Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study
Cefazolin (CFZ) is the first-line treatment for beta-lactamase-producing methicillin-sensitive <i>Staphylococcus aureus</i> (BP-MSSA) infection. In 2019, Japan experienced a CFZ shortage because of foreign object inclusion in a batch. Ampicillin/sulbactam (SAM) was preferred in many case...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/11/1505 |
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| author | Jun Hirai Nobuhiro Asai Mao Hagihara Takaaki Kishino Hideo Kato Daisuke Sakanashi Wataru Ohashi Hiroshige Mikamo |
| author_facet | Jun Hirai Nobuhiro Asai Mao Hagihara Takaaki Kishino Hideo Kato Daisuke Sakanashi Wataru Ohashi Hiroshige Mikamo |
| author_sort | Jun Hirai |
| collection | DOAJ |
| description | Cefazolin (CFZ) is the first-line treatment for beta-lactamase-producing methicillin-sensitive <i>Staphylococcus aureus</i> (BP-MSSA) infection. In 2019, Japan experienced a CFZ shortage because of foreign object inclusion in a batch. Ampicillin/sulbactam (SAM) was preferred in many cases as definitive therapy for the treatment of BP-MSSA bacteremia to preserve broad-spectrum antibiotic stock. However, there are no previous studies reporting the clinical efficacy of SAM for BP-MSSA bacteremia. We aimed to compare the clinical efficacy and adverse effects of SAM versus CFZ in patients with BP-MSSA bacteremia. In total, 41 and 30 patients treated with SAM and CFZ, respectively, were identified. The baseline characteristics were similar in both groups. No significant differences were observed in length of hospital stay and all 30-day mortality between the two groups (<i>p</i> = 0.270 and 0.643, respectively). Moreover, no intergroup difference in 90-day mortality was found (hazard ratio 1.02, 95% confidential interval 0.227–4.53). Adverse effects, such as liver dysfunction, were less in the CFZ group than in the SAM group (<i>p</i> = 0.030). Therefore, in cases of poor CFZ supply or in patients allergic to CFZ and penicillinase-stable penicillins, SAM can be an effective therapeutic option for bacteremia due to BP-MSSA with attention of adverse effects, such as liver dysfunction. |
| first_indexed | 2024-03-09T19:20:26Z |
| format | Article |
| id | doaj.art-ca5968978c9e4e36a2685b4d1cc81b9d |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T19:20:26Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-ca5968978c9e4e36a2685b4d1cc81b9d2023-11-24T03:27:29ZengMDPI AGAntibiotics2079-63822022-10-011111150510.3390/antibiotics11111505Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective StudyJun Hirai0Nobuhiro Asai1Mao Hagihara2Takaaki Kishino3Hideo Kato4Daisuke Sakanashi5Wataru Ohashi6Hiroshige Mikamo7Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1103, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1103, JapanDepartment of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute 480-1103, JapanDepartment of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Nagakute 480-1103, JapanDepartment of Pharmacy, Mie University Hospital, Tsu 514-8507, JapanDepartment of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1103, JapanDivision of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute 480-1103, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1103, JapanCefazolin (CFZ) is the first-line treatment for beta-lactamase-producing methicillin-sensitive <i>Staphylococcus aureus</i> (BP-MSSA) infection. In 2019, Japan experienced a CFZ shortage because of foreign object inclusion in a batch. Ampicillin/sulbactam (SAM) was preferred in many cases as definitive therapy for the treatment of BP-MSSA bacteremia to preserve broad-spectrum antibiotic stock. However, there are no previous studies reporting the clinical efficacy of SAM for BP-MSSA bacteremia. We aimed to compare the clinical efficacy and adverse effects of SAM versus CFZ in patients with BP-MSSA bacteremia. In total, 41 and 30 patients treated with SAM and CFZ, respectively, were identified. The baseline characteristics were similar in both groups. No significant differences were observed in length of hospital stay and all 30-day mortality between the two groups (<i>p</i> = 0.270 and 0.643, respectively). Moreover, no intergroup difference in 90-day mortality was found (hazard ratio 1.02, 95% confidential interval 0.227–4.53). Adverse effects, such as liver dysfunction, were less in the CFZ group than in the SAM group (<i>p</i> = 0.030). Therefore, in cases of poor CFZ supply or in patients allergic to CFZ and penicillinase-stable penicillins, SAM can be an effective therapeutic option for bacteremia due to BP-MSSA with attention of adverse effects, such as liver dysfunction.https://www.mdpi.com/2079-6382/11/11/1505beta-lactamase-producing methicillin-sensitive <i>Staphylococcus aureus</i>bacteremiaampicillin/sulbactamcefazolindefinitive therapyJapan |
| spellingShingle | Jun Hirai Nobuhiro Asai Mao Hagihara Takaaki Kishino Hideo Kato Daisuke Sakanashi Wataru Ohashi Hiroshige Mikamo Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study Antibiotics beta-lactamase-producing methicillin-sensitive <i>Staphylococcus aureus</i> bacteremia ampicillin/sulbactam cefazolin definitive therapy Japan |
| title | Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study |
| title_full | Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study |
| title_fullStr | Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study |
| title_full_unstemmed | Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study |
| title_short | Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive <i>Staphylococcus aureus</i>: A Single-Center Retrospective Study |
| title_sort | comparative effectiveness of ampicillin sulbactam versus cefazolin as targeted therapy for bacteremia caused by beta lactamase producing methicillin sensitive i staphylococcus aureus i a single center retrospective study |
| topic | beta-lactamase-producing methicillin-sensitive <i>Staphylococcus aureus</i> bacteremia ampicillin/sulbactam cefazolin definitive therapy Japan |
| url | https://www.mdpi.com/2079-6382/11/11/1505 |
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