Cefazolin Versus Antistaphylococcal Penicillins for Methicillin Susceptible Staphylococcus Aureus Bacteremia

NCT07186894 | Active Not Recruiting

• 1 other identifier: TriPasCef
• Study Type: observational
• Target: 5,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

Background Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a common and serious infection, associated with significant morbidity and high mortality rates. Antistaphylococcal penicillins (ASPs) have traditionally been recommended as the first-line treatment. However, this established position has recently been challenged by meta-analyses suggesting that cefazolin may provide comparable efficacy, along with a more favourable safety profile. Further clinical and real-world studies are warranted to substantiate these findings. Objectives The aim of this study was to assess the effectiveness and safety of cefazolin compared with ASPs in the management of MSSA bacteraemia.

Conditions

Bacteriemia; Methicillin Susceptible Staphylococcus Aureus (MSSA) Infection

Keywords

Methicillin-susceptible Staphylococcus aureus; bacteremia; antistaphylococcal penicillins; cefazolin; real-word evaluation; TriNetX

Outcome Measures

Primary Outcomes (1)

• 90 days all-cause mortality

  All-cause mortality, at day 90

  90 days after the inclusion

Secondary Outcomes (2)

• All-cause mortality measured at other timeframes

  day 7, day 30, and 1 year

• Safety outcomes

  30 or 90 days after the inclusion

Study Arms (2)

Antistaphylococcal penicillins (ASPs)

ASPs group Inclusion criteria * Monobacterial methicillin susceptible Staphylococcus aureus (MSSa) bacteremia * Antistaphylococcal penicillins (ASPs) injectable prescription (flucloxacillin, floxacillin, cloxacillin, oxacillin, nafcillin and dicloxacillin) in the week before or the week after MSSa bacteremia Exclusion criteria : cefazolin injectable prescription in the year before or the year after MSSa bacteremia

Drug: Antistaphylococcal penicillins

Cefazolin

Cefazolin group Inclusion criteria * Monobacterial methicillin susceptible Staphylococcus aureus (MSSa) bacteremia * Cefazolin injectable prescription in the week before or the week after MSSa bacteremia Exclusion criteria : ASP injectable prescription in the year before or the year after MSSa bacteremia

Drug: Cefazolin

Interventions

Antistaphylococcal penicillins DRUG

It in not an interventional study. This project is a phase IV, retrospective, descriptive, and multicentric study.

Antistaphylococcal penicillins (ASPs)

Cefazolin DRUG

It in not an interventional study. This project is a phase IV, retrospective, descriptive, and multicentric study.

Cefazolin

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Variables : age, sex, medical history, type of infection and antibiotic used. Variables will be described as number and percentage for categorical variables, and mean and standard-deviation for continuous ones. A propensity score matching method will be conducted including (i) variables significantly different between the two cohorts in the bivariate descriptive analyses between the patient birth and the index event date (standard difference \< 0.10 ; appendix 1), and (ii) clinically relevant variables (known confusion factors linked to mortality and safety outcomes ; appendix 2) at the index event date. Variables related to patients will be described before and after propensity score matching.

You may qualify if:

• Monobacterial methicillin susceptible Staphylococcus aureus (MSSa) bacteremia
• In the cefazolin group : Cefazolin injectable prescription in the week before or the week after MSSa bacteremia
• In the ASPs group :ASPs injectable prescription (flucloxacillin, floxacillin, cloxacillin, oxacillin, nafcillin and dicloxacillin) in the week before or the week after MSSa bacteremia

You may not qualify if:

• In the cefazolin group : ASP injectable prescription in the year before or the year after MSSa bacteremia
• In the ASPs group : cefazolin injectable prescription in the year before or the year after MSSa bacteremia

Sponsors & Collaborators

• Central Hospital, Nancy, France: lead

MeSH Terms

Conditions

Infections; Bacteremia

Interventions

Cefazolin

Condition Hierarchy (Ancestors)

Bacterial Infections; Bacterial Infections and Mycoses; Sepsis; Systemic Inflammatory Response Syndrome; Inflammation; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Cephalosporins; beta-Lactams; Lactams; Amides; Organic Chemicals; Thiazines; Sulfur Compounds; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor (MD PhD)

Study Record Dates

• First Submitted: September 16, 2025
• First Posted: September 22, 2025
• Study Start: January 1, 2000
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: September 22, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share