{"id":29411,"date":"2026-02-12T04:30:00","date_gmt":"2026-02-11T20:30:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29411"},"modified":"2026-02-12T06:00:21","modified_gmt":"2026-02-11T22:00:21","slug":"lancet%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%b0%af%e5%94%91%e8%a5%bf%e6%9e%97%e4%b8%8e%e5%a4%b4%e5%ad%a2%e5%94%91%e5%95%89%e6%b2%bb%e7%96%97mssa%e8%8f%8c%e8%a1%80%e7%97%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29411","title":{"rendered":"[Lancet\u53d1\u8868\u8bba\u6587]\uff1a\u6c2f\u5511\u897f\u6797\u4e0e\u5934\u5b62\u5511\u5549\u6cbb\u7597MSSA\u83cc\u8840\u75c7"},"content":{"rendered":"\n

Articles<\/p>\n\n\n\n

Cloxacillin versus cefazolin for meticillin-susceptible\u00a0Staphylococcus aureus<\/em> bacteraemia (CloCeBa): a prospective, open-label, multicentre, non-inferiority, randomised clinical trial<\/h1>\n\n\n\n

Charles\u00a0Burdet,\u00a0Nadia\u00a0Sa\u00efdani,\u00a0C\u00e9line\u00a0Dupieux, et al<\/h3>\n\n\n\n

Lancet Available online 17 October 2025<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1016\/S0140-6736(25)01624-1<\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Although widely used, cefazolin efficacy for the treatment of meticillin-susceptible Staphylococcus aureus<\/em> (MSSA) bacteraemia has not thus far been investigated in a clinical trial. In this study, we aimed to compare the efficacy and safety of cefazolin with that of cloxacillin in patients with MSSA bacteraemia.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

We conducted an open-label, non-inferiority, randomised clinical trial in 21 university and non-university hospitals in France in adults (aged \u226518 years) with MSSA bacteraemia, without intravascular implant or suspicion of CNS infection. Participants were randomly assigned (1:1) to receive intravenously cefazolin (25\u201350 mg\/kg every 8 h) or cloxacillin (25\u201350 mg\/kg every 4\u20136 h) for the first 7 days of therapy using computer-generated blocks of various sizes and stratification on vascular-access associated bacteraemia and centre. Subsequent treatment was left to the choice of the investigator (total duration \u226514 days). The primary endpoint was a composite of sterile blood cultures at day 3 (day 5 for endocarditis) without relapse of bacteraemia, survival, and clinical success at day 90, and was assessed in the intention-to-treat population. A non-inferiority margin of 12% was chosen. This trial is registered on ClinicalTrials.gov<\/a> (NCT03248063) and is complete.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Between Sept 5, 2018, and Nov 16, 2023, 315 participants were enrolled and assigned to cefazolin (n=158) or cloxacillin (n=157); 12 participants were excluded from analysis in the cefazolin group, and 11 in the cloxacillin group (final population of 146 in each group). Mean age was 62\u00b77 years (SD 16\u00b74), 215 (74%) participants were male, and race or ethnicity data were not collected. Median Pitt score was 0 (IQR 0\u20130). The primary endpoint was met in 109 (75%) of 146 participants in the cefazolin group versus 108 (74%) of 146 participants in the cloxacillin group (treatment difference \u20131%; 95% CI \u201311 to 9; p=0\u00b7012). At the end of study treatment, 22 (15%) of 146 participants assigned to cefazolin and 40 (27%) of 146 participants assigned to cloxacillin had had a serious adverse event (p=0\u00b7010). Acute kidney injury occurred more frequently in participants assigned to cloxacillin (15 [12%] of 128) than in those assigned to cefazolin (one [1%] of 134; p=0\u00b70002).<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Cefazolin constitutes an alternative to cloxacillin for the treatment of MSSA bacteraemia, offering non-inferior clinical efficacy and potentially enhanced tolerability.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

French Ministry of Health.<\/p>\n","protected":false},"excerpt":{"rendered":"

Articles Cloxacillin versus cefazolin for meticillin-su […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29411"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29411"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29411\/revisions"}],"predecessor-version":[{"id":29412,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29411\/revisions\/29412"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29411"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29411"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29411"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}