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Rev Esp Quimioter 2021; February 15

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

ALICIA ALONSO ÁLVAREZ, LUCÍA RAMOS MERINO, LAURA MARÍA CASTELO CORRAL, ANA PADÍN TRIGO, DOLORES SOUSA REGUEIRO, ENRIQUE MÍGUEZ REY, EFRÉN SÁNCHEZ VIDAL

Published: 15 February 2021

http://www.doi.org/10.37201/req/119.2020

Objective. To determine the indications, success rate and adverse effects of ceftaroline fosamil treatment in a tertiary hospital.
Material and methods. In total, 84 cases from February 2018 to December 2019 were retrospectively analysed. No exclusion criteria were applied.
Results. 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.
Conclusions. 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.

Rev Esp Quimioter 2021; February 15 [Full-text PDF]