Clinical Experience of Ceftaroline Fosamil in Gram-Positive Infective Endocarditis: A Multicenter Real-World...

Area of Science:

• Infectious Diseases
• Cardiology
• Pharmacology

Background:

• Ceftaroline fosamil (CFT) is a fifth-generation cephalosporin with activity against Gram-positive pathogens.
• Its utility in Gram-positive infective endocarditis (GP-IE) requires real-world evaluation, especially in complex patient populations.

Purpose of the Study:

• To assess the effectiveness and safety of ceftaroline fosamil (CFT) in patients with Gram-positive infective endocarditis (GP-IE).
• To evaluate CFT's outcomes in a real-world setting, focusing on clinically complex patients with high comorbidity.

Main Methods:

• Observational, retrospective, multicenter study of adults with GP-IE treated with CFT for ≥48 hours.
• Data collected included demographics, clinical characteristics, microbiological data, adverse effects, mortality, and unfavorable outcomes.
• Multivariate analysis identified factors associated with mortality.

Main Results:

• Seventy-six patients with GP-IE were included; 65.8% were male, with a mean age of 68.9 years and high comorbidity.
• Staphylococcus aureus was the most common pathogen (48.7%), including methicillin-resistant strains.
• At six months, adverse effect rate was 9.2%, overall mortality 38.2%, infection-related mortality 28.9%, and unfavorable outcome 40.1%. Age-adjusted Charlson index, septic shock, and methicillin-sensitive S. aureus were mortality predictors.

Conclusions:

• Ceftaroline fosamil (CFT) demonstrated favorable outcomes and acceptable safety in the real-world treatment of GP-IE.
• CFT is effective in clinically complex patients with high comorbidity and previous antibiotic therapy failures.
• The study supports CFT's role as a valuable therapeutic option for challenging GP-IE cases.