TABLE 1.

Characteristics of included studies^a

Reference	Study design	Study period (yr)	Location	No. of patients in cefazolin arm vs no. of patients in antistaphylococcal penicillin arm	Avg age of patients in cefazolin arm vs age of patients in antistaphylococcal penicillin arm (yr)	Patient characteristic(s)	Antistaphylococcal penicillin(s)	Nephrotoxicity definition	Hepatotoxicity definition	Neutropenia definition	No. of days of therapy in cefazolin arm vs no. of days of therapy in antistaphylococcal penicillin arm
12	Retrospective cohort	2011–2015	1 site in U.S.	27 vs 73	56 vs 58	Inpatients with MSSA BSI; renal dysfunction in 41% vs 7%; hepatic dysfunction in 11% vs 8%; ICU admission in 44% vs 23%; APACHE II score of 17 vs 10	Nafcillin	Increase in SCr level of ≥0.5 mg/dl or 50%	ALT level >3× the upper normal limit		NA
13	Retrospective cohort	2013–2015	1 site in U.S.	50 vs 46	NA	Inpatients with MSSA BSI	Nafcillin	Increases in GFR of ≥25%, ≥50%, and ≥75%	Increase in AST or ALT level		NA
14	Retrospective cohort	2013–2015	4 sites in U.S.	68 vs 81	65 vs 54	Inpatients with MSSA BSI; those with renal dysfunction were excluded	Nafcillin at 12 g/day	Increase in SCr level of ≥0.3 mg/dl or 50%	LFTs >3× the upper normal limit	ANC of <1,000	9 vs 8
15	Retrospective cohort	2011–2015	1 site in U.S.	30 vs 50	56 vs 52	Inpatients with MSSA BSI; those with ESRD were excluded	Nafcillin at 10–12 g/day			ANC of 1,000–1,500, 500–999, and <500	23 vs 31
16	Retrospective cohort	2011–2014	1 site in U.S.	71 vs 71	50 vs 53	Inpatients with MSSA BSI; ESRD in 31% vs 14%; liver cirrhosis in 7% vs 11%; ICU admission in 11% vs 31%	Nafcillin at 12 g/day	Increase in SCr level of ≥0.5 mg/dl or 50%		ANC of <1,000	14 vs 10
17	Case-control	2004–2009	1 site in South Korea	41 vs 41	53 vs 54	Propensity score-matched inpatients with MSSA BSI; ESRD in 5% vs 15%; liver cirrhosis in 17% vs 12%	Nafcillin				17 vs 15
18	Retrospective cohort	2008–2012	2 sites in U.S.	59 vs 34	51 vs 51	Inpatients with MSSA BSI; ESRD in 25% vs 0%; ICU admission in 7% vs 18%	Oxacillin at 12 g/day	Increase in SCr level of ≥0.5 mg/dl or 50%	ALT or AST level >5× the upper normal limit		39 vs 31
19	Retrospective cohort	2000–2009	1 site in U.S.	26 vs 13	NA	Inpatients with MSSA BSI	Nafcillin				36
20	Retrospective cohort	2007–2015	1 site in U.S.	518 vs 518	49 vs 50	Propensity score-matched inpatients with any infection; those with renal dysfunction were excluded; ICU admission in 11% vs 31%	Nafcillin	Increases in GFR of ≥25%, ≥50%, and ≥75%			NA
21	Retrospective cohort	2010–2013	2 sites in U.S.	103 vs 58	53 vs 54	MSSA BSI; renal dysfunction in 50% vs 29%; ICU admission in 42% vs 33%; APACHE II scores of 13 vs 10.3	Oxacillin at 12 g/day	Not defined	Not defined		29 vs 33
22	Retrospective cohort	2011–2013	1 site in U.S.	54 vs 29	NA	Inpatients with MSSA BSI	Nafcillin and oxacillin at 12 g/day	Increase in SCr level of ≥0.5 mg/dl or 50%	ALT or AST level >5× the upper normal limit	ANC of <1,500	9 vs 7
23	Case-control	2009–2013	1 site in South Korea	38 vs 130	61 vs 56	Propensity score-matched outpatients (OPAT in-home and rehabilitation facility) with any infection; chronic kidney disease in 42% vs 15%; liver dysfunction in 24% vs 11%	Oxacillin at 8–12 g/day	Increase in SCr level of ≥0.5 mg/dl or 50% from baseline	ALT level of >42 U/liter or AST level of >54 U/liter	ANC of <1,500	NA
24	Retrospective cohort	2007–2011	1 site in U.S.	119 vs 366	56 vs 57	Outpatients (OPAT in-home, skilled nursing facility, and rehabilitation facility) with any MSSA infection; chronic renal failure in 10% vs 7.1%; liver dysfunction in 6% vs 6%	Nafcillin	Increase in SCr level of ≥0.5 mg/dl or 50% from baseline	Increase in ALT level of >100 U/liter	ANC of <1,000	29 vs 28 (planned)
25	Retrospective cohort	1996–2001	27 sites in U.S.	203 vs 295	NA	Outpatients (OPAT in-home health organization and physician-based or hospital-based programs) with any MSSA infections	Nafcillin and oxacillin at 10 g/day				NA

^aComparisons are presented as the cefazolin arm versus the antistaphylococcal penicillin arm. NA, not available; MSSA, methicillin-susceptible Staphylococcus aureus; BSI, bloodstream infection; ICU, intensive care unit; APACHE II, acute physiology and chronic health evaluation II; ESRD, end-stage renal disease; SCr, serum creatinine; ALT, alanine transaminase; AST, aspartate transaminase; ANC, absolute neutrophil count; GFR, glomerular filtration rate; OPAT, outpatient parenteral antimicrobial therapy; LFTs, liver function tests.