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Master Thesis

Évaluation de l’efficacité et de la tolérance de la céfazoline dans les bactériémies simples ou compliquées (localisations secondaires) ou les infections osteo-articulaires à Staphylococcus spp meti-sensible au Centre Hospitalier de la Côte Basque

Abstract : Background: in 2016, a Penicillin M shortage has lead the Agence Nationale de sécurité du Médicament (ANSM) and health product to propose cefazolin as a therapeutic alternative for physicians, and no longer resort to penicillin M apart from central nervous system infection. The purpose of this study was to assess efficacy and tolerability of cefazolin for treatment of uncomplicated and complicated bacteraemia or bones and joints infections by methicillin-susceptible Staphylococcus spp and to evaluate if its systematic use can lead to antibiotic-resistant strain over methicillin-susceptible Staphylococcus aureus (MSSA) or enterobacteriaceae of the gut microbiota. Methods: exhaustive retrospective study of Staphylococcus spp cases hospitalized in the Centre Hospitalier de la Côte Basque between January 2015 and July 2017. Patients with bacteraemia and bones and joints infections by methicillin-susceptible Staphylococcus spp and who received cefazolin more than 48 hours were included. The primary outcome was the rate of clinical cure at the end of therapy. The secondary outcomes were the evaluation of tolerability of cefazolin and the antibiotic-resistant strain onset as methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lacatamases enterobacteriaceae (ESBL). Results: fifty-eight patients were included. A MSSA was isolated in 82,8% (48 / 58). The study showed 70,7% of bacteraemia (41 / 58), with 62% of complicated bacteraemia (36 / 58) and 29,3% of bones and joints infections (25 / 58). The clinical cure at the end of therapy was 89,7% (52 / 58). The rate of adverse drug events was 13,8% (8 / 58). Respectively 65,6% (38 / 58) and 63,8% (37 / 58) of patients have got a nasal and rectal swab at the inclusion. No MRSA or ESBL at the end of treatment were detected among patiens who had been tested before cefazolin treatment. Conclusion: our study shows the efficacy and the safety of cefazolin for treatment of bacteraemia and bones and joints infections by methicillin-susceptible Staphylococcus spp. The lack of antibiotic-resistant strains onset needs to be confirmed by another larger study with higher-quality of detection.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01637712
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Amaury Barret. Évaluation de l’efficacité et de la tolérance de la céfazoline dans les bactériémies simples ou compliquées (localisations secondaires) ou les infections osteo-articulaires à Staphylococcus spp meti-sensible au Centre Hospitalier de la Côte Basque . Médecine humaine et pathologie. 2017. ⟨dumas-01637712⟩

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