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Ceftaroline: Systematic Review of Clinical Uses and Emerging Drug Resistance

Getahun Abate1, Grace Wang1, Jared Frisby1

  • 1Division of Infectious Diseases, Saint Louis University, Saint Louis, MO, USA.

The Annals of Pharmacotherapy
|March 18, 2022
PubMed
Abstract

Insights

Ceftaroline shows promising efficacy for off-label methicillin-resistant Staphylococcus aureus (MRSA) infections, but emerging resistance necessitates judicious use. Careful monitoring is crucial as ceftaroline-resistant MRSA strains appear.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Ceftaroline is approved for acute bacterial skin and soft tissue infections and community-acquired pneumonia.
  • Off-label use of ceftaroline for other methicillin-resistant Staphylococcus aureus (MRSA) infections is increasing.
  • Emerging resistance to ceftaroline is a growing concern.

Purpose of the Study:

  • To assess the success rates of off-label ceftaroline use in MRSA infections.
  • To evaluate the emergence and characteristics of ceftaroline resistance.
  • To review the clinical utility of ceftaroline in various MRSA infections.

Main Methods:

  • Systematic literature search of PubMed/MEDLINE (January 2009-January 2022) using the term "Ceftaroline."
  • Inclusion of clinical trials, observational studies, and case reports detailing efficacy, safety, pharmacokinetics, and resistance.
  • Review of 103 publications, with 46 focusing on efficacy/safety/off-label use and 7 on resistance.

Main Results:

  • Ceftaroline efficacy in off-label MRSA infections ranged from 66.7% to 87.3%.
  • Successful treatment was documented for bone and joint, endovascular, and diabetic foot infections, and bacteremia.
  • Fourteen cases of ceftaroline resistance linked to PBP2a alterations were reported.

Conclusions:

  • Ceftaroline demonstrates potential as salvage therapy for diverse MRSA infections, supported by case series and observational data.
  • Judicious use of ceftaroline is recommended due to the emergence of resistant MRSA strains.
  • Further research, including randomized controlled trials, is needed to fully establish ceftaroline's role in complex MRSA infections.
Keywords:
MRSAceftarolineresistance

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