Ceftaroline Fosamil as an Alternative for a Severe Methicillin-resistant Staphylococcus aureus Infection: A Case Report

Abstract

Bacteremia secondary to methicillin-resistant Staphylococcus aureus (MRSA) is a dreaded medical condition that is not only associated with a significant medical cost but also carries high morbidity and mortality. The poor clinical outcomes seen in MRSA patients and the nephrotoxic effects of high-doses of vancomycin are challenging its current status as the first-line treatment for MRSA. Fortunately, vancomycin-intermediate-staphylococcus aureus (VISA) and vancomycin-resistant-staphylococcus aureus (VRSA) are not common in the United States. However, MRSA still presents different treatment challenges. Elevated vancomycin minimum inhibitory concentrations (MICs) commonly result in decreased efficacy and an increased probability of treatment failure, prompting the use of alternative agents. Although daptomycin is an alternative, adverse effects (i.e., elevations in serum creatine phosphokinase (CPK), drug-induced myopathy, peripheral neuropathy, and eosinophilic pneumonia) may limit its use in some patients. In the search for a suitable replacement for vancomycin, great promise has been shown by anti-MRSA cephalosporins. We present a case of MRSA bacteremia and endocarditis requiring a different approach to treatment as compared to traditional treatment with vancomycin alone. This case report describes the successful treatment of MRSA bacteremia with ceftaroline fosamil in a patient who responded poorly to conventional therapy, specifically vancomycin, due to an elevated MIC (2 µg/mL).

Teicoplanin combined with conventional vancomycin therapy for the treatment of pulmonary methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis infections

“…Pulmonary MRSA and MRSE infections are types of antimicrobial-resistant infections that are common in our hospital and are associated with shock, ventilator use, invasive surgeries, and anesthesia. Most patients with these infections experience some degree of dyspnea, fever, expectoration, and other manifestations[ 12 , 13 ]. Moreover, the incidence of pulmonary infections caused by MRSA and MRSE has continued to increase over recent years due to the increasing frequency of antibiotic misuse.…”

Ceftaroline fosamil in the treatment of methicillin-resistant Staphylococcus aureus

“…However, its activity against Gram-negative pathogens is limited, with no efficacy against extended-spectrum β-lactamase (ESBL)producing or the AmpC-overexpressing Enterobacteriaceae. 6…”

New Antimicrobials and New Therapy Strategies for Endocarditis: Weapons That Should Be Defended

“…Few single-centre observational studies reported positive clinical and/or microbiological outcomes in MRSA BSI populations, with or without specific data on the IE subgroups [70][71][72][73][74][75][76]. Additionally, several case series and complicated case reports showed microbiological cure and clinical success in IE patients treated with CPT as a monotherapy or in combination [56,72,[77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92].…”