Ceftaroline fosamil: clinical experience after 23-month prescription in a tertiary hospital

• Published in: Revista española de quimioterapia Vol. 34; no. 2; pp. 115 - 119
• Main Authors: Alonso Álvarez, A, Ramos Merino, L, Castelo Corral, L M, Padín Trigo, A, Sousa Regueiro, D, Míguez Rey, E, Sánchez Vidal, E
• Format: Journal Article
• Language: English
• Published: Spain Sociedad Española de Quimioterapia 01.04.2021
• Subjects: Aged; Anti-Bacterial Agents; Ceftaroline; Cephalosporins; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Original; Prescriptions; Retrospective Studies; Staphylococcus aureus; Tertiary Care Centers; ceftaroline fosamil; endocarditis; off-label
• ISSN: 0214-3429; 1988-9518
• DOI: 10.37201/req/119.2020

To determine the indications, success rate and adverse effects of ceftaroline fosamil treatment in a tertiary hospital. In total, 84 cases from February 2018 to December 2019 were retrospectively analysed. No exclusion criteria were applied. Eighty-four patients, with a median age of 70 years, of which, 6.7% (56) were male, were treated with ceftaroline fosamil for a median of 14 days. Most indications were off-label, including 29 endocarditis (34.5%), 14 bacteraemia (16.6%), 5 Central nervous system (CNS) infections (6%) and 19 osteoarticular infections (22.6%). Staphylococcus aureus was the most frequently isolated microorganism, including 28 methicillin-sensitive S. aureus (MSSA; 33.3%) and 14 methicillin-resistant S. aureus (MRSA; 16.7%), followed by coagulase-negative Staphylococcus (23, 27.4%). The main reason for ceftaroline fosamil prescription was the failure of previous treatment (41.7% of cases). Treatment was successful in 60/84 patients (71.4%) and failed clinically or microbiologically in 14 (16.7%). Eight patients died for a reason not related to the infection and two were found to have a non-infectious condition. Twenty-two of thirty-five (62.8%) patients prescribed ceftaroline because of failure of previous treatment improved, including eight endocarditis and seven bacteraemia. Adverse effects were reported in five patients (5.9%) including neutropenia, thrombocytopenia, transaminases elevation and creatinine elevation; all except one were mild and all resolved after discontinuation of treatment. Ceftaroline fosamil is a well-tolerated cephalosporine, effective against multi- resistant gram-positive and many gram-negative microorganisms. Our experience suggests that it is effective as a rescue or first-line therapy in other indications than those currently approved.