Ceftaroline for Methicillin-Resistant Staphylococcus aureus Endovascular Infection

Methicillin-resistant Staphylococcus aureus (MRSA) endovascular infections are associated with high mortality. The increasing reports of clinical failure and toxicities associated with first-line vancomycin provide a medical need for alternative therapies. In this narrative review, we analyze studies published from 2017 to 2025 on the efficacy and tolerability of ceftaroline, a β-lactam antibiotic with anti-MRSA activity, for off-label treatment of endovascular infections. Identified publications included 1 randomized controlled trial (RCT), 17 retrospective cohort studies, four case series, and one meta-analysis. Failure rates were similar between ceftaroline, vancomycin, and daptomycin when used as monotherapies. Ceftaroline, used in combination with vancomycin or daptomycin, showed efficacy and tolerability in high-risk MRSA bacteremia cases. Although higher-level evidence is needed to definitively establish ceftaroline as a mainstay treatment of MRSA endovascular infections, the current evidence positions ceftaroline as one of several antibiotic strategies in serious cases of MRSA endovascular infections.