ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
Comparative evaluation of the tolerability of cefazolin and nafcillin for treatment of methicillin-susceptible Staphylococcus aureus infections in the outpatient setting.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- Meta-analysis of trials comparing cefazolin to antistaphylococcal penicillins in the treatment of methicillin-sensitive Staphylococcus aureus bacteraemia.British journal of clinical pharmacology · 2018Pooled it
- Systematic Review and Meta-analysis of the Safety of Antistaphylococcal Penicillins Compared to Cefazolin.Antimicrobial agents and chemotherapy · 2018Pooled it
- A Phase 1, Randomized, Single-Ascending-Dose Study To Investigate the Safety, Tolerability, and Pharmacokinetics of DSTA4637S, an Anti-Antimicrobial agents and chemotherapy · 2019Trial
- Trial
- Cefazolin Versus Antistaphylococcal Penicillins in Methicillin-SusceptibleAntibiotics (Basel, Switzerland) · 2026Review
- Development of a rapid diagnostic test for the cefazolin inoculum effect in methicillin-susceptible Staphylococcus aureus: Cefinase disk direct (CDD) test.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Re-examining cephalosporin activity against methicillin-susceptibleJAC-antimicrobial resistance · 2026Article
- The Cefazolin Inoculum Effect: An Underappreciated Factor in MSSA Treatment Strategies.Infectious diseases and therapy · 2026Review
- Treatment effect based on antimicrobial resistance in Staphylococcus aureus infections related to orthopedics.Scientific reports · 2025Article
- The combinations of cefazolin with linezolid and cefazolin with clindamycin are indifferent against methicillin-susceptibleMicrobiology spectrum · 2025Article
- Evolution under vancomycin selection drives divergent collateral sensitivity patterns inProceedings of the National Academy of Sciences of the United States of America · 2025Article
- Polymorphisms in the type AAntimicrobial agents and chemotherapy · 2025Article
- Adverse Events Comparison of Double Beta-Lactam Combinations for Bloodstream Infections: Ampicillin plus Ceftriaxone and Ampicillin/Cloxacillin.Antibiotics (Basel, Switzerland) · 2024Article
- Retrospective Evaluation of the Association of Oxacillin MIC on Acute Treatment Outcomes with Cefazolin and Antistaphylococcal Penicillins in Methicillin-Susceptible Staphylococcus aureus Bacteremia.Journal of clinical microbiology · 2023Article
- Clinical Impact ofAntibiotics (Basel, Switzerland) · 2023Review
- Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy forAntibiotics (Basel, Switzerland) · 2023Article
- Comparison of Clinical Outcomes for Glycopeptides and Beta-Lactams in Methicillin-SusceptibleYonsei medical journal · 2022Article
- Myelosuppression Rates with Administration of Nafcillin with and without Rifampin in Pediatric Patients.Pediatric reports · 2022Article
- Safety and Effectiveness of High-Dose Cefazolin in Patients With High Body Weight: A Retrospective Cohort Study.Open forum infectious diseases · 2022Article
- Clinical Outcomes of an Innovative Cefazolin Delivery Program for MSSA Infections in OPAT.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundNafcillin and cefazolin are considered first-line therapy for most infections with methicillin-susceptible Staphylococcus aureus (MSSA), and recent studies have suggested similar clinical efficacy. Limited data are available on the comparative tolerability of these agents.
methodsIn this retrospective cohort analysis of patients treated with either nafcillin or cefazolin for MSSA infection in the outpatient parenteral antimicrobial therapy clinic at Massachusetts General Hospital from 2007 to 2011, the frequency of premature antimicrobial discontinuation (PAD) and drug-emergent events (DEEs) was calculated.
resultsThree hundred sixty-six and 119 patients were treated with nafcillin or cefazolin, respectively. The median anticipated duration of therapy was comparable at 28 (interquartile range [IQR], 16-37) and 29 (IQR, 24-39) days, respectively, for those treated with nafcillin and cefazolin. Fewer patients completed the prespecified treatment course with nafcillin than with cefazolin (PAD rate, 33.8% vs 6.7%; P < .0001). The hazard ratio for PAD in the nafcillin vs cefazolin groups was 2.81 (95% confidence interval [CI], 1.26-3.68). More patients in the nafcillin group developed rash (13.9% vs 4.2%; P = .002), renal dysfunction (11.4% vs 3.3%; P = .006), and liver function abnormalities (8.1% vs 1.6%; P = .01). Overall rates of DEEs per 1000 patient-days were 16.9 (95% CI, 10.4-27.3) and 4.8 (95% CI, 1.1-10.2), respectively. In 9 cases of nafcillin discontinuation, treatment was changed to cefazolin; all 9 completed treatment with no further observed DEEs.
conclusionsNafcillin treatment was associated with higher rates of both PAD as well as DEEs compared with cefazolin treatment. This difference in tolerability, in addition to efficacy and cost, should be considered when decisions for outpatient parenteral MSSA treatment are made.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.