Ceftaroline as Salvage Monotherapy for Persistent MRSA Bacteremia

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Medicine

Background:

• Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia presents limited treatment options.
• Salvage therapy is often required for refractory cases.

Purpose of the Study:

• To review published data on ceftaroline use as monotherapy for persistent MRSA bacteremia.
• To evaluate the efficacy and safety of ceftaroline in this clinical setting.

Main Methods:

• A PubMed search (1980-2016) identified English-language, full-text articles on ceftaroline for persistent MRSA bacteremia.
• Four retrospective case series were included in the analysis.

Main Results:

• Ceftaroline monotherapy was associated with bacteremia clearance within 3 days in most patients.
• Common reasons for ceftaroline use included disease progression or lack of response to prior therapy.
• Higher, off-label doses of ceftaroline were frequently employed.

Conclusions:

• Ceftaroline is a viable salvage treatment option for persistent MRSA bacteremia.
• Optimizing pharmacokinetic/pharmacodynamic parameters may necessitate doses up to 600 mg every 8 hours.
• Further research is needed to fully define adverse events associated with prolonged ceftaroline use.