Ceftaroline Fosamil Use in 2 Pediatric Patients With Invasive Methicillin-Resistant Staphylococcus aureus Infections

Abstract

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is one of the most common pathogens causing pediatric infections including skin and soft tissue infections, pyogenic arthritis, osteomyelitis, and septic shock. For decades, patients were treated with antibiotics such as vancomycin and clindamycin, but there is an increasing incidence of resistance to these traditional therapies. We describe 2 cases of patients with CA-MRSA invasive infections with bacteremia who experienced vancomycin therapy failure but who were successfully treated with ceftaroline fosamil. Case 1 involves an 8-year-old Hispanic male who was diagnosed with CA-MRSA bacteremia, thigh abscess, and osteomyelitis. The patient was admitted to the pediatric intensive care unit in septic shock. Case 2 involves an 8-year-old Caucasian male who was diagnosed with CA-MRSA sepsis, right arm abscess, and osteomyelitis. We were able to successfully treat both patients with CA-MRSA sepsis and invasive infection-who failed vancomycin therapy-with ceftaroline fosamil with no adverse effects. Despite the positive outcome in both pediatric patients, clinical trials with ceftaroline fosamil are needed to further support its use in pediatric patients.

Management of Pediatric Acute Hematogenous Osteomyelitis, Part II: A Focus on Methicillin‐Resistant Staphylococcus aureus, Current and Emerging Therapies

“…Before ceftaroline, both patients received appropriate therapy including vancomycin, but they did not improve until transitioning to ceftaroline. Patient 1 was switched to ceftaroline fosamil #bib600 mg (13 mg/kg) q8 h. Patient 2 was switched to ceftaroline fosamil 600 mg (21 mg/kg/dose) q12 h initially, but after 48 hours he was increased to 15 mg/kg q8 h. At completion of ceftaroline therapy and 6‐month follow‐up, the infection was completely resolved in both patients . In these case reports, no adverse effects were reported, and overall, ceftaroline appears to be well tolerated as demonstrated throughout the pediatric trials for approval, although durations of treatment were shorter than expected for AHO (Table ) …”

“…Available data on the use of ceftaroline in pediatric AHO are limited to two male 8‐year‐old patients who presented with MRSA bacteremia and osteomyelitis (Table ) . Before ceftaroline, both patients received appropriate therapy including vancomycin, but they did not improve until transitioning to ceftaroline.…”

<p>Acute Hematogenous Osteomyelitis in Children: Clinical Presentation and Management</p>

“…Data on the use of this agent in children with AHO are, however, currently limited to case reports. 75 While recognizing that staphylococci and streptococci are the predominant causes of disease, certain clinical situations may necessitate expanding empiric antibiotic coverage ( Table 2). In patients with hemoglobinopathies or when Salmonella spp.…”

“…Data on the use of this agent in children with AHO are, however, currently limited to case reports. 75 …”

In Vitro Testing of Crude Natural Plant Extracts from Costa Rica for Their Ability to Boost Innate Immune Cells against Staphylococcus aureus

“…In addition to being the causative agent of several life-threatening diseases, S. aureus is an important zoonotic pathogen, and because of the emergence of antibiotic resistance, is nowadays a major healthcare issue [ 3 ]. Since there is an increasing prevalence of methicillin-resistant S. aureus (MRSA), the classical antibiotic-based treatment will become even more limited [ 4 , 5 ].…”