1126. Clinical Use of Ceftaroline Fosamil for the Treatment of Gram-Positive Osteomyelitis
Session: Poster Abstract Session: Clinical Infectious Diseases: Bone and Joint, Skin and Soft Tissue
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Osteomyelitis IDW 2016(CEF16079.3003).pdf (1.2 MB)
  • Background: Osteomyelitis is often challenging to treat. This analysis examined the clinical experience of patients with gram-positive osteomyelitis treated with ceftaroline fosamil in CAPTURE, a phase 4 study.

    Methods:  Data including patient demographics, medical history and risk factors, disease characteristics, antibiotic use, pathogens isolated, and clinical outcome were collected between September 2013 and February 2015 by review of randomly ordered patient charts from participating sites in the US. Clinical success was defined as discontinuation of ceftaroline fosamil following clinical cure with no further need for antibiotic or clinical improvement with switch to another antibiotic.

    Results: A total of 150 patients with gram-positive osteomyelitis were treated with ceftaroline fosamil. Most patients (78.0%) were treated with 600 mg; 95.3% received a dose every 12 hours. The majority (89 [59.3%]) had been previously diagnosed with diabetes mellitus or peripheral vascular disease. Osteomyelitis was associated with hardware in 32 (21.3%) patients. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus(MRSA; MSSA) were the most commonly isolated pathogens, observed in 93 (62.0%) and 21 (14.0%) patients, respectively. Clinical success with ceftaroline fosamil therapy was observed in 139/150 (92.7%) patients overall, 81/89 (91.0%) patients with diabetes or peripheral vascular disease, and 18/20 (90.0%) patients who had hardware implanted before ceftaroline fosamil therapy (none had hardware removed during therapy). Patients who received prior antibiotic therapy or ceftaroline fosamil as monotherapy experienced clinical success rates of 93.9% (107/114) and 91% (91/100), respectively. Among patients who received concurrent antibiotic therapy, the clinical success rate was 96.0% (48/50). Patients who were infected with MRSA or MSSA had clinical success rates of 92.5% (86/93) and 100% (21/21), respectively. A total of 2 (1.3%) patients discontinued ceftaroline fosamil therapy because of adverse events.

    Conclusion: Clinical success rates with ceftaroline fosamil were high in patients with gram-positive osteomyelitis, including those with diabetes, peripheral vascular disease, MRSA, or MSSA.

    Leonard B. Johnson, MD, FIDSA, Internal Medicine, St. John & Medical Center, Detroit, MI, Jose Vazquez, MD, FACP, FIDSA, Georgia Regents University, Augusta, GA, Ananthakrishnan Ramani, MD, Columbia Memorial Hospital, Catskill, NY and David Guervil, PharmD, Memorial Hermann-Texas Medical Center, Houston, TX

    Disclosures:

    L. B. Johnson, None

    J. Vazquez, Allergan: Consultant , Investigator and Scientific Advisor , Consulting fee and Speaker honorarium

    A. Ramani, Allergan: Speaker's Bureau , Speaker honorarium
    Gilead: Speaker's Bureau , Speaker honorarium

    D. Guervil, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.