{"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":1790484128878,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T00:00:00Z","timestamp":1523318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The objective of this study was to determine the effectiveness and safety of cefazolin <jats:italic>vs.<\/jats:italic> antistaphylococcal penicillin (ASP) in the treatment of methicillin\u2010sensitive <jats:italic>Staphylococcus aureus<\/jats:italic> (MSSA) bacteraemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The databases of PubMed, Embase and Cochrane Central were used to identify comparative trials of cefazolin <jats:italic>vs.<\/jats:italic> ASP in MSSA bacteraemia. Meta\u2010analysis of included trials was performed to assess any differences regarding mortality, clinical cure, recurrence and withdrawal from adverse effects between groups. Data were analysed using fixed effect model. Studies were weighted using Mantel\u2013Haenszel methodology. Heterogeneity was calculated using the I<jats:sup>2<\/jats:sup> statistic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine retrospective and one prospective trials were identified involving 4728 patients, 2954 with ASP and 1774 with cefazolin. Meta\u2010analysis showed a lower mortality rate with cefazolin <jats:italic>vs.<\/jats:italic> ASP using fixed effect model [risk ratio (RR) 0.78, 95% confidence interval (CI) 0.69\u20130.88, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001] with borderline high heterogeneity (I<jats:sup>2<\/jats:sup>\u00a0=\u00a051%). Clinical cure was noted more often with cefazolin (RR 1.09, 95% CI 1.02\u20131.17, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), although no difference was noted with relapse (RR 1.29, 95% CI 0.96\u20131.74 <jats:italic>P<\/jats:italic>\u00a0=\u00a00.09). Analysis also showed more withdrawals from adverse events with ASP <jats:italic>vs.<\/jats:italic> cefazolin (RR 0.27, 95% CI 0.16\u20130.47, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.00001). A minority of patients enrolled in these trials were admitted to the intensive care unit or had endocarditis (11.4% with ASP and 9% with cefazolin).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our meta\u2010analysis of retrospective data demonstrate that cefazolin is more effective and safer ASP in patients with MSSA bacteraemia from various causes. Low quality of trials, borderline high heterogeneity, and possible publication bias may limit the validity of our findings. Randomized trials are needed to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.13554","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T08:00:57Z","timestamp":1522396857000},"page":"1258-1266","source":"Crossref","is-referenced-by-count":38,"title":["Meta\u2010analysis of trials comparing cefazolin to antistaphylococcal penicillins in the treatment of methicillin\u2010sensitive <scp><i>Staphylococcus aureus<\/i><\/scp> bacteraemia"],"prefix":"10.1111","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9741-2455","authenticated-orcid":false,"given":"Joseph P.","family":"Rindone","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Section Northern Arizona VA Health Care System  500 N Hwy 89 Prescott AZ 86313 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadwick K.","family":"Mellen","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Section Northern Arizona VA Health Care System  500 N Hwy 89 Prescott AZ 86313 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/421946"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/599376"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000296"},{"key":"e_1_2_9_5_1","unstructured":"Sanford Guide to Antimicrobial Therapy. 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