Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia (MRSAB): A comparative clinical outcomes study.
Int J Infect Dis. 2017 Jan 25;:
Authors: Arshad S, Huang V, Hartman P, Perri MB, Moreno D, Zervos MJ
OBJECTIVES: Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, it has been scrutinized due to failure in severe infections. Ceftaroline fosamil (CPT-F) is approved for MRSA acute bacterial skin and skin structure infection (ABSSSI) but not in bloodstream infections. We evaluated clinical outcomes of treatment with CPT-F in patients with MRSA bacteremia (MRSAB).
METHODS: Patients diagnosed with MRSAB at Henry Ford Hospital in Detroit, MI due to isolates with vancomycin MIC≥1.0mg/L, and susceptible in vitro to CPT-F were systematically reviewed retrospectively. CPT-F-treated patients were matched with vancomycin- and daptomycin-treated patients based on age (≥65years), ICU status, and severity of illness. Outcomes evaluated included duration of hospitalization, duration of therapy, adverse events, relapse, hospital readmission, and death.
RESULTS: 30 consecutive cases of MRSAB treated with CPT-F were identified from May 2011 – June 2013, and matched to 56 vancomycin and 46 daptomycin MRSAB patients. Primary sources of CPT-F-treated MRSAB cohort were endocarditis (n=7, 23%), skin/wound (n=9, 30%), and bone/joint (n=8, 27%). Origin of CPT-F-treated MRSAB was 43% community-acquired, 43% healthcare-associated, and 13% hospital- acquired. Mean hospital length of stay for CPT-F pts was 22 days. Overall 30-day mortality rate was observed in 13% (n=4) of CPT-F cases versus 24% (n=11) of daptomycin pts and 11% (n=6) in the vancomycin cohort (p=0.188).
CONCLUSIONS: Ceftaroline fosamil demonstrated comparable clinical outcomes in MRSAB patients compared with the other agents, especially as salvage therapy.
PMID: 28131729 [PubMed – as supplied by publisher]