Repositorio Dspace

Cloxacillin plus fosfomycin versus cloxacillin alone for methicillin-susceptible Staphylococcus aureus bacteremia: a randomized trial

Mostrar el registro sencillo del ítem

dc.contributor SAFO study group
dc.creator Grillo, Sara
dc.creator Pujol, Miquel
dc.creator Miró, Josep M.
dc.creator López-Contreras, Joaquín
dc.creator Euba, Gorane
dc.creator Gasch, Oriol
dc.creator Boix-Palop, Lucia
dc.creator Garcia-País, Maria José
dc.creator Pérez-Rodríguez, Maria Teresa
dc.creator Gomez-Zorrilla, Silvia
dc.creator Oriol, Isabel
dc.creator López-Cortés, Luis Eduardo
dc.creator Pedro-Botet, Maria Luisa
dc.creator San-Juan, Rafael
dc.creator Aguado, José María
dc.creator Gioia, Francesca
dc.creator Iftimie, Simona
dc.creator Morata, Laura
dc.creator Jover, Alfredo
dc.creator García-Pardo, Graciano
dc.creator Loeches, Belén
dc.creator Izquierdo-Cárdenas, Álvaro
dc.creator Goikoetxea, Ane Josune
dc.creator Gomila-Grange, Aina
dc.creator Dietl, Beatriz
dc.creator Berbel, Damaris
dc.creator Videla, Sebastian
dc.creator Hereu, Pilar
dc.creator Padullés, Ariadna
dc.creator Pallarès, Natalia
dc.creator Tebé, Cristian
dc.creator Cuervo, Guillermo
dc.creator Carratalà, Jordi
dc.date 2023
dc.date.accessioned 2025-11-03T12:14:20Z
dc.date.available 2025-11-03T12:14:20Z
dc.identifier https://doi.org/10.1038/s41591-023-02569-0
dc.identifier 1078-8956
dc.identifier 1546-170X
dc.identifier https://hdl.handle.net/10459.1/464756
dc.identifier.uri http://fima-docencia.ub.edu:8080/xmlui/handle/123456789/23650
dc.description Treatment failure occurs in about 25% of patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. We assessed whether cloxacillin plus fosfomycin achieves better treatment success than cloxacillin alone in hospitalized adults with MSSA bacteremia. We conducted a multicenter, open-label, phase III–IV superiority randomized clinical trial. We randomly assigned patients (1:1) to receive 2 g of intravenous cloxacillin alone every 4 h or with 3 g of intravenous fosfomycin every 6 h for the initial 7 days. The primary endpoint was treatment success at day 7, a composite endpoint with the following criteria: patient alive, stable or with improved quick Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA, adjudicated by an independent committee blinded to treatment allocation. We randomized 215 patients, of whom 105 received cloxacillin plus fosfomycin and 110 received cloxacillin alone. We analyzed the primary endpoint with the intention-to-treat approach in 214 patients who received at least 1 day of treatment. Treatment success at day 7 after randomization was achieved in 83 (79.8%) of 104 patients receiving combination treatment versus 82 (74.5%) of 110 patients receiving monotherapy (risk difference 5.3%; 95% confidence interval (CI), –5.95–16.48). Secondary endpoints, including mortality and adverse events, were similar in the two groups except for persistent bacteremia at day 3, which was less common in the combination arm. In a prespecified interim analysis, the independent committee recommended stopping recruitment for futility prior to meeting the planned randomization of 366 patients. Cloxacillin plus fosfomycin did not achieve better treatment success at day 7 of therapy than cloxacillin alone in MSSA bacteremia. Further trials should consider the intrinsic heterogeneity of the infection by using a more personalized approach.
dc.language eng
dc.publisher Nature Research
dc.relation Reproducció del document publicat a: https://doi.org/10.1038/s41591-023-02569-0
dc.relation Nature Medicine, 2023, vol. 29 , p. 2518–2525
dc.rights cc-by (c)The Authors, 2023
dc.rights info:eu-repo/semantics/openAccess
dc.rights https://creativecommons.org/licenses/by/4.0/deed.es
dc.title Cloxacillin plus fosfomycin versus cloxacillin alone for methicillin-susceptible Staphylococcus aureus bacteremia: a randomized trial
dc.type info:eu-repo/semantics/article
dc.type info:eu-repo/semantics/publishedVersion


Ficheros en el ítem

Ficheros Tamaño Formato Ver

No hay ficheros asociados a este ítem.

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem

Buscar en DSpace


Búsqueda avanzada

Listar

Mi cuenta