Large Retrospective Evaluation of the Effectiveness and Safety of Ceftaroline Fosamil Therapy

Abstract

Ceftaroline has been approved for acute bacterial skin infections and community-acquired bacterial pneumonia. Limited clinical experience exists for use outside these indications. The objective of this study was to describe the outcomes of patients treated with ceftaroline for various infections. Retrospective analyses of patients receiving ceftaroline >72 h from 2011 to 2013 were included. Clinical and microbiological outcomes were analyzed. Clinical success was defined as resolution of all signs and symptoms of infection with no further need for escalation while on ceftaroline treatment during hospitalization. A total of 527 patients received ceftaroline, and 67% were treated for off-label indications. Twenty-eight percent (148/527) of patients had bacteremia. Most patients (80%) were initiated on ceftaroline after receipt of another antimicrobial, with 48% citing disease progression as a reason for switching. The median duration of ceftaroline treatment was 6 days, with an interquartile range of 4 to 9 days. A total of 327 (62%) patients were culture positive, and the most prevalent pathogen was Staphylococcus aureus, with a frequency of 83% (271/327). Of these patients, 88.9% (241/271) were infected with methicillin-resistant S. aureus (MRSA). Clinically, 88% (426/484) achieved clinical success and hospital mortality was seen in 8% (40/527). While on ceftaroline, adverse events were experienced in 8% (41/527) of the patients and 9% (28/307) were readmitted within 30 days after discharge for the same infection. Patients treated with ceftaroline for both FDA-approved and off-label infections had favorable outcomes. Further research is necessary to further describe the role of ceftaroline in a variety of infections and its impact on patient outcomes.

In Vitro Activity of Ceftaroline against Staphylococcus aureus Isolates Collected in 2012 from Latin American Countries as Part of the AWARE Surveillance Program

“…Ceftaroline has in vitro bactericidal activity against MDR-MRSA, has a good safety profile, and has been approved by the Food and Drug Administration for treating adults with ABSSSI and CABP (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). This report from Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE) summarizes the in vitro activity of ceftaroline against S. aureus isolates collected in Latin America during 2012, including molecular characterization of isolates with reduced susceptibility to ceftaroline.…”

Treating Central Catheter–Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin

“…6,9 In addition, ceftaroline has increasing retrospective clinical data to support its use as an alternative agent in MRSA bacteremia, including CLABSIs, and in patients in whom standard therapy has been unsuccessful. [35][36][37][38][39][40] Recently, 3 new MRSA-active agents have been approved by the FDA: dalbavancin, oritavancin, and tedizolid. All 3 agents have activity against MRSA, but currently no data are available to support their use in MRSA bacteremia or CLABSIs.…”

“…6 Since publication of the guidelines, several retrospective studies and case reports on use of this antibiotic, both as monotherapy and in combination with other agents, for treatment of MRSA bacteremia have been published. [35][36][37][38][39][40] Polenakovik and Pleiman 39 reported clinical success with ceftaroline therapy in 23 of 31 patients (74.2%) with MRSA bacteremia. The sample included 7 patients with intravenous catheter-associated MRSA infections and 10 patients given combination MRSA therapy.…”

“…In another retrospective study, Casapao et al 35 analyzed ceftaroline use at several sites during a 2.5-year period. Of the 527 patients included in the study, 241 (45.7%) had documented MRSA infections.…”

In Vitro Activity of Ceftaroline against Staphylococcus aureus Isolated in 2012 from Asia-Pacific Countries as Part of the AWARE Surveillance Program

“…The recently approved agent ceftaroline-fosamil has a good safety profile and is approved by the U.S. Food and Drug Administration (in 2010) and the European Medicines Agency (in 2012) for the treatment of infections caused by S. aureus (7)(8)(9)(10). Current clinical indications include community-acquired pneumonia (CAP) and complicated skin and skin structure infections (cSSSI), with MRSA included among the target pathogens for cSSSI (11)(12)(13)(14)(15)(16)(17)(18)(19)(20). In addition to inhibiting essential penicillin-binding proteins (PBPs), ceftaroline also has a high affinity for PBP2a, which confers resistance to an array of other beta-lactams characteristic of MRSA (21).…”