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DISC: Describing Infections of the Spine treated with Ceftaroline
Richard R Watkins1, George Yendewa2, Steven D Burdette3
1Division of Infectious Diseases, Cleveland Clinic Akron General, Akron, OH, USA; Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
Objectives:
Infections of the spine lead to considerable morbidity and a high cost to the global healthcare system. Currently, evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited.
Methods:
Describing Infections of the Spine treated with Ceftaroline (DISC) is a multicentre, retrospective, cohort study that evaluated ceftaroline for treating spine infections. Patients were included if they were aged ≥18 years, diagnosed with a spine infection and treated with ceftaroline for ≥28 days. A control group was identified with the same inclusion criteria as the study population except they were treated with a comparator antibiotic for ≥28 days.
Results:
Thirty-seven patients were included each in the ceftaroline and control groups. MRSA was the most commonly identified pathogen. With no differences between groups in age, sex, race or co-morbidities (with the exception of chronic kidney disease), treatment with ceftaroline led to similar clinical success compared with the control group. Multivariate regression analysis did not show a significant difference between the two groups in terms of clinical success after controlling for other covariates (adjusted odds ratio=1.49; P=0.711). More patients who received ceftaroline were discharged to an extended-care or rehabilitation facility than home compared with controls (81% vs. 54%, respectively; P=0.024). Side effects and toxicities were rare, including one case of eosinophilic pneumonia in the ceftaroline group.
Conclusions:
Ceftaroline appears to be a safe and effective therapy for infections of the spine, including from MRSA.
Insights
Ceftaroline is a safe and effective treatment for spine infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). This study found similar clinical success rates compared to other antibiotics.
Area of Science:
- Infectious Diseases
- Pharmacology
- Orthopedic Surgery
Background:
- Spine infections cause significant morbidity and healthcare costs.
- Evidence for ceftaroline, an advanced cephalosporin active against MRSA, in spine infections is limited.
Purpose of the Study:
- To evaluate the safety and efficacy of ceftaroline for treating spine infections.
- To compare ceftaroline treatment outcomes against a comparator antibiotic group.
Main Methods:
- A multicentre, retrospective cohort study (Describing Infections of the Spine treated with Ceftaroline - DISC).
- Included patients aged ≥18 years with spine infections treated for ≥28 days with ceftaroline or a comparator antibiotic.
Main Results:
- 37 patients in each group; MRSA was the most common pathogen.
- Ceftaroline showed similar clinical success to comparator antibiotics (aOR=1.49; P=0.711).
- Higher discharge to extended-care/rehab for ceftaroline group (81% vs. 54%; P=0.024); rare side effects.
Conclusions:
- Ceftaroline is a safe and effective option for spine infections, including MRSA.
- Further research may explore optimal use in specific patient populations.
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