Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study
Objectives: Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, its use has been subject to scrutiny due to failure in severe infections. Ceftaroline fosamil (CPT-F) is approved for MRSA acute bacterial skin and skin structure infections,...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-04-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S120197121730022X |
| _version_ | 1819114163201376256 |
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| author | Samia Arshad Vanthida Huang Pamela Hartman Mary B. Perri Daniela Moreno Marcus J. Zervos |
| author_facet | Samia Arshad Vanthida Huang Pamela Hartman Mary B. Perri Daniela Moreno Marcus J. Zervos |
| author_sort | Samia Arshad |
| collection | DOAJ |
| description | Objectives: Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, its use has been subject to scrutiny due to failure in severe infections. Ceftaroline fosamil (CPT-F) is approved for MRSA acute bacterial skin and skin structure infections, but not for bloodstream infections. The clinical outcomes of treatment with CPT-F in patients with MRSA bacteremia were evaluated.
Methods: Patients diagnosed with MRSA bacteremia at Henry Ford Hospital in Detroit, Michigan, USA, involving isolates with a vancomycin minimum inhibitory concentration ≥1.0 mg/l and susceptible in vitro to CPT-F, were systematically reviewed retrospectively. Ceftaroline fosamil-treated patients were matched with at least two vancomycin- and/or one daptomycin-treated control patient based on age-patients age 65 years or greater or less than 65 years of age. Outcomes evaluated included the duration of hospitalization, duration of therapy, adverse events, relapse, hospital readmission, and death.
Results: Thirty consecutive cases of MRSA bacteremia treated with CPT-F during the period May 2011 to June 2013 were identified; these patients were matched to 56 MRSA bacteremia patients treated with vancomycin and 46 MRSA bacteremia patients treated with daptomycin. The primary source of MRSA bacteremia in the cohort treated with CPT-F was endocarditis (n = 7, 23%), skin/wound (n = 9, 30%), and bone/joint (n = 8, 27%). The MRSA bacteremia in those treated with CPT-F was community-acquired in 43% of cases, healthcare-associated in 43%, and hospital-acquired in 13%. The mean length of hospital stay for these patients was 22 days. The overall 30-day mortality rate was 13% (n = 4) in CPT-F patients versus 24% (n = 11) in daptomycin patients and 11% (n = 6) in vancomycin patients (p = 0.188).
Conclusions: CPT-F demonstrated comparable clinical outcomes in MRSA bacteremia patients compared with the other agents, especially as salvage therapy. |
| first_indexed | 2024-12-22T04:40:56Z |
| format | Article |
| id | doaj.art-ffa6040e9c48450296c9ff72aec67e63 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 1878-3511 |
| language | English |
| last_indexed | 2024-12-22T04:40:56Z |
| publishDate | 2017-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-ffa6040e9c48450296c9ff72aec67e632022-12-21T18:38:46ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112017-04-0157C273110.1016/j.ijid.2017.01.019Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes studySamia Arshad0Vanthida Huang1Pamela Hartman2Mary B. Perri3Daniela Moreno4Marcus J. Zervos5Division of Infectious Diseases, Henry Ford Hospital, 2799 West Grand Blvd, CFP 314, Detroit, MI 48202, USAMidwestern University College of Pharmacy–Glendale, Glendale, Arizona, USADivision of Infectious Diseases, Henry Ford Hospital, 2799 West Grand Blvd, CFP 314, Detroit, MI 48202, USADivision of Infectious Diseases, Henry Ford Hospital, 2799 West Grand Blvd, CFP 314, Detroit, MI 48202, USADivision of Infectious Diseases, Henry Ford Hospital, 2799 West Grand Blvd, CFP 314, Detroit, MI 48202, USADivision of Infectious Diseases, Henry Ford Hospital, 2799 West Grand Blvd, CFP 314, Detroit, MI 48202, USAObjectives: Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, its use has been subject to scrutiny due to failure in severe infections. Ceftaroline fosamil (CPT-F) is approved for MRSA acute bacterial skin and skin structure infections, but not for bloodstream infections. The clinical outcomes of treatment with CPT-F in patients with MRSA bacteremia were evaluated. Methods: Patients diagnosed with MRSA bacteremia at Henry Ford Hospital in Detroit, Michigan, USA, involving isolates with a vancomycin minimum inhibitory concentration ≥1.0 mg/l and susceptible in vitro to CPT-F, were systematically reviewed retrospectively. Ceftaroline fosamil-treated patients were matched with at least two vancomycin- and/or one daptomycin-treated control patient based on age-patients age 65 years or greater or less than 65 years of age. Outcomes evaluated included the duration of hospitalization, duration of therapy, adverse events, relapse, hospital readmission, and death. Results: Thirty consecutive cases of MRSA bacteremia treated with CPT-F during the period May 2011 to June 2013 were identified; these patients were matched to 56 MRSA bacteremia patients treated with vancomycin and 46 MRSA bacteremia patients treated with daptomycin. The primary source of MRSA bacteremia in the cohort treated with CPT-F was endocarditis (n = 7, 23%), skin/wound (n = 9, 30%), and bone/joint (n = 8, 27%). The MRSA bacteremia in those treated with CPT-F was community-acquired in 43% of cases, healthcare-associated in 43%, and hospital-acquired in 13%. The mean length of hospital stay for these patients was 22 days. The overall 30-day mortality rate was 13% (n = 4) in CPT-F patients versus 24% (n = 11) in daptomycin patients and 11% (n = 6) in vancomycin patients (p = 0.188). Conclusions: CPT-F demonstrated comparable clinical outcomes in MRSA bacteremia patients compared with the other agents, especially as salvage therapy.http://www.sciencedirect.com/science/article/pii/S120197121730022XMethicillin-resistant Staphylococcus aureusBacteremiaBloodstream infectionCeftaroline fosamil |
| spellingShingle | Samia Arshad Vanthida Huang Pamela Hartman Mary B. Perri Daniela Moreno Marcus J. Zervos Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study International Journal of Infectious Diseases Methicillin-resistant Staphylococcus aureus Bacteremia Bloodstream infection Ceftaroline fosamil |
| title | Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study |
| title_full | Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study |
| title_fullStr | Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study |
| title_full_unstemmed | Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study |
| title_short | Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study |
| title_sort | ceftaroline fosamil monotherapy for methicillin resistant staphylococcus aureus bacteremia a comparative clinical outcomes study |
| topic | Methicillin-resistant Staphylococcus aureus Bacteremia Bloodstream infection Ceftaroline fosamil |
| url | http://www.sciencedirect.com/science/article/pii/S120197121730022X |
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