Background: Gram-positive bacteremia is associated with substantial morbidity and mortality. CAPTURE is a retrospective, multicenter study describing the contemporary clinical use of ceftaroline fosamil in the United States. The clinical experience in patients with gram-positive bacteremia treated with ceftaroline fosamil is presented.
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 37 participating sites in the US.
Results: In total, 252 patients with gram-positive bacteremia were treated with ceftaroline fosamil. Risk factors included intravascular device (IVD; 43.7%), hemodialysis (19.0%), prior Staphylococcus aureus bacteremia (15.9%), and injection drug use (10.7%). The most common source of bacteremia was an IVD (24.6%). The pathogens most commonly isolated were methicillin-resistant S. aureus (MRSA; 71.0%), methicillin-susceptible S. aureus (MSSA; 12.3%), and coagulase-negative staphylococci (9.5%). Antibiotics were administered before ceftaroline fosamil treatment in 90.1% of the patients. Vancomycin and piperacillin with tazobactam were the most commonly used prior therapies (67.1% and 30.6%, respectively). The mean (SD) duration of ceftaroline fosamil therapy was 9.6 (9.5) days; median (range) was 7.0 (268) days. Most patients (75.4%) received a dose every 12 hours (30.6% received a dose every 8 hours). Clinical success rates assessed by risk factors, medical history, and source of infection are summarized in Figure 1. Overall clinical success was 77.4% (195/252). Clinical success in those with an IVD was 77.3% (85/110), prior S. aureus bacteremia was 80.0% (32/40), hemodialysis was 75.0% (36/48), injection drug use was 85.2% (23/27), and prior endocarditis was 83.3% (10/12). The success rate was 76.5% (137/179) in patients with bacteremia due to MRSA and 71.0% (22/31) due to MSSA.
Conclusion: Clinical success rates were high for patients with gram-positive bacteremia treated with ceftaroline fosamil, including those with prior antibiotic treatment and with MRSA and MSSA.
K. Kaye, Allergan: Consultant , Consulting fee
C. M. Cannon, Allergan: Institutional research support for CAPTURE study and Speaker's Bureau , Institutional research support for CAPTURE study and Speaker honorarium
J. Vazquez, Allergan: Consultant , Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium
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