Marci E Dearing1, Sarah V Burgess2, Valerie Murphy3, Samuel Campbell4, Lynn Johnston5, Tasha D Ramsey2. 1. , RPh, BSc(Pharm), ACPR, PharmD, is with the Pharmacy Department, Nova Scotia Health Authority, Halifax, Nova Scotia. 2. , RPh, BSc(Pharm), ACPR, PharmD, is with the Pharmacy Department, Nova Scotia Health Authority, and the College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia. 3. , RPh, BSc(Pharm), ACPR, is with the Pharmacy Department, Nova Scotia Health Authority, Halifax, Nova Scotia. 4. , MB BCh, CCFP(EM), DipPEC(SA), FCCHL, is with the Department of Emergency Medicine, Charles V Keating Emergency and Trauma Centre, Central Zone, Nova Scotia Health Authority, Halifax, Nova Scotia. 5. , MD, MSc, FRCPC, is with the Division of Infectious Diseases, Central Zone, Nova Scotia Health Authority, Halifax, Nova Scotia.
Abstract
BACKGROUND: Previous studies have described the use of cefazolin with probenecid to treat uncomplicated skin and soft-tissue infections. Some prescribers are extrapolating from this evidence to treat more invasive infections, which have a greater potential for poor outcomes, including treatment failure that could lead to increased morbidity and mortality. Information supporting cefazolin with probenecid as effective treatment in this context is needed. OBJECTIVES: To describe prescribing patterns and outcomes for patients who received cefazolin with probenecid for the treatment of bone and joint infections. METHODS: This single-centre retrospective study involved adult outpatients for whom cefazolin and probenecid were prescribed for bone and joint infections between April 1, 2012, and March 31, 2017. Patient charts were reviewed, and data were collected for clinical and microbiological variables using a standardized data collection form. RESULTS: In a total of 80 cases, the patient received cefazolin and probenecid for treatment of a bone or joint infection, of which 69 cases met the inclusion criteria. In most cases (n = 67), the patients were treated with cefazolin 2 g IV plus probenecid 1 g PO, both given twice daily. Completion of prescribed treatment occurred in 56 patient cases (81%), resolution of signs and symptoms in 53 (77%), readmission to hospital in 11 (16%), recurrence of infection in 6 (9%), and treatment failure requiring a change in therapy in 7 (10%). CONCLUSIONS: The effectiveness of cefazolin and probenecid for the treatment of bone and joint infections appears to be similar to that of standard treatment, as reported in the literature. Antibiotic effectiveness is difficult to determine conclusively in a retrospective analysis, so these results should be interpreted with caution, but they may stimulate further research. 2020 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.
BACKGROUND: Previous studies have described the use of cefazolin with probenecid to treat uncomplicated skin and soft-tissue infections. Some prescribers are extrapolating from this evidence to treat more invasive infections, which have a greater potential for poor outcomes, including treatment failure that could lead to increased morbidity and mortality. Information supporting cefazolin with probenecid as effective treatment in this context is needed. OBJECTIVES: To describe prescribing patterns and outcomes for patients who received cefazolin with probenecid for the treatment of bone and joint infections. METHODS: This single-centre retrospective study involved adult outpatients for whom cefazolin and probenecid were prescribed for bone and joint infections between April 1, 2012, and March 31, 2017. Patient charts were reviewed, and data were collected for clinical and microbiological variables using a standardized data collection form. RESULTS: In a total of 80 cases, the patient received cefazolin and probenecid for treatment of a bone or joint infection, of which 69 cases met the inclusion criteria. In most cases (n = 67), the patients were treated with cefazolin 2 g IV plus probenecid 1 g PO, both given twice daily. Completion of prescribed treatment occurred in 56 patient cases (81%), resolution of signs and symptoms in 53 (77%), readmission to hospital in 11 (16%), recurrence of infection in 6 (9%), and treatment failure requiring a change in therapy in 7 (10%). CONCLUSIONS: The effectiveness of cefazolin and probenecid for the treatment of bone and joint infections appears to be similar to that of standard treatment, as reported in the literature. Antibiotic effectiveness is difficult to determine conclusively in a retrospective analysis, so these results should be interpreted with caution, but they may stimulate further research. 2020 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.
Authors: Elie F Berbari; Souha S Kanj; Todd J Kowalski; Rabih O Darouiche; Andreas F Widmer; Steven K Schmitt; Edward F Hendershot; Paul D Holtom; Paul M Huddleston; Gregory W Petermann; Douglas R Osmon Journal: Clin Infect Dis Date: 2015-07-29 Impact factor: 9.079