Methods: This was a retrospective case series of patients who received ceftaroline for treatment of MRSA BSI at Temple University Hospital in Philadelphia, PA from July 2013 to April 2015. Patients were identified by pharmacy records and included if they received at least 24 hours of therapy with ceftaroline and had a blood culture positive for MRSA. The primary outcome was clinical success, defined as a composite of 30-day survival and clearance of MRSA from blood cultures on antimicrobial therapy. The secondary outcome was microbiological cure defined as clearance of MRSA from blood cultures on ceftaroline.
Results: 61 patients who received greater than 24 hours of ceftaroline administration were identified. 33 patients were excluded for indications other than MRSA BSI. A total of 28 patients were included in the analysis. Patients had a median age of 52 and 50% were male. The median duration of bacteremia was 5 days (range 1-45 days). All patients received at least 24 hours of antibiotics for MRSA BSI prior to ceftaroline. Patients had a median of 8 days of MRSA-active drugs (range 1-74 days) prior to initiation of ceftaroline. Of 28 patients included, 23 (82%) achieved clinical success. All 28 patients achieved microbiological cure. At the time of ceftaroline initiation, 16 patients had cleared their MRSA BSI on prior therapy and 11 patients still had MRSA BSI. When switched to ceftaroline, patients had a median of 0 days (range 0-4) of additional bacteremia. All patients had clearance of their BSI within 96 hours. Median duration of ceftaroline therapy was 28 days (range 4-215). 11 patients received combination therapy with ceftaroline and an additional MRSA-active drug. 11 patients had proven endocarditis; 9 of these had clinical success. 5 patients (18%) experienced mortality within 30 days. 3 patients developed Clostridium difficile infection on ceftaroline; no other significant adverse drug reactions were reported.
Conclusion: Ceftaroline was an effective therapy for MRSA BSIs in our treatment-experienced population.
J. Gallagher, Actavis: Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium