Dr Joshua Davis presents data on Cefazolin vs (Flu)cloxacillin for MSSA.
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
April 12, 2025 at 3:13 PM
Dr Joshua Davis presents data on Cefazolin vs (Flu)cloxacillin for MSSA.
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
The most anticipated RCT in ID
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
April 12, 2025 at 3:09 PM
The most anticipated RCT in ID
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
🆕🔥🔥CloCeBa RCT
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
October 19, 2025 at 4:34 AM
🆕🔥🔥CloCeBa RCT
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
🔥SNAP passed 3500🔥
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
November 17, 2024 at 8:19 PM
🔥SNAP passed 3500🔥
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
Cefazolin vs Antistaphylococcal Penicillins for Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia: A Systematic Review & Meta-Analysis
@connorprosty.bsky.social @seanong.bsky.social &c
Cefaz more effective, safer #idsky
www.clinicalmicrobiologyandinfection.com/article/S119... 🔓
@connorprosty.bsky.social @seanong.bsky.social &c
Cefaz more effective, safer #idsky
www.clinicalmicrobiologyandinfection.com/article/S119... 🔓
May 9, 2025 at 4:29 PM
Cefazolin vs Antistaphylococcal Penicillins for Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia: A Systematic Review & Meta-Analysis
@connorprosty.bsky.social @seanong.bsky.social &c
Cefaz more effective, safer #idsky
www.clinicalmicrobiologyandinfection.com/article/S119... 🔓
@connorprosty.bsky.social @seanong.bsky.social &c
Cefaz more effective, safer #idsky
www.clinicalmicrobiologyandinfection.com/article/S119... 🔓
@gurujosh.bsky.social presents the results of the MSSA domain of the SNAP 🫰 trial at #ESCMID2025
fluclox caused more acute kidney injury than cefazolin; early mortality favored cefazolin
Absolutely Herculean effort by the entire global trial team and practice changing data #teamcefazolin
fluclox caused more acute kidney injury than cefazolin; early mortality favored cefazolin
Absolutely Herculean effort by the entire global trial team and practice changing data #teamcefazolin
April 12, 2025 at 3:00 PM
@gurujosh.bsky.social presents the results of the MSSA domain of the SNAP 🫰 trial at #ESCMID2025
fluclox caused more acute kidney injury than cefazolin; early mortality favored cefazolin
Absolutely Herculean effort by the entire global trial team and practice changing data #teamcefazolin
fluclox caused more acute kidney injury than cefazolin; early mortality favored cefazolin
Absolutely Herculean effort by the entire global trial team and practice changing data #teamcefazolin
The SNAP trial domain on cefazolin vs cloxacillin for MSSA bacteremia is finally published!
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
June 17, 2026 at 9:43 PM
The SNAP trial domain on cefazolin vs cloxacillin for MSSA bacteremia is finally published!
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
"Flu"cloxacillin is out, cefazolin is in.
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
April 24, 2026 at 2:35 PM
"Flu"cloxacillin is out, cefazolin is in.
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
SNAP trial results reported
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
April 12, 2025 at 4:43 PM
SNAP trial results reported
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
🔥Just published 🔥NEJM
SNAP RCT
In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky
www.nejm.org/doi/full/10....
SNAP RCT
In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky
www.nejm.org/doi/full/10....
Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia | NEJM
Staphylococcus aureus bacteremia is associated with high mortality. Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S. aureus ...
www.nejm.org
June 17, 2026 at 9:29 PM
🔥Just published 🔥NEJM
SNAP RCT
In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky
www.nejm.org/doi/full/10....
SNAP RCT
In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky
www.nejm.org/doi/full/10....
🔥 Late Breakers
SNAP platform RCT| Adjunctive Clindamycin in S.aureus bacteraemia
❌ No mortality benefit
90d mortality:16.9% vs 15.2% aOR 1.16 (CrI cross 1)
📊PPSup(~7%)→Futility threshold reached
⚠️ICU subgp:numerically worse with clinda
⚖️CDAD:no # (~2%)😯
#ESCMIDGlobal2026 #idsky
SNAP platform RCT| Adjunctive Clindamycin in S.aureus bacteraemia
❌ No mortality benefit
90d mortality:16.9% vs 15.2% aOR 1.16 (CrI cross 1)
📊PPSup(~7%)→Futility threshold reached
⚠️ICU subgp:numerically worse with clinda
⚖️CDAD:no # (~2%)😯
#ESCMIDGlobal2026 #idsky
April 22, 2026 at 1:33 AM
First, you locate the second gram of cefazolin you’ll need
December 12, 2024 at 12:43 AM
First, you locate the second gram of cefazolin you’ll need
A time-honored tradition 😇
I got cefazolin!
I got cefazolin!
November 19, 2024 at 12:48 AM
A time-honored tradition 😇
I got cefazolin!
I got cefazolin!
Die Therapie einer S. Aureus Bakteriämie (MSSA) ist Flucloxacillin oder alternativ Cefazolin, beides in adäquater Dosierung.
Flucloxacillin z.B.: 2g alle 4 h oder Cefazolin 3x2g
Therapiedauer:
Unkompliziert: 2 Wochen
Kompliziert: 4-6 Wochen ab 1. negativer Blutkultur
#FOAMed #ABS #ICU
Flucloxacillin z.B.: 2g alle 4 h oder Cefazolin 3x2g
Therapiedauer:
Unkompliziert: 2 Wochen
Kompliziert: 4-6 Wochen ab 1. negativer Blutkultur
#FOAMed #ABS #ICU
February 2, 2025 at 3:39 PM
Medical student test: hand them a vial of Ancef and an empty syringe and see if they can figure out how to put the powder in the patient (get some… creative… solutions sometimes!)
December 11, 2024 at 6:32 PM
Medical student test: hand them a vial of Ancef and an empty syringe and see if they can figure out how to put the powder in the patient (get some… creative… solutions sometimes!)
November 29, 2024 at 9:10 PM
🆕💫 Systematic Review and Meta-Analysis
30 observational studies( SNAP & CloCeBa not included)
N: 3869
Cefazolin versus Antistaphylococcal Penicillins for the Treatment of MSSA Bacteremia #idsky
www.clinicalmicrobiologyandinfection.com/article/S119...
30 observational studies( SNAP & CloCeBa not included)
N: 3869
Cefazolin versus Antistaphylococcal Penicillins for the Treatment of MSSA Bacteremia #idsky
www.clinicalmicrobiologyandinfection.com/article/S119...
Cefazolin versus Antistaphylococcal Penicillins for the Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia: A Systematic Review and Meta-Analysis
There is debate on whether cefazolin or antistaphylococcal penicillins should be the
first-line treatment for methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia.
Ongoing trials are invest...
www.clinicalmicrobiologyandinfection.com
May 9, 2025 at 9:55 AM
🆕💫 Systematic Review and Meta-Analysis
30 observational studies( SNAP & CloCeBa not included)
N: 3869
Cefazolin versus Antistaphylococcal Penicillins for the Treatment of MSSA Bacteremia #idsky
www.clinicalmicrobiologyandinfection.com/article/S119...
30 observational studies( SNAP & CloCeBa not included)
N: 3869
Cefazolin versus Antistaphylococcal Penicillins for the Treatment of MSSA Bacteremia #idsky
www.clinicalmicrobiologyandinfection.com/article/S119...
And in the big SNAP trial run 🏃♀️ for MSSA... it's cefazolin crossing the line ahead of (flu)cloxacillin 🏅
Cefazolin manufacturers are gonna have to really step up after this (still on shortage restrictions in 🇬🇧 😢)
RIP fluclox 🪦
@gurujosh.bsky.social gave an excellent talk 🥁
#ESCMIDGlobal
Cefazolin manufacturers are gonna have to really step up after this (still on shortage restrictions in 🇬🇧 😢)
RIP fluclox 🪦
@gurujosh.bsky.social gave an excellent talk 🥁
#ESCMIDGlobal
April 12, 2025 at 2:58 PM
And in the big SNAP trial run 🏃♀️ for MSSA... it's cefazolin crossing the line ahead of (flu)cloxacillin 🏅
Cefazolin manufacturers are gonna have to really step up after this (still on shortage restrictions in 🇬🇧 😢)
RIP fluclox 🪦
@gurujosh.bsky.social gave an excellent talk 🥁
#ESCMIDGlobal
Cefazolin manufacturers are gonna have to really step up after this (still on shortage restrictions in 🇬🇧 😢)
RIP fluclox 🪦
@gurujosh.bsky.social gave an excellent talk 🥁
#ESCMIDGlobal
Here we see a mother Cefazolin bag; utterly spent after having brought 50 baby cefazolins into the world.
August 22, 2023 at 3:44 PM
Here we see a mother Cefazolin bag; utterly spent after having brought 50 baby cefazolins into the world.
Anti-staphylococcal penicillins are now a historic curiosity. Cefazolin FTW 👏🏻👏🏻
🔥Just published 🔥NEJM
SNAP RCT
In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky
www.nejm.org/doi/full/10....
SNAP RCT
In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky
www.nejm.org/doi/full/10....
Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia | NEJM
Staphylococcus aureus bacteremia is associated with high mortality. Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S. aureus ...
www.nejm.org
June 17, 2026 at 10:31 PM
Anti-staphylococcal penicillins are now a historic curiosity. Cefazolin FTW 👏🏻👏🏻
1. Cefazolin
2. ?
3. Ceftriaxone
4. Cefepime
5. Ceftaroline
2. ?
3. Ceftriaxone
4. Cefepime
5. Ceftaroline
February 23, 2025 at 2:02 AM
1. Cefazolin
2. ?
3. Ceftriaxone
4. Cefepime
5. Ceftaroline
2. ?
3. Ceftriaxone
4. Cefepime
5. Ceftaroline
SNAP:
Cefazolin is non-inferior to Fluclox for MSSA-BSI &causes less AKI
Penicillin is non-inferior to Fluclox for PSSA-B
Adjunctive clindamycin did not reduce 90-day mortality in SAB
Ongoing:
Vanco+cefazolin in MRSA BSI
Erta/cefaz SAB
Early oral switch
PET CT
#ESCMIDGlobal2026 #idsky
Cefazolin is non-inferior to Fluclox for MSSA-BSI &causes less AKI
Penicillin is non-inferior to Fluclox for PSSA-B
Adjunctive clindamycin did not reduce 90-day mortality in SAB
Ongoing:
Vanco+cefazolin in MRSA BSI
Erta/cefaz SAB
Early oral switch
PET CT
#ESCMIDGlobal2026 #idsky
April 25, 2026 at 8:45 PM
SNAP:
Cefazolin is non-inferior to Fluclox for MSSA-BSI &causes less AKI
Penicillin is non-inferior to Fluclox for PSSA-B
Adjunctive clindamycin did not reduce 90-day mortality in SAB
Ongoing:
Vanco+cefazolin in MRSA BSI
Erta/cefaz SAB
Early oral switch
PET CT
#ESCMIDGlobal2026 #idsky
Cefazolin is non-inferior to Fluclox for MSSA-BSI &causes less AKI
Penicillin is non-inferior to Fluclox for PSSA-B
Adjunctive clindamycin did not reduce 90-day mortality in SAB
Ongoing:
Vanco+cefazolin in MRSA BSI
Erta/cefaz SAB
Early oral switch
PET CT
#ESCMIDGlobal2026 #idsky
It’s regular strength cefazolin. Here’s what you do. Get them to open their mouth, take a handful…
December 12, 2024 at 1:26 AM
It’s regular strength cefazolin. Here’s what you do. Get them to open their mouth, take a handful…