Neutropenia Associated with Long-Term Ceftaroline Use.

Area of Science:

• Infectious Diseases
• Hematology
• Pharmacology

Background:

• Ceftaroline, a fifth-generation cephalosporin, exhibits broad-spectrum antimicrobial activity.
• Neutropenia is a known, albeit rare, adverse event associated with cephalosporins.
• Clinical observations suggested a potential link between ceftaroline and severe neutropenia in an outpatient setting.

Purpose of the Study:

• To determine the incidence of neutropenia in patients receiving ceftaroline for over 7 days.
• To assess the severity and outcomes of neutropenia associated with ceftaroline therapy.
• To establish monitoring guidelines for ceftaroline-induced neutropenia.

Main Methods:

• Retrospective cohort analysis of 39 patients treated with ceftaroline for >7 days.
• Data collected included demographics, diagnoses, and laboratory values.
• Clinically significant neutropenia defined as absolute neutrophil count (ANC) <1,500 cells/mm³.

Main Results:

• Seven patients (18%) developed neutropenia during ceftaroline therapy (median duration 27 days).
• Four patients (10%) experienced severe neutropenia with ANC <500 cells/mm³.
• Neutropenia onset was typically around day 17, with a median nadir ANC of 432 cells/mm³.

Conclusions:

• Extended ceftaroline infusion is associated with an increased incidence of neutropenia.
• Recommendations include baseline and weekly CBC monitoring, with increased frequency if ANC decreases.
• Discontinuation of ceftaroline is advised if ANC drops to ≤1,500 cells/mm³.