Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UMLS:C0027947 (
neutropenia
)
17,527
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Background:
Nafcillin or cefazolin are drugs of choice for methicillin-susceptible
Staphylococcus aureus
(MSSA) infections. Prior studies indicate a higher incidence of acute kidney injury (AKI) with nafcillin, although AKI classification and time to occurrence is not well described.
Objective:
To characterize the incidence and time to adverse drug events for nafcillin versus cefazolin in the inpatient setting.
Methods:
A retrospective cohort study evaluated hospitalized, adult patients receiving intravenous nafcillin or cefazolin for treatment of MSSA infection. Incidence and time to AKI based on
RIFLE
criteria were measured. Secondary end points included antibiotic discontinuation and incidence of
neutropenia
, thrombocytopenia, elevated transaminases, and
Clostridioides difficile
infection (CDI).
Results:
Of 324 patients who received nafcillin (n = 119) or cefazolin (n = 205), higher rates of AKI were found for nafcillin versus cefazolin (19% vs 2%, respectively;
P
< 0.0001). Median time to AKI with nafcillin was 6.5 days (range, 3-14 days). The majority of patients were classified as
RIFLE
"Risk" stratum. Nafcillin treatment discontinuations were more frequent than for cefazolin (17.6% vs 0.9%, respectively;
P
< 0.0001). Nafcillin was an independent predictor of AKI (odds ratio = 12.4; 95% CI = 4.14-47.60,
P
< 0.0001). No differences in
neutropenia
, thrombocytopenia, elevated transaminases, or CDI were observed.
Conclusion and Relevance:
Nafcillin displayed higher rates of AKI at a median of 1 week of therapy, which provides a framework for clinician monitoring and consideration of antibiotic modification. Most patients developed "Risk" class AKI (
RIFLE
classification), which may be reversible with prompt intervention.
...
PMID:Retrospective Analysis of Adverse Drug Events Between Nafcillin Versus Cefazolin for Treatment of Methicillin-Susceptible
Staphylococcus aureus
Infections. 3188 47
