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Clinical Therapeutics

Multicenter Observational Study of Ceftaroline Fosamil for Methicillin-Resistant Staphylococcus aureus Bloodstream Infections

Evan J. Zasowski, Trang D. Trinh, Kimberly C. Claeys, Anthony M. Casapao, Noor Sabagha, Abdalhamid M. Lagnf, Kenneth P. Klinker, Susan L. Davis, Michael J. Rybak
Evan J. Zasowski
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
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Trang D. Trinh
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
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Kimberly C. Claeys
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
bDepartment of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
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Anthony M. Casapao
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
cDepartment of Pharmacy Practice, Husson University School of Pharmacy, Bangor, Maine, USA
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Noor Sabagha
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
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Abdalhamid M. Lagnf
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
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Kenneth P. Klinker
dUniversity of Florida, College of Pharmacy, Gainesville, Florida, USA
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Susan L. Davis
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
eDepartment of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan, USA
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Michael J. Rybak
aAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
fDepartment of Medicine, Division of Infectious Diseases, School of Medicine, Wayne State University, Detroit, Michigan, USA
gDepartment of Pharmacy Services, Detroit Medical Center, Detroit, Michigan, USA
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DOI: 10.1128/AAC.02015-16
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ABSTRACT

Novel 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.

FOOTNOTES

    • Received 16 September 2016.
    • Returned for modification 6 October 2016.
    • Accepted 20 November 2016.
    • Accepted manuscript posted online 28 November 2016.
  • Supplemental material for this article may be found at https://doi.org/10.1128/AAC.02015-16 .

  • Copyright © 2017 American Society for Microbiology.

All Rights Reserved .

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Multicenter Observational Study of Ceftaroline Fosamil for Methicillin-Resistant Staphylococcus aureus Bloodstream Infections
Evan J. Zasowski, Trang D. Trinh, Kimberly C. Claeys, Anthony M. Casapao, Noor Sabagha, Abdalhamid M. Lagnf, Kenneth P. Klinker, Susan L. Davis, Michael J. Rybak
Antimicrobial Agents and Chemotherapy Jan 2017, 61 (2) e02015-16; DOI: 10.1128/AAC.02015-16

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Multicenter Observational Study of Ceftaroline Fosamil for Methicillin-Resistant Staphylococcus aureus Bloodstream Infections
Evan J. Zasowski, Trang D. Trinh, Kimberly C. Claeys, Anthony M. Casapao, Noor Sabagha, Abdalhamid M. Lagnf, Kenneth P. Klinker, Susan L. Davis, Michael J. Rybak
Antimicrobial Agents and Chemotherapy Jan 2017, 61 (2) e02015-16; DOI: 10.1128/AAC.02015-16
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KEYWORDS

bacteremia
cephalosporins
endocarditis
methicillin-resistant Staphylococcus aureus
MRSA
bacteremia
treatment failure
infective endocarditis
pneumonia
bone and joint infection
beta-lactam
vancomycin
daptomycin

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