Ceftaroline versus vancomycin for methicillin-resistant Staphylococcus aureus bacteraemia, a matched cohort study

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Medicine

Background:

• Vancomycin is the standard treatment for MRSA bacteraemia (MRSAB).
• Vancomycin has significant limitations in treating MRSAB.
• Exploring alternative treatments for MRSAB is crucial.

Purpose of the Study:

• To compare the effectiveness of ceftaroline and vancomycin monotherapy.
• To evaluate initial targeted therapy for MRSAB.
• To assess treatment failure rates in MRSAB patients.

Main Methods:

• Retrospective matched cohort study.
• Adult patients treated with ceftaroline (2019-2021) matched with vancomycin recipients.
• Primary outcome: composite of 90-day mortality or microbiological failure.

Main Results:

• Treatment failure rates were similar between ceftaroline (51.1%) and vancomycin (57.8%) groups (P=0.47).
• Age was the only factor associated with treatment failure (aOR 1.06, P=0.02).
• Acute kidney injury was more frequent with ceftaroline (51.1%) versus vancomycin (18.1%, P<0.001).

Conclusions:

• Ceftaroline is a viable alternative to vancomycin for initial MRSAB treatment.
• Ceftaroline did not demonstrate improved outcomes compared to vancomycin.
• Further studies are required to confirm efficacy and evaluate ceftaroline's nephrotoxicity risk.