Use of Ceftaroline in the Management of Vertebral Osteomyelitis

Zainah, Hadeel; Hammoud, Marwa; Vázquez, José Antonio

doi:10.1097/ipc.0b013e318276959f

Cited by 4 publications

(8 citation statements)

References 11 publications

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“…The results reported here for obese versus nonobese patients also support the conclusion of a previous study that found that dosage adjustment for ceftaroline fosamil based on body weight was not necessary in patients with adequate renal function [21]. In two recent case reports, clinical success was observed with 4 to 6 weeks of ceftaroline fosamil therapy for osteomyelitis using dosing schedules (600 mg twice daily) similar to that used for the majority of patients reported here [16, 17].…”

Section: Discussionsupporting

confidence: 86%

“…Several recent case reports have described success in the treatment of osteomyelitis with ceftaroline fosamil [16, 17], as have large retrospective observational studies [18, 19]. This retrospective registry study sought to evaluate the experience of patients with osteomyelitis treated with ceftaroline fosamil in Clinical Assessment Program and Teflaro® Utilization REgistry (CAPTURE), a phase 4, multicenter, retrospective cohort study designed to describe the contemporary clinical use of ceftaroline fosamil, including off-label use, in the United States [20].…”

Section: Introductionmentioning

confidence: 99%

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Use of Ceftaroline Fosamil in Osteomyelitis: CAPTURE Study Experience

2019

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Background Osteomyelitis is often challenging to treat. This analysis examined the clinical experience of patients with gram-positive osteomyelitis treated with ceftaroline fosamil in the phase 4 Clinical Assessment Program and Teflaro® Utilization Registry (CAPTURE) study. Methods Data including patient demographics, past illnesses, risk factors, disease characteristics, antibiotic use, pathogens isolated, and clinical outcome were collected between September 2013 and February 2015 by review of randomly ordered patient charts from participating sites in the United States. Clinical success was defined as discontinuation of ceftaroline fosamil following clinical cure with no further need for antibiotics or clinical improvement with switch to another antibiotic treatment. Results A total of 150 patients with gram-positive osteomyelitis were treated with ceftaroline fosamil. Most patients (117/150; 78.0%) were treated with 600 mg ceftaroline fosamil per dose; 143/150 patients (95.3%) received a dose every 12 h. The majority (89/150 patients; 59.3%) had been previously diagnosed with diabetes mellitus or peripheral arterial disease. Osteomyelitis was associated with hardware in 32/150 patients (21.3%). Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA; MSSA) were the most commonly isolated pathogens, observed in 93/150 (62.0%) and 21/150 (14.0%) patients, respectively. Clinical success with ceftaroline fosamil therapy was observed in 139/150 (92.7%) patients overall, 81/89 (91.0%) patients with diabetes or peripheral arterial disease, and 18/20 (90.0%) patients who had hardware implanted before ceftaroline fosamil therapy (none had hardware removed during therapy). Patients who received prior antibiotic therapy or ceftaroline fosamil as monotherapy experienced clinical success rates of 93.9% (107/114) and 91% (91/100), respectively. Among patients who received concurrent antibiotic therapy, the clinical success rate was 96.0% (48/50). Patients who were infected with MRSA or MSSA had clinical success rates of 92.5% (86/93) and 100% (21/21), respectively. A total of 2/150 (1.3%) patients discontinued ceftaroline fosamil therapy because of adverse events. Conclusions Clinical success rates with ceftaroline fosamil were high in patients with gram-positive osteomyelitis, including those with diabetes or peripheral arterial disease and those with MRSA or MSSA. Electronic supplementary material The online version of this article (10.1186/s12879-019-3791-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Use of Ceftaroline Fosamil in Osteomyelitis: CAPTURE Study Experience

2019

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“…Several case series of ceftaroline in both standard dose (600 mg IV every 12 hrs) and high dose (600 mg IV every 8 hrs and every 6 hrs) with extended duration (range 4 days to 18 wks) in the treatment of severe MRSA infections have been published to date . Interestingly, ceftaroline was reported to be well tolerated without serious adverse effects despite the similarities in baseline characteristics with our cohort of patients.…”

Section: Discussionmentioning

confidence: 61%

“…Since its approval, ceftaroline has been used as salvage therapy in the treatment of deep‐ seated MRSA infections in multiple case reports . We describe our clinical experience with ceftaroline for the treatment of refractory MRSA and coagulase‐negative Staphylococcus (CoNS) infections.…”

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confidence: 99%

High Incidence of Discontinuations Due to Adverse Events in Patients Treated with Ceftaroline

et al. 2014

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“…[6][7][8] Recent reports demonstrate the efficacy of ceftaroline fosamil for systemic MRSA infections such as bacteremia, endocarditis, and osteomyelitis. 4,[9][10][11] This case report describes the successful treatment of MRSA bacteremia with ceftaroline fosamil.…”

mentioning

confidence: 98%

Successful Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia with Ceftaroline Fosamil

Patatanian

Chandler

2016

Hosp Pharm

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Objectives To describe a case of successful treatment of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with ceftaroline fosamil after failure with vancomycin and daptomycin. Case Summary A 53-year-old female with a past medical history of cancer (unknown source/type) and hypothyroidism was admitted to the hospital with cervical and paravertebral abscess with suspected sepsis. In the emergency department (ED), magnetic resonance imaging (MRI) revealed possible spinal abscess and narrowing of the spinal canal. The patient was initiated on vancomycin 1,250 mg (~15 mg/kg) every 12 hours and cefepime 2 g every 8 hours empirically. On hospital day 4, blood and wound cultures revealed MRSA susceptible to vancomycin, but with a vancomycin minimum inhibitory concentration (MIC) of 2. Repeat blood cultures were also positive on hospital days 2 and 4. Per infectious disease team consult, therapy was converted to daptomycin 8 mg/kg/day. Although the patient responded well, acute kidney injury (AKI) on hospital day 15 prompted a change in therapy to ceftaroline fosamil 400 mg intravenous every 8 hours. For the remainder of the hospital stay, blood cultures were negative and white blood cell count was within normal limits. On day 20, the patient was discharged to a long-term care facility for continued ceftaroline treatment. Discussion The management of MRSA bacteremia remains challenging due to increasing antimicrobial resistance. Although the standard therapy for serious MRSA infections is vancomycin, treatment failures are becoming common in clinical practice due to increasing MICs (≥2 μg/mL). Other therapies may include daptomycin and off-label treatment with telavancin, quinupristin/dalfopristin, or ceftaroline fosamil. This report describes a patient with paravertebral abscess and MRSA bacteremia failing 3 days of vancomycin therapy due to MIC greater than or equal to 2 μg/mL and persistent bacteremia. Treatment with ceftaroline fosamil was well tolerated and resulted in continued clinical improvement. Based on this case report, ceftaroline fosamil may be a reasonable alternative for invasive MRSA infections. Conclusions This case report describes successful treatment of MRSA bacteremia with ceftaroline in a patient who responded poorly to conventional therapy, specifically vancomycin due to an elevated MIC (2 μg/mL).

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Use of Ceftaroline in the Management of Vertebral Osteomyelitis

Cited by 4 publications

References 11 publications

Use of Ceftaroline Fosamil in Osteomyelitis: CAPTURE Study Experience

Use of Ceftaroline Fosamil in Osteomyelitis: CAPTURE Study Experience

High Incidence of Discontinuations Due to Adverse Events in Patients Treated with Ceftaroline

Successful Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia with Ceftaroline Fosamil

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