or publication of this article. Laura Herrera Hidalgo was supported by the Instituto de Salud Carlos III, co-financed by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Juan Rodés (grant JR22/00049). DAM was supported by the Instituto de Salud Carlos III, co-financed by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Rio Hortega (grant CM21/00274).},
publisher = {Elsevier},
publisher = {International Journal of Infectious Diseases, 2023, 137, 134-143},
title = {Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort},
author = {Herrera-Hidalgo, Laura and Muñoz, Patricia and Álvarez-Uría, Ana and Alonso-Menchén, David and Luque-Márquez, Rafael and Gutiérrez-Carretero, Encarnación and Fariñas Álvarez, María del Carmen and Miró, José María and Goenaga, Miguel Ángel and López-Cortés, Luis Eduardo and Angulo-Lara, Basilio and Boix-Palop, Lucía and Alarcón González, Arístides de},
}