Multicenter Study of the Real-World Use of Ceftaroline versus Vancomycin for Acute Bacterial Skin and Skin Structure Infections

Abstract

The objective of this study was to determine if real-world ceftaroline treatment in adults hospitalized for acute bacterial skin and skin structure infections (ABSSSI) is associated with decreased infection-related length of stay (LOSinf) compared to that with vancomycin. This was a retrospective, multicenter, cohort study from 2012 to 2017. Cox proportional hazard regression, propensity score matching, and inverse probability of treatment weighting (IPTW) were used to determine the independent effect of treatment group on LOSinf. The patients were adults hospitalized with ABSSSI and treated with ceftaroline or vancomycin for ≥72 h within 120 h of diagnosis at four academic medical centers and two community hospitals in Arizona, Florida, Michigan, and West Virginia. A total of 724 patients were included (325 ceftaroline treated and 399 vancomycin treated). In general, ceftaroline-treated patients had characteristics consistent with a higher risk of poor outcomes. The unadjusted median LOSinf values were 5 (interquartile range [IQR], 3 to 7) days and 6 (IQR, 4 to 8) days in the vancomycin and ceftaroline groups, respectively (hazard ratio [HR], 0.866; 95% confidence interval [CI], 0.747 to 1.002). The Cox proportional hazard model (adjusted HR [aHR], 0.891; 95% CI, 0.748 to 1.060), propensity score-matched (aHR, 0.955; 95% CI, 0.786 to 1.159), and IPTW (aHR, 0.918; 95% CI, 0.793 to 1.063) analyses demonstrated no significant difference in LOSinf between groups. Patients treated with ceftaroline were significantly more likely to meet criteria for discharge readiness at day 3 in unadjusted and adjusted analyses. Although discharge readiness at day 3 was higher in ceftaroline-treated patients, LOSinf values were similar between treatment groups. Clinical and nonclinical factors were associated with LOSinf.

The Epidemiology of Antibiotic-Related Adverse Events in the Treatment of Diabetic Foot Infections: A Narrative Review of the Literature

“…Infusion reactions have also less been described with telavancin, dalbavancin, and oritavancin. Other true AEs may include vancomycin nephrotoxicity [ 54 , 55 ] or elevated serum creatin-phosphokinase or rhabdomyolysis with daptomycin (2.8–3%) [ 56 , 57 ]. Data on newer lipoglycopeptide drugs indicate that dalbavancin showed reduced AEs in soft-tissue infections [ 58 ], with less nausea, diarrhea, and pruritus [ 59 , 60 ].…”

Real-World Use and Treatment Outcomes of Ceftaroline Fosamil in Patients with Complicated Skin and Soft Tissue Infection: A Multinational Retrospective Study

“… 32 Furthermore, a multicenter, retrospective, comparative cohort study in adults with ABSSSI found that discharge readiness at day 3 was higher in patients receiving ceftaroline fosamil than those receiving vancomycin; however, no differences in infection-related length of stay were demonstrated. 34 The variations in the reported impact of ceftaroline fosamil on healthcare resource use across these analyses may reflect differences in the patients studied, the design of the analyses, and in healthcare services in Europe and Latin America compared with the USA. 35 …”