Kamfose Musaiwale M, Muriithi Francis G, Knight Thomas, Lasserson Daniel, Hayward Gail
Department of Infection Control and Microbiology, John Radcliffe Hospital, Headley Way, Oxford OX3 7JS, UK.
Obstetrics and Gynaecology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Rd, Nottingham NG7 2UH, UK.
Antibiotics (Basel). 2020 Jan 21;9(2):39. doi: 10.3390/antibiotics9020039.
Methicillin-susceptible Staphylococcus aureus (MSSA) is a common pathogen associated with a range of clinically important infections. MSSA can cause deep-seated infections requiring prolonged courses of intravenous antibiotic therapy to achieve effective resolution. The move toward ambulatory or outpatient delivery of parenteral antibiotics has led to an increase in the use of ceftriaxone as a pragmatic first choice given its advantageous single daily dosing schedule.
To compare the efficacy of once daily ceftriaxone in the treatment of infections due to confirmed or suspected MSSA to multiple dosing regimes of anti-staphylococcal antibiotics.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Global Health, PubMed, EMBASE and CINAHL for randomised controlled trials as well as prospective and retrospective cohort studies that compared ceftriaxone to any multiple dosing regime of anti-staphylococcal antibiotics. Outcome measures were the proportion of patients with a resolution of infection based on time after initiation of therapy, adverse reactions, recurrence and duration of hospital admission.
We included two randomized controlled trials, one prospective observational study and three retrospective cohort studies (643 participants; 246 children, 397 adults). There was no difference in time to resolution of symptoms. The number of adverse reactions, recurrence of bacteraemia and duration of hospital stay were not significantly different between ceftriaxone and other anti-staphylococcal antibiotics.
Based on a small number of low-quality studies, ceftriaxone is as effective as multiple dosing regimes for the treatment of infections due MSSA. An appropriately powered randomized trial is required to demonstrate equivalence and cost effectiveness.
甲氧西林敏感金黄色葡萄球菌（MSSA）是一种常见病原体，与一系列具有临床重要意义的感染相关。MSSA可引起深部感染，需要长时间静脉使用抗生素治疗才能有效治愈。随着肠外抗生素门诊或门诊给药的普及，鉴于头孢曲松每日一次给药方案的优势，其作为务实的首选药物的使用有所增加。
比较每日一次使用头孢曲松与多种给药方案的抗葡萄球菌抗生素治疗确诊或疑似MSSA感染的疗效。
我们检索了Cochrane对照试验中心注册库（CENTRAL）、循证医学数据库（DARE）、全球卫生数据库、PubMed、EMBASE和CINAHL，以查找比较头孢曲松与任何多种给药方案的抗葡萄球菌抗生素的随机对照试验以及前瞻性和回顾性队列研究。观察指标为治疗开始后根据时间计算的感染治愈患者比例、不良反应、复发情况和住院时间。
我们纳入了两项随机对照试验、一项前瞻性观察性研究和三项回顾性队列研究（643名参与者；246名儿童，397名成人）。症状缓解时间没有差异。头孢曲松与其他抗葡萄球菌抗生素之间的不良反应数量、菌血症复发情况和住院时间没有显著差异。
基于少数低质量研究，头孢曲松在治疗MSSA感染方面与多种给药方案同样有效。需要进行一项样本量充足的随机试验来证明等效性和成本效益。
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