Multicenter observational study of ceftaroline fosamil for methicillin-resistant Staphylococcus aureus bloodstream infections
JournalAntimicrobial Agents and Chemotherapy
PublisherAmerican Society for Microbiology
MetadataShow full item record
AbstractNovel therapies for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) are needed in the setting of reduced antibiotic susceptibilities and therapeutic failure. Ceftaroline is a cephalosporin antibiotic with MRSA activity. Although not FDA approved for MRSA BSI, ceftaroline has generated much interest as a potential treatment option. However, detailed descriptions of its use in this setting remain limited. To address this, we conducted a retrospective, multicenter, observational study of adult patients with MRSA BSI treated with at least 72 h of ceftaroline from 2011 to 2015. Safety outcomes were examined in the overall cohort, while efficacy outcomes were examined among patients who had not cleared their BSI prior to ceftaroline initiation. Data were also stratified by ceftaroline monotherapy or combination therapy. Predictors of clinical failure on ceftaroline treatment were also sought. Overall, 211 patients were included in the safety population; Clostridium difficile infection, rash, and neutropenia occurred in 6 patients (2.8%), 7 patients (3.3%), and 3 patients (1.4%), respectively. Clinical success was observed in 86 (68.3%) of the 126 patients included in the efficacy population. The monotherapy and combination therapy subgroups had similar proportions of patients experiencing success (69.7 and 64.9%, respectively). The median BSI durations post-ceftaroline treatment were 2 days (interquartile range, 1 to 4 days) for monotherapy and 3 days (interquartile range, 1.5 to 5 days) for combination therapy. Higher acute physiology and chronic health evaluation II scores and comorbid malignancy independently predicted treatment failure. Ceftaroline appears effective for MRSA BSI as both monotherapy and combination therapy. However, comparative studies are needed to further delineate the role of ceftaroline in MRSA BSI treatment. Copyright 2017 American Society for Microbiology. All Rights Reserved.
SponsorsS.L.D. is a grant recipient and has served on the advisory boards of Allergan and Merck and Co. and has served on the advisory board of Melinta. M.J.R. is a grant recipient of, consultant for, member of the advisory board of, and on the speaker's bureau for Allergan, Bayer, Cempra Inc., Merck and Co., The Medicines Company, Sunovian, and Theravance and is supported in part by NIH grants R21 AI109266-01 and R01 AI121400-01. All other authors report no potential conflicts. The investigators received no funding for the execution of this study.
Bone and joint infection
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85011003433&doi=10.1128%2fAAC.02015-16&partnerID=40&md5=7068e209fa2c09feb58cbf1fd74c043b; http://hdl.handle.net/10713/10069