Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis

(1) Background: Ceftriaxone is a potential alternative for the treatment of methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA) bloodstream infections (BSIs) in acute care and outpatient parenteral antimicrobial therapy (OPAT) settings. We evaluated the effectiveness and safety o...

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Main Authors: Yazed Saleh Alsowaida, Gregorio Benitez, Khalid Bin Saleh, Thamer A. Almangour, Fadi Shehadeh, Eleftherios Mylonakis
Format: Article
Language:English
Published: MDPI AG 2022-03-01
Series:Antibiotics
Subjects:
Online Access:https://www.mdpi.com/2079-6382/11/3/375
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author Yazed Saleh Alsowaida
Gregorio Benitez
Khalid Bin Saleh
Thamer A. Almangour
Fadi Shehadeh
Eleftherios Mylonakis
author_facet Yazed Saleh Alsowaida
Gregorio Benitez
Khalid Bin Saleh
Thamer A. Almangour
Fadi Shehadeh
Eleftherios Mylonakis
author_sort Yazed Saleh Alsowaida
collection DOAJ
description (1) Background: Ceftriaxone is a potential alternative for the treatment of methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA) bloodstream infections (BSIs) in acute care and outpatient parenteral antimicrobial therapy (OPAT) settings. We evaluated the effectiveness and safety of ceftriaxone for the treatment of MSSA BSIs. (2) Method: We searched PubMed, Embase, and Cochrane Library from their inception to October 30th 2021. Our outcomes included clinical cure, microbiological cure, 30- and 90-day mortality, 90-day hospital readmission, and adverse drug reactions (ADRs). We compared ceftriaxone against standard of care (SOC) therapy. We used the random-effects model for the meta-analysis, and our estimated effects were reported as odds ratios (ORs) with 95% confidence intervals (CI). (3) Results: Twelve retrospective cohort studies were included, comprising 1037 patients in the ceftriaxone arms and 2088 patients in the SOC arms. The clinical cure rate of the ceftriaxone regimen was not statistically different from SOC: OR 0.65 (95% CI: 0.29–1.45). Ceftriaxone was also not statistically different from SOC in microbiological cure: OR 1.48 (95% CI: 0.29–7.51); 30-day mortality: OR 0.79 (95% CI: 0.14–4.65); 90-day mortality: OR 0.82 (95% CI: 0.38–1.80); 90-day hospital readmission: OR 1.20 (95% CI: 0.92–1.56); and ADRs: OR 0.92 (95% CI: 0.39–2.18). (4) Conclusion: Ceftriaxone could provide an alternative for the treatment of MSSA BSIs in acute care and OPAT settings (except in patients whose BSIs were due to infective endocarditis).
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spelling doaj.art-3a23e6b7328a4c28928cd121381bc7b62023-11-24T00:11:34ZengMDPI AGAntibiotics2079-63822022-03-0111337510.3390/antibiotics11030375Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-AnalysisYazed Saleh Alsowaida0Gregorio Benitez1Khalid Bin Saleh2Thamer A. Almangour3Fadi Shehadeh4Eleftherios Mylonakis5Division of Infectious Diseases, Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Infectious Diseases, Rhode Island Hospital, Providence, RI 02903, USACollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Pharmaceutical Care Department, King Abdulaziz Medical City, P.O. Box 3660, Riyadh 11481, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi ArabiaDivision of Infectious Diseases, Alpert Medical School, Brown University, Providence, RI 02903, USADivision of Infectious Diseases, Alpert Medical School, Brown University, Providence, RI 02903, USA(1) Background: Ceftriaxone is a potential alternative for the treatment of methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA) bloodstream infections (BSIs) in acute care and outpatient parenteral antimicrobial therapy (OPAT) settings. We evaluated the effectiveness and safety of ceftriaxone for the treatment of MSSA BSIs. (2) Method: We searched PubMed, Embase, and Cochrane Library from their inception to October 30th 2021. Our outcomes included clinical cure, microbiological cure, 30- and 90-day mortality, 90-day hospital readmission, and adverse drug reactions (ADRs). We compared ceftriaxone against standard of care (SOC) therapy. We used the random-effects model for the meta-analysis, and our estimated effects were reported as odds ratios (ORs) with 95% confidence intervals (CI). (3) Results: Twelve retrospective cohort studies were included, comprising 1037 patients in the ceftriaxone arms and 2088 patients in the SOC arms. The clinical cure rate of the ceftriaxone regimen was not statistically different from SOC: OR 0.65 (95% CI: 0.29–1.45). Ceftriaxone was also not statistically different from SOC in microbiological cure: OR 1.48 (95% CI: 0.29–7.51); 30-day mortality: OR 0.79 (95% CI: 0.14–4.65); 90-day mortality: OR 0.82 (95% CI: 0.38–1.80); 90-day hospital readmission: OR 1.20 (95% CI: 0.92–1.56); and ADRs: OR 0.92 (95% CI: 0.39–2.18). (4) Conclusion: Ceftriaxone could provide an alternative for the treatment of MSSA BSIs in acute care and OPAT settings (except in patients whose BSIs were due to infective endocarditis).https://www.mdpi.com/2079-6382/11/3/375ceftriaxonebacteremiabloodstream infectionmethicillin-susceptible <i>Staphylococcus aureus</i>MSSAoutpatient parenteral antimicrobial therapy
spellingShingle Yazed Saleh Alsowaida
Gregorio Benitez
Khalid Bin Saleh
Thamer A. Almangour
Fadi Shehadeh
Eleftherios Mylonakis
Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis
Antibiotics
ceftriaxone
bacteremia
bloodstream infection
methicillin-susceptible <i>Staphylococcus aureus</i>
MSSA
outpatient parenteral antimicrobial therapy
title Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis
title_full Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis
title_fullStr Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis
title_full_unstemmed Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis
title_short Effectiveness and Safety of Ceftriaxone Compared to Standard of Care for Treatment of Bloodstream Infections Due to Methicillin-Susceptible <em>Staphylococcus aureus</em>: A Systematic Review and Meta-Analysis
title_sort effectiveness and safety of ceftriaxone compared to standard of care for treatment of bloodstream infections due to methicillin susceptible em staphylococcus aureus em a systematic review and meta analysis
topic ceftriaxone
bacteremia
bloodstream infection
methicillin-susceptible <i>Staphylococcus aureus</i>
MSSA
outpatient parenteral antimicrobial therapy
url https://www.mdpi.com/2079-6382/11/3/375
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