PMID- 30305037
OWN - NLM
STAT- MEDLINE
DCOM- 20181126
LR  - 20190318
IS  - 1471-2334 (Electronic)
IS  - 1471-2334 (Linking)
VI  - 18
IP  - 1
DP  - 2018 Oct 11
TI  - Efficacy and safety of cefazolin versus antistaphylococcal penicillins for the 
      treatment of methicillin-susceptible Staphylococcus aureus bacteremia: a 
      systematic review and meta-analysis.
PG  - 508
LID - 10.1186/s12879-018-3418-9 [doi]
LID - 508
AB  - BACKGROUND: Antistaphylococcal penicillins (ASPs) and cefazolin have become the 
      most frequent choices for the treatment of methicillin-susceptible Staphylococcus 
      aureus (MSSA) infections. However, the best therapeutic agent to treat MSSA 
      bacteremia remains to be established. METHODS: We conducted a systematic review 
      and meta-analysis to evaluate the efficacy and safety of these two regimens for 
      the treatment of MSSA bacteremia. PubMed, EMBASE and the Cochrane Library from 
      inception to February 2018 were searched. The primary outcome was mortality. The 
      secondary outcomes included treatment failure, recurrence of bacteremia, adverse 
      effects (AEs) and discontinuation due to AEs. Data were extracted and pooled odds 
      ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: A total 
      of ten observational studies met the inclusion criteria. The results indicate 
      that compared to ASPs, cefazolin was associated with significant reduction in 
      mortality (OR, 0.69; 95% CI, 0.58 to 0.82; I(2) = 3.4%) and clinical failure (OR, 
      0.56; 95% CI, 0.37 to 0.85; I(2) = 44.9%) without increasing the recurrence of 
      bacteremia (OR, 1.12; 95% CI, 0.94 to 1.34; I(2) = 0%). There were no significant 
      differences for the risk of anaphylaxis (OR, 0.91; 95% CI, 0.36 to 2.99; 
      I(2) = 0%) or hematotoxicity (OR, 0.56; 95% CI, 0.17 to 1.88; I(2) = 0%). 
      However, nephrotoxicity (OR, 0.36; 95% CI, 0.16 to 0.81; I(2) = 0%) and 
      hepatotoxicity (OR, 0.12; 95% CI, 0.04 to 0.41; I(2) = 0%) were significantly 
      lower in the cefazolin group. Moreover, cefazolin was associated with lower 
      probability of discontinuation due to AEs compared with the ASPs (OR, 0.24; 95% 
      CI, 0.12 to 0.48; I(2) = 18%). CONCLUSION: The results of present study favor the 
      application of cefazolin and should be regarded as important evidence to help 
      make clinical decisions in choosing a treatment option for treating MSSA 
      bacteremia.
FAU - Shi, Changcheng
AU  - Shi C
AD  - Department of Clinical Pharmacy, Affiliated Hangzhou First People's Hospital, 
      Zhejiang University School of Medicine, Hangzhou, China.
AD  - Department of Clinical Pharmacy, Hangzhou First People's Hospital, Nanjing 
      Medical University, Hangzhou, China.
FAU - Xiao, Yubo
AU  - Xiao Y
AD  - Department of Pharmacometrics, Mosim Co., Ltd, Shanghai, China.
FAU - Zhang, Qi
AU  - Zhang Q
AD  - Department of Clinical Pharmacy, Hangzhou First People's Hospital, Nanjing 
      Medical University, Hangzhou, China.
FAU - Li, Qingyu
AU  - Li Q
AD  - Department of Clinical Pharmacy, Affiliated Hangzhou First People's Hospital, 
      Zhejiang University School of Medicine, Hangzhou, China.
FAU - Wang, Fei
AU  - Wang F
AD  - Department of Clinical Pharmacy, Affiliated Hangzhou First People's Hospital, 
      Zhejiang University School of Medicine, Hangzhou, China.
FAU - Wu, Jing
AU  - Wu J
AD  - Department of Pharmacy, Hangzhou Obstetrics & Gynecology Hospital, Hangzhou, 
      China.
FAU - Lin, Nengming
AU  - Lin N
AD  - Department of Clinical Pharmacy, Affiliated Hangzhou First People's Hospital, 
      Zhejiang University School of Medicine, Hangzhou, China. lnm1013@163.com.
AD  - Department of Clinical Pharmacy, Hangzhou First People's Hospital, Nanjing 
      Medical University, Hangzhou, China. lnm1013@163.com.
AD  - Department of Clinical Pharmacology, Translational Medicine Research Center, 
      Affiliated Hangzhou First People's Hospital, Zhejiang University School of 
      Medicine, Hangzhou, China. lnm1013@163.com.
LA  - eng
GR  - 2010-190-4/Zhejiang Provincial Program for the Cultivation of High-level 
      Innovative Health Talents/
GR  - 2018-2-3/Clinical Pharmacy of Zhejiang Medical Key Discipline/
GR  - 2017-68-7/Clinical Pharmacy of Hangzhou Medical Key Discipline/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20181011
PL  - England
TA  - BMC Infect Dis
JT  - BMC infectious diseases
JID - 100968551
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Penicillins)
RN  - IHS69L0Y4T (Cefazolin)
SB  - IM
CIN - BMC Infect Dis. 2019 Oct 25;19(1):892. PMID: 31653196
MH  - *Anti-Bacterial Agents/adverse effects/therapeutic use
MH  - *Cefazolin/adverse effects/therapeutic use
MH  - Humans
MH  - *Penicillins/adverse effects/therapeutic use
MH  - *Staphylococcal Infections/drug therapy/mortality
MH  - Staphylococcus aureus
PMC - PMC6180622
OTO - NOTNLM
OT  - Antistaphylococcal penicillins
OT  - Bacteremia
OT  - Cefazolin
OT  - Meta-analysis
OT  - Methicillin-susceptible Staphylococcus aureus
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they 
      have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral 
      with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2018/10/12 06:00
MHDA- 2018/11/27 06:00
PMCR- 2018/10/11
CRDT- 2018/10/12 06:00
PHST- 2018/05/09 00:00 [received]
PHST- 2018/09/27 00:00 [accepted]
PHST- 2018/10/12 06:00 [entrez]
PHST- 2018/10/12 06:00 [pubmed]
PHST- 2018/11/27 06:00 [medline]
PHST- 2018/10/11 00:00 [pmc-release]
AID - 10.1186/s12879-018-3418-9 [pii]
AID - 3418 [pii]
AID - 10.1186/s12879-018-3418-9 [doi]
PST - epublish
SO  - BMC Infect Dis. 2018 Oct 11;18(1):508. doi: 10.1186/s12879-018-3418-9.