Ceftaroline fosamil: just another intravenous antibiotic

Various antibiotics, especially cephalosporins, are used for empirical treatment of community-acquired pneumonia requiring hospitalisation and intravenous treatment, and for serious infections of the skin and soft tissues. When the infection is caused by bacteria that are resistant to common antibiotics, some antibiotics such as vancomycin are available. Ceftaroline (Zinforo, AstraZeneca) is a new cephalosporin intended for intravenous administration (as ceftaroline fosamil). It is authorised for the treatment of community-acquired pneumonia and for serious infections of the skin and soft tissues. In two double-blind, randomised trials of ceftaroline versus ceftriaxone (a cephalosporin), ceftaroline showed no advantage in patients with community-acquired pneumonia. Note that the results of these trials are undermined by the use of a suboptimal dose of ceftriaxone. Ceftaroline has not been evaluated versus a first-line treatment for serious skin infections. It has been compared with second-line antibiotics in patients with serious skin infections in four randomised trials. None of these trials showed that ceftaroline has superior efficacy. The known adverse effect profile of ceftaroline is similar to that of all cephalosporins, and comprises hypersensitivity reactions (including anaphylaxis) and gastrointestinal disorders (including rare cases of pseudomembranous colitis). A possible excess of haematological and renal adverse effects has also been raised. Given the absence of relevant data, it is best to avoid using ceftaroline during pregnancy. In practice, there is no proof that ceftaroline represents a therapeutic advance for patients with community-acquired pneumonia warranting hospitalisation or with serious skin or soft-tissue infections. It is best to stick with better-known antibiotics.