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Miró, Jose Maria; Angulo-Lara, Basilio; de Alarcón, Arístides; Carrión, Laura Guio; Zuazabal, Josu Irurzun; Vitoria, Yolanda; Voces, Roberto; Georgieva, Radka Ivanova; Bailón, Isabel Rodríguez; Rodríguez, Ignacio Álvarez; Galparsoro, Harkaitz Azkune; Boronat, Elisa Berritu; Yarza, Alberto Eizaguirre; Bauza, Ángela Granda; Iribarren, José Antonio; Urkola, Xabier Kortajarena; Arrieta, Mar Zabalo; Castelo, Brais; Gutiérrez, Laura; Regueiro, Dolores Sousa; González, Julia González; Ramírez, Alina Pérez; Arrondo, Pablo Prada; Álvarez, Víctor Asensi; de la Hera, Jesús; Fraile, Lisardo Iglesias; Asensio, Mauricio Telenti; Azqueta, Manuel; Cartañá, Ramón; Cuervo, Guillermo; Falces, Carlos; Fernández-Pittol, Mariana J; Fita, Guillermina; García-Pares, Delia; Ninot, Salvador; Paré, Carlos; Pereda, Daniel; Ramírez, José; Sitges, Marta; Tolosana, José M.; Alonso, Juan Carlos; Bermejo, Javier; Moraga, Francisco Javier González; Hualde, Amaia Mari; Marín, Mercedes; Martínez-Sellés, Manuel; Monzón, Diego; Pedraz, Álvaro; Sánchez-Pérez, Eduardo; Toledo, Neera; Vázquez, Pilar; Moreno, Mar; Ramírez, Ulises; Romero, María; Rosillo, Sandra; Balbín, Jesús Agüero; Fernández, Cristina Amado; Gutiérrez-Cuadra, Manuel; Zarauza, Jesús; Romero, Isabel Sánchez; Hermida, José Manuel; Ruiz, Soledad; López-Haldón, José; Luque-Márquez, Rafael; Armas, Estíbaliz Corral; Oteo, José Antonio; Grillo, Sara; Petracca, Rubén Leta; López-Contreras, Joaquín; Martínez, María Alba Rivera; Fernández, A.L.; Regueiro, Benito; Quiñonero, Amaia Aguirre; Blázquez, Ana; Sierra, Pilar Toledano; Alcolea, Eva Cascales; Luna, Carmen Cifuentes; Vidal, Begoña Alcaraz; Villmarín, Mª Belén; Bonet, Laura Vidal; Borràs, Miquel Vives; Munera, Mª Carmen Bellón; Garaizabal, Elena Escribano; Ibars, Sónia; Herrera, Ibalia Horcajada; Pulido, Imanol; Esteve, Andrea Eixerés; Ostalaza, Yolanda Revilla; Fernández, Marcos Sánchez; Rallo, Javier Solera; Grau, Inmaculada; Salado, José Carlos Sánchez; Sánchez, Laura Gracia; Úbeda, Alfonso Cabello; Kancev, Cristina Landaeta; Prieto, Laura; Ble, Mireia; Mas, Alexandra; Molina, Lluís; Taurón, Manuel
International journal of infectious diseases, December 2023, 2023-12-00, 20231201, 2023-12-01, Letnik: 137Journal Article
•Cefazolin is an alternative for methicillin-susceptible Staphylococcus aureus endocarditis.•Prospective observational study of a 12-year national cohort.•Relapses and mortality with cefazolin and standard treatment are similar.•Cefazolin is less toxic than antistaphylococcal penicillin.•Cefazolin might be considered first-line treatment for methicillin-susceptible S. aureus endocarditis. Display omitted This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective.
