Novel therapies for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) are needed in the setting of reduced antibiotic susceptibilities and therapeutic failure. Ceftaroline is an advanced generation cephalosporin with MRSA activity. Although not FDA approved for MRSA BSI, ceftaroline has generated much interest as a potential treatment option. However, detailed description of its use in this setting remains limited. To address this, we conducted a retrospective, multicenter, observational study of adult patients with MRSA BSI treated with at least 72 hours of ceftaroline from 2011 to 2015. Safety outcomes were examined in the overall cohort while efficacy outcomes were examined among patients who had not cleared their BSI prior to ceftaroline initiation. Data were also stratified by ceftaroline monotherapy or combination therapy. Predictors of clinical failure on ceftaroline were also sought. Overall, 211 patients were included in the safety population; Clostridium difficile infection, rash, and neutropenia occurred in 6 (2.8%), 7 (3.3%), and 3 (1.4%) of patients, respectively. Clinical success was observed in 86 (68.3%) of the 126 patients included in efficacy population. The monotherapy and combination therapy subgroups had a similar proportion of patients experiencing success (69.7 and 64.9%, respectively). The median BSI duration post-ceftaroline was 2 (1 – 4) days among monotherapy and 3 (1.5 – 5) days for combination therapy. Higher APACHE II score and comorbid malignancy independently predicted treatment failure. Ceftaroline appears effective for MRSA BSI as both monotherapy and combination therapy. However, comparative studies are needed to further delineate the role of ceftaroline in MRSA BSI treatment.
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