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The use of ceftaroline fosamil in methicillin-resistant Staphylococcus aureus endocarditis and deep-seated MRSA infections: a retrospective case series of 10 patients

  • Original Article
  • Published:
Journal of Infection and Chemotherapy

Abstract

There are many limitations to the current antibiotics used for the treatment of severe methicillin-resistant Staphylococcus aureus (MRSA) infections. Ceftaroline is a new fifth-generation cephalosporin approved for the treatment of skin and soft tissue infections caused by MRSA and community-acquired pneumonia. We propose that ceftaroline can also be used successfully in more severe MRSA infections, including endocarditis. We conducted a retrospective chart review in a university-affiliated Department of Veterans Affairs hospital in San Diego, California (USA) of ten inpatients treated with ceftaroline for severe MRSA infection, including five cases of probable endocarditis (including two endocardial pacemaker infections), one case of pyomyositis with possible endocarditis, two cases of pneumonia (including one case of empyema), two cases of septic arthritis (including one case of prosthetic joint infection), and two cases of osteomyelitis. Seven of the 10 patients achieved microbiological cure. Six of the 10 patients achieved clinical cure. Seven patients were discharged from the hospital. Three patients were placed on comfort care and expired in the hospital; one achieved microbiological cure before death, and two remained bacteremic at time of death. In most patients, ceftaroline was effective for treatment of MRSA bacteremia and other severe MRSA infections. Adverse effects seen included rash, eosinophilia, pruritus, and Clostridium difficile infection. Ceftaroline can be a safe and effective drug for treatment of severe MRSA infections, and further comparative studies are warranted.

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References

  1. Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis. 2003;36(1):53–9.

    Article  PubMed  Google Scholar 

  2. Whitby M, McLaws ML, Berry G. Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: a meta-analysis. Med J Aust. 2001;175(5):264–7.

    PubMed  CAS  Google Scholar 

  3. Stryjewski ME, Szczech LA, Benjamin DK Jr, Inrig JK, Kanafani ZA, Engemann JJ, et al. Use of vancomycin or first-generation cephalosporins for the treatment of hemodialysis-dependent patients with methicillin-susceptible Staphylococcus aureus bacteremia. Clin Infect Dis. 2007;44(2):190–6.

    Article  PubMed  CAS  Google Scholar 

  4. Chang FY, Peacock JE Jr, Musher DM, Triplett P, MacDonald BB, Mylotte JM, et al. Staphylococcus aureus bacteremia: recurrence and the impact of antibiotic treatment in a prospective multicenter study. Medicine (Baltim). 2003;82(5):333–9.

    Article  CAS  Google Scholar 

  5. Fowler VG Jr, Boucher HW, Corey GR, Abrutyn E, Karchmer AW, Rupp ME, et al. Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus. N Engl J Med. 2006;355(7):653–65.

    Article  PubMed  CAS  Google Scholar 

  6. Kosowska-Shick K, McGhee PL, Appelbaum PC. Affinity of ceftaroline and other beta-lactams for penicillin-binding proteins from Staphylococcus aureus and Streptococcus pneumoniae. Antimicrob Agents Chemother. 2010;54(5):1670–7.

    Article  PubMed  CAS  Google Scholar 

  7. Corey GR, Wilcox MH, Talbot GH, Thye D, Friedland D, Baculik T (2010) CANVAS 1: the first phase III, randomized, double-blind study evaluating ceftaroline fosamil for the treatment of patients with complicated skin and skin structure infections. J Antimicrob Chemother 65(suppl 4):iv41–iv51

    Google Scholar 

  8. Wilcox MH, Corey GR, Talbot GH, Thye D, Friedland D, Baculik T (2010) CANVAS 2: the second phase III, randomized, double-blind study evaluating ceftaroline fosamil for the treatment of patients with complicated skin and skin structure infections. J Antimicrob Chemother 65(suppl 4):iv53–iv65.

    Google Scholar 

  9. File TM Jr, Low DE, Eckburg PB, Talbot GH, Friedland HD, Lee J, et al (2011) FOCUS 1: a randomized, double-blinded, multicentre, phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia. J Antimicrob Chemother 2011;66(suppl 3):iii19–iii32.

    Google Scholar 

  10. Low DE, File TM, Jr., Eckburg PB, Talbot GH, David Friedland H, Lee J, et al. (2011) FOCUS 2: a randomized, double-blinded, multicentre, Phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia. J Antimicrob Chemother 66(suppl 3):iii33–iii44.

    Google Scholar 

  11. Ho TT, Cadena J, Childs LM, Gonzalez-Velez M, Lewis JS 2nd (2012) Methicillin-resistant Staphylococcus aureus bacteraemia and endocarditis treated with ceftaroline salvage therapy. J Antimicrob Chemother 67(5):1267–1270

    Google Scholar 

  12. Steed ME, Rybak MJ. Ceftaroline: a new cephalosporin with activity against resistant gram-positive pathogens. Pharmacotherapy. 2010;30(4):375–89.

    Article  PubMed  CAS  Google Scholar 

  13. Laudano JB (2011) Ceftaroline fosamil: a new broad-spectrum cephalosporin. J Antimicrob Chemother 2011;66(suppl 3):iii11–iii18

    Google Scholar 

  14. Laboratories F (2010) Teflaro (ceftaroline fosamil) package insert. Forest Laboratories, St. Louis, MO

  15. Jones RN, Mendes RE, Sader HS (2010) Ceftaroline activity against pathogens associated with complicated skin and skin structure infections: results from an international surveillance study. J Antimicrob Chemother 65(suppl 4):iv17–iv31.

    Google Scholar 

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Acknowledgments

We thank the faculty and the fellows of the University of California, San Diego, Division of Infectious Diseases, as well as the medical and surgical teams, for their excellent care and management of these patients. We thank Michael Tyndale (Supervisor of Microbiology Laboratory at the Veterans Affairs hospital) for performing drug susceptibility testing on our isolates. This work was supported by the National Institutes of Health (T32 AI 007036 to J.C.L.); and Veterans Affairs Merit Review Grant (to J.F.).

Conflicts of interest

None of the authors has any conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, University of California San Diego, 9500 Gilman Drive #0711, San Diego, CA, 92093, USA

    Jennifer C. Lin & Joshua Fierer

  2. Department of Pharmacy, Veterans Affairs (VA) Healthcare System, San Diego, CA, USA

    Gregory Aung & Scott Johns

  3. Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA, USA

    Amy Thomas

  4. Department of Pharmacy, New Mexico Veterans Affairs (VA) Healthcare System, Albuquerque, NM, USA

    Maximillian Jahng

  5. Medical Service, Veterans Affairs (VA) Healthcare System, San Diego, CA, USA

    Joshua Fierer

  6. Department of Pathology, University of California San Diego, San Diego, CA, USA

    Joshua Fierer

Authors
  1. Jennifer C. Lin
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  2. Gregory Aung
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  3. Amy Thomas
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  4. Maximillian Jahng
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  5. Scott Johns
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  6. Joshua Fierer
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Corresponding author

Correspondence to Jennifer C. Lin.

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Lin, J.C., Aung, G., Thomas, A. et al. The use of ceftaroline fosamil in methicillin-resistant Staphylococcus aureus endocarditis and deep-seated MRSA infections: a retrospective case series of 10 patients. J Infect Chemother 19, 42–49 (2013). https://doi.org/10.1007/s10156-012-0449-9

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  • DOI: https://doi.org/10.1007/s10156-012-0449-9

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