2026-04-18T04:38:27Zhttps://recercat.cat/oai/requestoai:recercat.cat:10230/705972025-06-04T00:15:01Zcom_2072_6col_2072_452952
2025-06-04T00:15:01Z
urn:hdl:10230/70597
Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort
Herrera Hidalgo, Laura
Muñoz, Patricia
Álvarez-Uría, Ana
Alonso-Menchén, David
Luque Márquez, Rafael
Gutiérrez Carretero, Encarnación
Fariñas, Mari Carmen
Miró, José María
Goenaga, Miguel Angel
López-Cortés, Luis E.
Angulo-Lara, Basilio
Boix Palop, Lucía
Alarcón, Arístides de
Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) Cohort Investigators
Antistaphylococcal penicillin
Cefazolin
Infective endocarditis
Methicillin-susceptible Staphylococcus aureus
Objectives: 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). Methods: 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. Results: 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.Conclusion: 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.
2025-06-04T00:15:01Z
2025-06-04T00:15:01Z
2025-06-03T06:11:58Z
2025-06-03T06:11:58Z
2023
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://hdl.handle.net/10230/70597
Int J Infect Dis. 2023 Dec;137:134-43
© 2023 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
Elsevier