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Title: Penicillin versus anti-staphylococcal beta-lactams for penicillin-susceptible Staphylococcus aureus blood stream infections: a retrospective cohort study.
Austin Authors: Reynolds, Gemma;Crawford, Simeon;Cuenca, Jose;Ghosh, Niladri;Newton, Peter
Affiliation: Microbiology, NSW Health Pathology, Wollongong Hospital, Wollongong, Australia
Department of Infectious Diseases and Microbiology, Wollongong Hospital, Wollongong, NSW, Australia
Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
Research Central, Illawarra Shoalhaven Local Health District, NSW, Wollongong, Australia
Infectious Diseases
Issue Date: Jan-2022
Date: 2021-08-25
Publication information: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2022-01; 41(1): 147-151
Abstract: The objective of the study is to assess the efficacy and tolerability of penicillins compared to anti-staphylococcal beta-lactams for treatment of penicillin-susceptible Staphylococcus aureus bloodstream infections (PSSA BSI). A retrospective cohort study was conducted of 140 sequential PSSA BSI presenting to a local health district (90 cases included). Penicillin susceptibility was confirmed by disc diffusion, Vitek® and Nitrocefin beta-lactamase methods. Clinical information regarding comorbidities and infection complexity was recorded. Antibiotic choice, dosage and duration were reviewed. Outcomes were compared according to the definitive treatment with either penicillin or ASBLs. The primary outcome was 30-day mortality. Secondary outcomes included renal injury, microbiological relapse and treatment tolerability. Ninety patients met inclusion criteria and were included in subsequent analysis. Of PSSA BSI, 69% were community acquired. Eighty-two percent had complex PSSA infections. The average duration of bacteraemia was 2.8 days (SD = 1.8 days). Sixty-six patients received definitive penicillin treatment, with a mean of 3.5 days of empiric antibiotics prior to penicillin. Twenty-four patients received definitive ASBL treatment (11 cefazolin, 13 flucloxacillin). There was no difference in 30-day mortality between groups (p = 1). There was no difference in renal injury (p > 0.5), hospital length of stay (p = 0.59) or microbiological relapse within 1 year (p = 0.17). Penicillin treatment was well tolerated. Our data supports penicillin as a suitable and well-tolerated alternative to ASBL in managing complex PSSA BSI.
DOI: 10.1007/s10096-021-04330-2
ORCID: 0000-0002-9561-3592
Journal: European Journal of Clinical Microbiology & Infectious Diseases
PubMed URL: 34432165
Type: Journal Article
Appears in Collections:Journal articles

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