Plasma Pharmacological Monitoring of M Penicillins in Methicillin-sensitive Staphylococcus Aureus Bacteremia

Plasma Pharmacological Monitoring of M Penicillins in Methicillin-sensitive Staphylococcus Aureus Bacteremia - Single-center Retrospective Study

Status

Recruiting

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT06495697

Acronym

DOSESACLOXA

Enrollment

200

Registered

2024-07-11

Start date

2023-07-19

Completion date

2024-07-19

Last updated

2024-07-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Staphylococcus Aureus Infection

Keywords

Staphylococcus aureus Infection, Staphylococcus aureus bacteremia, Penicillins, Methicillin-sensitive, Cefazolin, Infectious endocarditis, Staphylococcal endocarditis, Oxacillin, Nephrotoxicity

Brief summary

The treatment of Methicillin-sensitive Staphylococcus aureus bacteremia is based on the first-line use of cefazolin or M penicillins (oxacillin and cloxacillin). The use of the latter is recommended at high doses (150-200 mg/kg/24h). In a study on infectious endocarditis, 52 of 56 patients with staphylococcal endocarditis treated with (cl)oxacillin were overdosed with the recommended doses. Although the main mechanism of renal toxicity described for M penicillins is immunoallergic, a frequent overdose is observed in cases of acute renal failure with M penicillins. There is also a significant association between overdose and risk of neurological toxicity. The currently recommended treatment duration is a minimum of 14 days of IV treatment from the first negative blood culture, which leaves room for carrying out a plasma assay and possible dosage adjustment subsequently. Overdose is a risk factor for nephrotoxicity and neurotoxicity. Plasma level could be predictive of clinical success. Systematic plasma dosing would reduce the risk of toxicity and improve the clinical cure rate.

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Inclusion criteria

* Adult patient (≥18 years old) * Having presented an infection with Staphylococcus aureus and treated at the University Hospitals of Strasbourg between January 1, 2019 and December 31, 2022.

Exclusion criteria

\- Patient having expressed his opposition to the reuse of his data for scientific research purposes.

Design outcomes

Primary

Measure	Time frame	Description
Clinical healing	day 30 after infection	Blood culture negative at 48-96 hours compared to the start of antibiotic therapy

Countries

France

Contacts

Primary ContactBaptiste HOELLINGER, MD

baptiste.hoellinger@chru-strasbourg.fr33 3 69 55 05 45

Outcome results