Utility of Ceftaroline in the Treatment of Persistent Bacteremia and Deep-Seated Infections
Methods: This IRB approved study evaluated adult inpatients from January 2012 - September 2013 with persistent MRSA bacteremia prior to the initiation of ceftaroline. All patients were identified from the UK Center for Clinical and Translational Science Enterprise Data Trust. Information collected included demographics, antibiotic usage, culture and sensitivity results, and treatment outcomes. Patients were monitored for clinical response and resolution of bacteremia. Susceptibility was performed using the Phoenix Testing System or E-test.
Results: There were a total of 11 patients (3 females and 8 males) with an average age of 46 years (range of 25-71). The majority of the patients had endocarditis (7/11). MRSA bacteremia ranged from 3 to 14 days prior to ceftaroline initiation. Ceftaroline was used in combination with vancomycin with or without rifampin (N=4), daptomycin (N=4), or linezolid (N=1). Three strains were daptomycin non-susceptible (MICs ranged from 3 -6 mcg/ml), 10 cases had vancomycin MICs > 1.5, one case had a hetero-resistant vancomycin isolate, and one case had ceftaroline non-susceptible isolate. With the addition of ceftaroline, bacteremia resolved within 1-7 days. Seven patients were treated successfully. However, one patient expired from complications of septic embolism leading to pulmonary hemorrhage and 3 patients expired after withdrawal of care.
Conclusion: Ceftaroline was safe and effective in clearing bacteremia in these patients with persistent MRSA infections that were resistant to other antibiotics. It is an alternative agent used in these difficult to treat multi-drug resistant serious infections where there are limited antimicrobial agents available.
D. R. Burgess,
T. Myint, None
A. Thornton, None