さまよう薬剤師のブログ

感染症治療を考える素材を提供します。最近は意思決定への応用が関心領域。双子と0歳の育児奮闘中。I have Ph.D. but less sense a ID pharmacist (ICPS). Another face is an investor.

Cefazolin versus anti-staphylococcal penicillins for the treatment of methicillin-susceptible Staphylococcus aureus bloodstream infections in acutely-ill adult patients: results of a systematic review and meta-analysis

IJAAに報告された重症MSSABに対するメタアナ

 

www.sciencedirect.com

 感想

CEZがやっぱり良さそうだね。

 

 

Highlights

  1. One prospective and eight retrospective studies with 4,442 patients were included.
  2. Significantly lower rates of failure and mortality were seen with cefazolin.
  3. Subgroup analyses in lower acuity patients were similar to the combined findings.
  4. Failure and mortality with cefazolin was not significantly lower in higher acuity.
  5. The overall risk of adverse drug reactions was reduced with cefazolin.

 

Abstract

A systematic literature review and meta-analysis was conducted to evaluate the comparative efficacy and tolerability of cefazolin versus anti-staphylococcal penicillins (ASPs) for methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSI). Utilizing published regression models, included studies were stratified into high and low pre-probability of mortality subgroups. Cefazolin was associated with significantly lower rates of treatment failure (OR: 0.70; 95% CI: 0.61-0.82; P<0.001; I2=14%) and crude, all-cause mortality (OR: 0.69; 95% CI: 0.59-0.81; P<0.001; I2=18%) when compared to ASP therapy. The overall risk of treatment-related adverse drug reactions was numerically lower with cefazolin (OR: 0.39; 95% CI: 0.15-1.00; P=0.05). Subgroup sensitivity analyses of studies conducted in less severely ill patients were similar to the combined analysis. The role of cefazolin in the most severely ill patients with MSSA BSI should be prospectively evaluated.

Keywords

Methicillin-susceptible Staphylococcus aureus
Bloodstream infection
Anti-staphylococcal penicillin
Cefazolin
Antibiotic stewardship
 

f:id:akinohanayuki:20181126054813p:plain

f:id:akinohanayuki:20181126055119p:plain

 

f:id:akinohanayuki:20181126055133p:plain

f:id:akinohanayuki:20181126055145p:plain

 

 

抗菌薬の考え方,使い方 ver.4   魔弾よ、ふたたび…

抗菌薬の考え方,使い方 ver.4 魔弾よ、ふたたび…

 

 

 

3ステップで推論する副作用のみかた・考えかた

3ステップで推論する副作用のみかた・考えかた