MSSA: oxacillin versus other beta- lactam choices

MSSA: oxacillin versus other betalactam choices

Alex Soriano Hospital Cl?nic de Barcelona

Minimun inhibitory concentration (MIC) of different ?lactams against methicillin-susceptible S. aureus. (access 20-2-2012)

B-lactam

MIC50 (?g/mL)

Cloxacillin 2 g/4h 0.25

Amoxi-clav 1-2 g/6-8h 1

Cefazolin (1st) 1-2 g/8h 0.5

Cefuroxime (2nd)

1

Ceftriaxone (3rd)

4

Cefepime (4th)

2

Ceftaroline* (5th)

0.25

Imipenem

0.03

MIC90 (?g/mL) 0.5 2 1 2 4 4 0.5 0.06

* Jones R, et al. JAC 2010; 65 (suppl 4): 17-31

Carrizosa J, et al. Treatment of Experimental Staphylococcus aureus Endocarditis: Comparison of Cephalothin, Cefazolin, and Methicillin Antimicrob Agents Chemother 1978; 13: 74-7

Clinical experience with cefazolin in infectious endocarditis and Staphylococcus aureus bacteremia

Reference

N? pat.

Failure (%)

AACh 1973; 4: 525

3

JAMA 1977; 237:569

2

CID 2003; 37: 1194

1

CID 2005; 41: 127

1

AACh 2009; 53: 3437

12

Total endocarditis

7

Total

19

1 2 1 1 3 5 (71.4) 8 (41)

Lee S, et al. Is Cefazolin Inferior to Nafcillin for Treatment of Methicillin-Susceptible S. aureus Bacteremia? Antimicrob Agents Chemother 2011; 55: 5122-6

N=138

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