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Incidence and risk factors for mortality in patients treated with combined ceftaroline for Gram-positive infective endocarditis

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Abstract

Background

Ceftaroline is a fifth-generation cephalosporin and represents an alternative in the treatment of infective endocarditis (IE). The main objective of this study was to describe the incidence of in-hospital and 42-day mortality in patients with IE treated with ceftaroline.

Methods

An observational retrospective study included adult patients with IE admitted during a 3.5-year period (January 2018–June 2021) and treated with ceftaroline in a single center. All cases were definite or possible IE according to the modified Duke criteria.

Results

Seventy cases were analyzed. The mean age was 67.35 ± 16.62 (16–89) and 39 (55.7%) were males. The mean number of days of treatment with ceftaroline was 21.26 ± 16.17 (1–75). Overall mortality at 42 days was 30%, 20.7% in the first line, and 36.6% in rescue therapy. Predictors of 42 days-mortality were increased Charlson comorbidity index (CCI) (OR of 1.7 per 1 point increment, 95% CI 1.2–2.4, P 0.001), presence of methicillin-resistance (OR 6.8, 95% CI 1.3–36.8, P 0.026) and evidence of septic shock (OR 8.6 95% CI 1.7–44.2, P 0.01). Predictors of 42 days of therapeutic failure were the increase in the CCI (OR of 1.6 per 1 point increment, 95% CI 1.3–2.1, P 0.000) and septic shock (OR 4.5 95% CI 1.1–18 P 0.036). Adverse effects were described in 6/70 (8.6%) of the patients, precipitating in 4/70 (5.7%) the definitive withdrawal of the antibiotic.

Conclusions

The incidence of in-hospital and 42 day-mortality of IE patients treated with ceftaroline remains similar to literature data. Increased CCI, septic shock, and methicillin resistance are associated with poor prognosis.

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Author information

Authors and Affiliations

  1. Pharmacy Deparment, Universitary Complex Hospital A Coruña (CHUAC), A Coruña, Spain

    D. Brandariz-Núñez, J. M. Gutiérrez-Urbón, C. Fernández-Oliveira, L. Margusino & I. Martín-Herranz

  2. Research Support Unit, Universitary Complex Hospital A Coruña (CHUAC), A Coruña, Spain

    J. Suanzes

  3. Institute of Biomedical Research (INIBIC), A Coruña, Spain

    J. Suanzes

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  1. D. Brandariz-Núñez
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  6. I. Martín-Herranz
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Contributions

Study concept and design: BND. Acquisition, analysis, and interpretation of date: GUJM, BND, and FOC. Drafting of the manuscript: BND, ML, GUJM, FOC, and MHI. Critical revision of the manuscript: GUJM, ML, and MHI. Statistical analysis: SJ.

Corresponding author

Correspondence to D. Brandariz-Núñez.

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The study was evaluated and approved by the Ethics Committee for Medicines of Galicia (CEIm-G) with registration code 2021/268.

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Not applicable.

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The authors declare no competing interests.

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Brandariz-Núñez, D., Suanzes, J., Gutiérrez-Urbón, J.M. et al. Incidence and risk factors for mortality in patients treated with combined ceftaroline for Gram-positive infective endocarditis. Eur J Clin Microbiol Infect Dis 41, 827–834 (2022). https://doi.org/10.1007/s10096-022-04443-2

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  • DOI: https://doi.org/10.1007/s10096-022-04443-2

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