Prolonged cefazolin course for treatment of methicillin susceptible staphylococcus species infections and the impact on the emergence of multidrug-resistant bacteria during cloxacillin shortage
- Resource Type
- Authors
- Amaury Barret; Brice Guerpillon; Camille Vinclair; Laure Alleman; Anne-Christine Jaouen; Heidi Wille; David Leyssene; Marc-Olivier Vareil
- Source
- Infectious Diseases Now. 51:304-307
- Subject
- Male
Methicillin-Resistant Staphylococcus aureus
Staphylococcus aureus
medicine.medical_specialty
Cefazolin
Bacteremia
medicine.disease_cause
Methicillin
Cloxacillin
Drug Resistance, Multiple, Bacterial
Internal medicine
polycyclic compounds
medicine
Humans
Endocarditis
Aged
Retrospective Studies
business.industry
Endocarditis, Bacterial
Bacteriological Cure
Middle Aged
Staphylococcal Infections
biochemical phenomena, metabolism, and nutrition
Bone Diseases, Infectious
bacterial infections and mycoses
medicine.disease
Methicillin-resistant Staphylococcus aureus
Anti-Bacterial Agents
Carbapenem-Resistant Enterobacteriaceae
Infectious Diseases
Female
business
Staphylococcus infection
medicine.drug
- Language
- ISSN
- 2666-9919
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 6.5 g/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.