Department of Clinical & Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, GA, USA.
Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA.
Ann Pharmacother. 2023 Nov;57(11):1312-1327. doi: 10.1177/10600280231158809. Epub 2023 Mar 22.
To compare the efficacy of antimicrobial therapies used in the management of persistent methicillin-susceptible (MSSA) bacteremia.
A literature search using the PubMed database (inception to December 2022) was conducted using the search terms " bacteremia," "methicillin-susceptible bacteremia," "persistent methicillin-susceptible bacteremia," and "refractory methicillin-susceptible bacteremia ." In addition, therapeutic agents which could be used as treatment for MSSA including "nafcillin," "oxacillin," "cefazolin," "ceftaroline," "gentamicin," "rifampin," and "daptomycin" were also combined with the aforementioned search terms to capture data using these agents.
STUDY SELECTION/DATA EXTRACTION: Clinical data were limited to those published in the English language. Articles and abstracts were considered for inclusion in addition to ongoing trials identified through ClinicalTrials.gov.
A total of 78 articles were reviewed including 17 in vitro or animal model studies and 39 studies including patient data. The remaining 22 articles included guidelines, review articles, and editorials. Recent data evaluating use of dual β-lactam regimens for persistent MSSA bacteremia were limited to 8 case reports or case series.
At present, there is little guidance on how to best manage patients with persistent MSSA bacteremia. This narrative review collates the available data to assist clinicians in selecting the best possible antimicrobial regimen when facing this clinical conundrum.
Modification of antimicrobial therapy, in conjunction with source control and infectious diseases consultation, may all be necessary to sterilize blood cultures in patients with persistent MSSA bacteremia.
比较治疗耐甲氧西林敏感金黄色葡萄球菌（MSSA）持续性菌血症的抗菌治疗效果。
使用 PubMed 数据库（从创建到 2022 年 12 月）进行文献检索，检索词包括“菌血症”、“耐甲氧西林敏感菌血症”、“持续性耐甲氧西林敏感菌血症”和“难治性耐甲氧西林敏感菌血症”。此外，还结合了可用于治疗 MSSA 的治疗药物，如“萘夫西林”、“苯唑西林”、“头孢唑林”、“头孢卡品酯”、“庆大霉素”、“利福平”和“达托霉素”，以捕获使用这些药物的数据。
研究选择/数据提取：临床数据仅限于以英文发表的内容。除了通过 ClinicalTrials.gov 确定的正在进行的试验外，还考虑了纳入的文章和摘要。
共回顾了 78 篇文章，包括 17 篇体外或动物模型研究和 39 篇包括患者数据的研究。其余 22 篇文章包括指南、综述文章和社论。最近评估双β-内酰胺方案治疗持续性 MSSA 菌血症的使用的数据仅限于 8 例病例报告或病例系列。
目前，关于如何最好地管理持续性 MSSA 菌血症患者的指导很少。本叙述性综述收集了现有数据，以帮助临床医生在面对这一临床难题时选择最佳的抗菌治疗方案。
可能需要修改抗菌治疗方案，同时进行源头控制和感染病学咨询，以使持续性 MSSA 菌血症患者的血液培养物达到灭菌效果。
