Ceftaroline for MRSA-Related Pneumonia

When vancomycin doesn’t work, ceftaroline may be a viable alternative for patients with nosocomial pneumonia (NP) due to methicillin-resistant Staphylococcus aureus (MRSA), say researchers from Summa Akron City Hospital in Ohio. They point out that ceftaroline is already approved for treatment of community-acquired bacterial pneumonia (CABP) due to Streptococcus pneumonia and MRSA (methicillin-susceptible isolates only), among other pathogens. Two large prospective, randomized clinical trials found ceftaroline effective and well tolerated in patients with CABP. However, its use in MRSA NP is unknown, the researchers say, which is why they retrospectively reviewed the cases of 10 patients admitted to their hospital who received ceftaroline for MRSA NP from September 2011 to September 2012.

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Of the 10 patients, 6 had health care-associated pneumonia, 3 had hospital-acquired pneumonia, and 1 had ventilator-associated pneumonia. All 10 had respiratory cultures positive for MRSA. Eight patients had MRSA isolates with resistance patterns consistent with traditional health care-associated MRSA strains, and 2 were consistent with community-acquired MRSA.

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In all, 9 patients received prior anti-MRSA therapy before the initiation of ceftaroline. Eight patients received ceftaroline 600 mg infused over 1 hour every 12 hours; 2 patients received renally adjusted lower doses. Therapy lasted from 4 to 28 days.

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Three patients died due to advanced age and multiple medical conditions after stopping antibiotic treatment and moving to palliative care. The remaining 7 patients responded well to the ceftaroline treatment, although 1 had microbiological and clinical relapse. The drug was well tolerated.

Although their case series is small and uncontrolled, the researchers say it suggests the potential of ceftaroline as an alternative agent for MRSA NP.

Source
Pasquale TR, Tan MJ, Trienski TL, File TM Jr. J Chemother. 2015;27(1):29-34.
doi: 10.1179/1973947813Y.0000000156.