1057. Treatment efficacy of ceftriaxone versus cefazolin for methicillin-susceptible Staphylococcus aureus infections
Session: Poster Abstract Session: Bacteremia and Endocarditis
Friday, October 5, 2018
Room: S Poster Hall
Background: Methicillin-susceptible Staphylococcus aureus (MSSA) infections are traditionally treated with intravenous (IV) nafcillin, oxacillin, or cefazolin, all antibiotics that require multiple doses per day. Despite theoretical limitations of using ceftriaxone in MSSA infections, some clinical studies suggest non-inferiority of ceftriaxone compared to standard of care. At Parkland Memorial Hospital, many patients diagnosed with MSSA infections receive self-administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT). Daily-dosed ceftriaxone is often used for convenience and feasibility of medication adherence

Methods:

We conducted a retrospective cohort study among S-OPAT patients receiving cefazolin and ceftriaxone for treatment of MSSA infections. We compared infection type and planned duration of therapy as baseline differences between the treatment cohorts. Our clinical outcomes of interest were 30-day readmission rates and treatment failure as defined by repeat positive blood culture within 6 months.

Results:

We identified 184 patients treated with cefazolin and 74 patients treated with ceftriaxone. Characteristics of treatment plan are shown in Table 1. There were no statistically significant differences in infection type or mean duration of therapy between the two treatment cohorts. Outcomes are shown in Table 2. There were no statistically significant differences in readmission rates and rate of treatment failure.

Conclusion:

Our retrospective review suggests patients treated with ceftriaxone for MSSA bacteremia had similar clinical outcomes as those treated with cefazolin. While this study is limited in its retrospective nature, the findings suggest that ceftriaxone may be a safe and more convenient antibiotic option in certain MSSA infections.

Cefazolin (n=184)

Ceftriaxone (n=74)

p-value

Infection type

0.87

Bacteremia

106

29

Osteomyelitis

23

30

Skin and Soft Tissue Infection

14

6

Endocarditis

14

2

Line-related

11

1

Pulmonary

9

2

GU

5

2

Other

2

2

Mean duration of therapy

30 days

32 days

0.26

Kavita Bhavan, MD, Infectious Disease, UT Southwestern Medical Center, Dallas, TX, Anisha Ganguly, B.S., B.A., ut southwestern medical center, Dallas, TX, Helen King, MD, ut southwestern medical center, dallas, TX, Aurelia Schmalstieg, MD, ut southwestern medical center, Dallas, TX, Afghanistan, Norman Mang, PharmD, Parkland Health And Hospital System, Dallas, TX and Ryan Collins, PA, Parkland Health and Hospital System, dallas, TX

Disclosures:

K. Bhavan, None

A. Ganguly, None

H. King, None

A. Schmalstieg, None

N. Mang, None

R. Collins, None

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