Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study
Background: First-line treatments for methicillin-susceptible <i>S. aureus</i> (MSSA) bacteraemia are nafcillin, oxacillin, or cefazolin. Regional shortages of these antibiotics force clinicians to use other options like dicloxacillin and cephalotin. This study aims to describe and compa...
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| Format: | Article |
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MDPI AG
2024-02-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/13/2/176 |
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| author | Alejandro Quiñonez-Flores Bernardo A. Martinez-Guerra Carla M. Román-Montes Karla M. Tamez-Torres María F. González-Lara Alfredo Ponce-de-León Sandra Rajme-López |
| author_facet | Alejandro Quiñonez-Flores Bernardo A. Martinez-Guerra Carla M. Román-Montes Karla M. Tamez-Torres María F. González-Lara Alfredo Ponce-de-León Sandra Rajme-López |
| author_sort | Alejandro Quiñonez-Flores |
| collection | DOAJ |
| description | Background: First-line treatments for methicillin-susceptible <i>S. aureus</i> (MSSA) bacteraemia are nafcillin, oxacillin, or cefazolin. Regional shortages of these antibiotics force clinicians to use other options like dicloxacillin and cephalotin. This study aims to describe and compare the safety and efficacy of cephalotin and dicloxacillin for the treatment of MSSA bacteraemia. Methods: This retrospective study was conducted in a referral centre in Mexico City. We identified MSSA isolates in blood cultures from 1 January 2012 to 31 December 2022. Patients ≥ 18 years of age, with a first episode of MSSA bacteraemia, who received cephalotin or dicloxacillin as the definitive antibiotic treatment, were included. The primary outcome was in-hospital all-cause mortality. Results: We included 202 patients, of which 48% (97/202) received cephalotin as the definitive therapy and 52% (105/202) received dicloxacillin. In-hospital all-cause mortality was 20.7% (42/202). There were no differences in all-cause in-hospital mortality between patients receiving cephalotin or dicloxacillin (20% vs. 21%, <i>p</i> = 0.43), nor in 30-day all-cause mortality (14% vs. 18%, <i>p</i> = 0.57) or 90-day all-cause mortality (24% vs. 22%, <i>p</i> = 0.82). No severe adverse reactions were associated with either antibiotic. Conclusions: Cephalotin and dicloxacillin were equally effective for treating MSSA bacteraemia, and both showed an adequate safety profile. |
| first_indexed | 2024-03-07T22:44:50Z |
| format | Article |
| id | doaj.art-adf38a00cfb341e089ef24d89886bd5e |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-07T22:44:50Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-adf38a00cfb341e089ef24d89886bd5e2024-02-23T15:05:11ZengMDPI AGAntibiotics2079-63822024-02-0113217610.3390/antibiotics13020176Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort StudyAlejandro Quiñonez-Flores0Bernardo A. Martinez-Guerra1Carla M. Román-Montes2Karla M. Tamez-Torres3María F. González-Lara4Alfredo Ponce-de-León5Sandra Rajme-López6Internal Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoBackground: First-line treatments for methicillin-susceptible <i>S. aureus</i> (MSSA) bacteraemia are nafcillin, oxacillin, or cefazolin. Regional shortages of these antibiotics force clinicians to use other options like dicloxacillin and cephalotin. This study aims to describe and compare the safety and efficacy of cephalotin and dicloxacillin for the treatment of MSSA bacteraemia. Methods: This retrospective study was conducted in a referral centre in Mexico City. We identified MSSA isolates in blood cultures from 1 January 2012 to 31 December 2022. Patients ≥ 18 years of age, with a first episode of MSSA bacteraemia, who received cephalotin or dicloxacillin as the definitive antibiotic treatment, were included. The primary outcome was in-hospital all-cause mortality. Results: We included 202 patients, of which 48% (97/202) received cephalotin as the definitive therapy and 52% (105/202) received dicloxacillin. In-hospital all-cause mortality was 20.7% (42/202). There were no differences in all-cause in-hospital mortality between patients receiving cephalotin or dicloxacillin (20% vs. 21%, <i>p</i> = 0.43), nor in 30-day all-cause mortality (14% vs. 18%, <i>p</i> = 0.57) or 90-day all-cause mortality (24% vs. 22%, <i>p</i> = 0.82). No severe adverse reactions were associated with either antibiotic. Conclusions: Cephalotin and dicloxacillin were equally effective for treating MSSA bacteraemia, and both showed an adequate safety profile.https://www.mdpi.com/2079-6382/13/2/176cephalotincephalothindicloxacillinStaphylococcus aureusMSSAbloodstream infection |
| spellingShingle | Alejandro Quiñonez-Flores Bernardo A. Martinez-Guerra Carla M. Román-Montes Karla M. Tamez-Torres María F. González-Lara Alfredo Ponce-de-León Sandra Rajme-López Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study Antibiotics cephalotin cephalothin dicloxacillin Staphylococcus aureus MSSA bloodstream infection |
| title | Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study |
| title_full | Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study |
| title_fullStr | Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study |
| title_full_unstemmed | Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study |
| title_short | Cephalotin Versus Dicloxacillin for the Treatment of Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteraemia: A Retrospective Cohort Study |
| title_sort | cephalotin versus dicloxacillin for the treatment of methicillin susceptible i staphylococcus aureus i bacteraemia a retrospective cohort study |
| topic | cephalotin cephalothin dicloxacillin Staphylococcus aureus MSSA bloodstream infection |
| url | https://www.mdpi.com/2079-6382/13/2/176 |
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