At the VA St. Louis Health Care System 17.3% of patients treated with ceftaroline developed an adverse drug reaction (ADR). This evaluation compares ADR rates between patients treated with ceftaroline and those treated with ceftriaxone.
This was a retrospective, single-center cohort study of patients treated with ceftaroline or ceftriaxone at the VA St. Louis Health Care System between 10/29/2010 and 3/28/2017. Patients included received at least 2 doses of either medication and were treated for osteomyelitis, acute bacterial skin and skin structure infections, blood stream infections, pneumonia, infective endocarditis, septic arthritis, prosthetic joint infections, or an empyema. Once identified, patients were matched 1:1 utilizing the nearest neighbor method accounting for age, indication, and duration of therapy.
The primary and secondary outcomes were the composite of any ADR while on therapy and any ADR leading to therapy discontinuation, respectively. Adverse reactions evaluated were rash, neutropenia, acute kidney injury, eosinophilia, thrombocytopenia, transaminitis, and hyperbilirubinemia.
There were 75 unique ceftaroline-treated and 312 ceftriaxone-treated patients identified. After propensity score matching, 50 patients per group were included and analyzed. The mean age of patients was 65.4 and 63.4 years (p=0.47), and the mean duration of therapy was 14.5 and 17 days (p=0.90), ceftriaxone compared to ceftaroline respectively. Any ADR occurred in 20% (10/50) of patients treated with ceftriaxone and 16% (8/50) of patients treated with ceftaroline (p=0.60). One patient (2%) treated with ceftriaxone and 16% (8/50) treated with ceftaroline had therapy discontinued for an ADR (p=0.03). The most common ADR was eosinophilia (3/50) in the ceftriaxone group and rash (5/50) in the ceftaroline group. In multivariate regression, ceftaroline therapy was identified as an independent risk factor for development of an ADR requiring discontinuation (OR 10.2; 95% CI 1.19-87.8), p=0.03).
There was no difference in the development of any ADR between patients treated with ceftriaxone or ceftaroline, but patients treated with ceftaroline had more ADRs leading to therapy discontinuation.
J. W. Jansen,
X. Tan, None
R. P. Moenster, None