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Ceftaroline Fosamil: A Review of its Use in the Treatment of Complicated Skin and Soft Tissue Infections and Community-Acquired Pneumonia

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Abstract

Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil (Zinforo™, Teflaro®), is an advanced-generation, parenteral cephalosporin with broad-spectrum antibacterial activity in vitro against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and multidrug resistant Streptococcus pneumoniae and Gram-negative bacteria, including Haemophilus influenzae and Moraxella catarrhalis, but not Pseudomonas aeruginosa. Ceftaroline has demonstrated a low potential for the selection of resistance in vitro for drug-resistant Gram-positive organisms, including MRSA, as well as for Gram-negative respiratory pathogens. In pivotal phase III studies, intravenous ceftaroline fosamil demonstrated noninferiority to intravenous vancomycin plus aztreonam in patients hospitalized with complicated skin and soft tissue infections (cSSTIs) and intravenous ceftriaxone in patients hospitalized with community-acquired pneumonia (CAP) [Pneumonia Outcomes Research Team (PORT) risk class III or IV]; however, patients with CAP admitted to the intensive care unit were not evaluated. Ceftaroline fosamil was generally well tolerated in these trials, with an adverse event profile similar to that of other cephalosporins. Diarrhoea was the most commonly reported adverse event; however, the risk of Clostridium difficile-associated diarrhoea with ceftaroline fosamil appeared to be low. Potential limitations of the drug include the lack of an oral formulation and the requirement for twice-daily administration. Nonetheless, ceftaroline fosamil represents an attractive option (either alone or in combination with other agents) for the initial empirical treatment of patients hospitalized with cSSTIs (including those with suspected MRSA infection) or CAP (PORT risk class III or IV) who require intravenous antimicrobial therapy. As with all antibacterial agents, ceftaroline fosamil should be used in accordance with good antimicrobial stewardship.

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The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editiorial merit.

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The manuscript was reviewed by: H. M. Lode, Research Center for Medical Studies, Institute for Clinical Pharmacology, Charité-Universitatsmedizin Berlin, Germany; H. S. Sader, JMI Laboratories, North Liberty, Iowa, USA; A. A. Torres, Servei de Pneumologia i Al.lergia Respiratoria, Institut Clìnic del Tòrax, Hospital Clínic de Barcelona (IDIBAPS), Barcelona, Spain.

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Frampton, J.E. Ceftaroline Fosamil: A Review of its Use in the Treatment of Complicated Skin and Soft Tissue Infections and Community-Acquired Pneumonia. Drugs 73, 1067–1094 (2013). https://doi.org/10.1007/s40265-013-0075-6

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