Popular Antibiotic May Not Be Best

Dialysis patients taking cefazolin have lower risk of hospitalization and death from bloodstream infection

(RxWiki News) Besides transplant, dialysis is the only way to keep a kidney failure patient alive. While dialysis may be lifesaving, it can lead to infection. Luckily, there are drugs to treat such infections.

Yet, the drug most commonly given to dialysis patients with bloodstream infections may not always be the best choice.

"Ask your doctor about the risks of antibiotic drugs."

Dialysis is a process that replaces the function of the kidney. When a person's kidneys fail, they are hooked up to a dialysis machine that filters the blood of harmful wastes. Because dialysis requires breaking through the skin, dialysis patients are at risk of infection from foreign invaders - particularly from Staphylococcus aureus bacteria, also known as "golden staph."

Kevin Chan, MD, of Fresenius Medical Care North American and Massachusetts General Hospital, and colleagues wanted to see which antibiotic drug worked best to prevent hospitalization and death from bloodstream infection in dialysis patients.

They found that vancomycin (sold as Vancocin) was the most commonly prescribed antibiotic (infection-fighting drug).

Vancomycin may be used more often than other drugs because it is known to fight more types of bacteria. However, doctors and patients need to think about other factors when choosing the best treatment.

Even though it was prescribed less than vancomycin, cefazolin (sold as Ancef and other brand names) was better than vancomycin at reducing the risk of hospitalization and death from infection.

More specifically, patients treated with cefazolin had a 38 percent lower rate of hospitalization and death, compared to those treated with vancomycin.

Cefazolin was also 48 percent better at preventing sepsis, the most serious kind of bloodstream infection.

"I think the data suggest there is an opportunity to improve outcomes for patients through appropriate antibiotic selection," said Dr. Chan.

For their research, Dr. Chan and colleagues studied more than 500,000 blood samples from a database of patients with chronic kidney disease.

None of the study's authors reported ties to the companies that make vancomycin and cefazolin.

The study was published August 16 in the Journal of the American Society of Nephrology.

Review Date: 
August 19, 2012