{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:42:08Z","timestamp":1790484128399,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T00:00:00Z","timestamp":1486425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>Methicillin\u2010susceptible <jats:italic>Staphylococcus aureus<\/jats:italic> (<jats:styled-content style=\"fixed-case\">MSSA<\/jats:styled-content>) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (<jats:styled-content style=\"fixed-case\">ASP<\/jats:styled-content>s) have been considered the agents of choice for the treatment of <jats:styled-content style=\"fixed-case\">MSSA<\/jats:styled-content> bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studies and is only recommended for patients with severe penicillin allergies. Although cefazolin is considered as an alternative to the <jats:styled-content style=\"fixed-case\">ASP<\/jats:styled-content>s for patients with nonsevere penicillin allergies, cefazolin offers several pharmacologic advantages over <jats:styled-content style=\"fixed-case\">ASP<\/jats:styled-content>s, such as more convenient dosing regimens, and antimicrobial stewardship programs are increasingly using cefazolin as the preferential agent for <jats:styled-content style=\"fixed-case\">MSSA<\/jats:styled-content> infections as part of cost\u2010saving initiatives. Concerns about susceptibility to hydrolysis by type A \u03b2\u2010lactamases, particularly at high inocula seen in deep\u2010seated infections such as endocarditis; selective pressures from unnecessary gram\u2010negative coverage; and lack of comparative clinical data have precluded recommending cefazolin as a first\u2010line therapy for <jats:styled-content style=\"fixed-case\">MSSA<\/jats:styled-content> bacteremia. Recent clinical studies, however, have suggested similar clinical efficacy but better tolerability, with lower rates of discontinuation due to adverse drug reactions, of cefazolin compared with <jats:styled-content style=\"fixed-case\">ASP<\/jats:styled-content>s. Other variables, such as adequate source control (e.g., intravascular catheter removal, debridement, or drainage) and enhanced pharmacodynamics through aggressive cefazolin dosing, may mitigate the role of cefazolin inoculum effect and factor into determining improved clinical outcomes. In this review, we highlight the utility of cefazolin versus <jats:styled-content style=\"fixed-case\">ASP<\/jats:styled-content>s in the treatment of <jats:styled-content style=\"fixed-case\">MSSA<\/jats:styled-content> bacteremia with a focus on clinical efficacy and safety.<\/jats:p>","DOI":"10.1002\/phar.1892","type":"journal-article","created":{"date-parts":[[2016,12,30]],"date-time":"2016-12-30T02:46:44Z","timestamp":1483066004000},"page":"346-360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["\u03b2\u2010Lactam Therapy for Methicillin\u2010Susceptible <i>Staphylococcus aureus<\/i> Bacteremia: A Comparative Review of Cefazolin versus Antistaphylococcal Penicillins"],"prefix":"10.1002","volume":"37","author":[{"given":"Julius","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmacy Ochsner Medical Center New Orleans Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly L.","family":"Echevarria","sequence":"additional","affiliation":[{"name":"South Texas Veterans Health Care System San Antonio Texas"},{"name":"The University of Texas at Austin College of Pharmacy Austin Texas"},{"name":"Pharmacotherapy Education and Research Center University of Texas Health Sciences Center San Antonio San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi A.","family":"Traugott","sequence":"additional","affiliation":[{"name":"The University of Texas at Austin College of Pharmacy Austin Texas"},{"name":"Pharmacotherapy Education and Research Center University of Texas Health Sciences Center San Antonio San Antonio Texas"},{"name":"Department of Pharmacy University Health System San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr278"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/345476"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/510386"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00700-07"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-279"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ308"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/599376"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000296"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq146"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1001\/jama.1977.03270330059022","article-title":"Unsuccessful treatment of staphylococcal endocarditis with cefazolin","volume":"237","author":"Bryant RE","year":"1977","journal-title":"JAMA"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/128.Supplement_2.S386"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/379021"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/430833"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028014527820"},{"key":"e_1_2_9_16_1","first-page":"175","article-title":"Penicillinase production in Staphylococcus aureus strains of clinical importance","volume":"33","author":"Rosdahl VT","year":"1986","journal-title":"Dan Med Bull"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.36.2.440"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/34.6.909"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00317-09"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00052-12"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/11.3.361"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2241-5"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90262-1"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/141.3.331"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/128.Supplement_2.S392"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2005.09.015"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2013.0229"},{"key":"e_1_2_9_28_1","volume-title":"Performance standards for antimicrobial susceptibility testing; twenty\u2010sixth informational supplement. 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