• Bacterial Infections
• Infectious Disease Clinical Trials
• Drug Resistance
• Pneumonia

There is a need for new antibiotics to treat the rising incidence of community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSI) caused by Gram-positive bacteria such as Streptococcus pneumoniae and Staphylococcus aureus, including the multidrug resistant (MDRSP) and methicillin-resistant (MRSA) forms of these bacteria. Ceftaroline (CPT) fosamil is an injectable novel cephalosporin antibiotic approved by the FDA to treat CABP and ABSSSI. Alena Jandourek, MD, Cerexa, Inc., Oakland, California, USA, presented a poster [Jandourek et al. ICAAC 2012 L1–300c] with results from the Clinical Assessment Program and Teflaro® Utilization Registry cohort [CAPTURE] study that showed CPT produced good clinical outcomes when used as monotherapy to treat CABP due to MRSA.

CAPTURE was a multicenter, retrospective chart review conducted to document outcomes in patients with CABP due to MRSA isolated from sputum and/or blood after CPT treatment. A successful outcome was defined as clinical improvement resulting in either a change to oral agents or end of antibacterial therapy. Men and women ≥18 years of age, diagnosed with CABP, and receiving ≥2 consecutive IV doses of CPT per the institution's standard of care between January 2011 and 2012 were included. Data collected included pathogens cultured, concomitant antibacterials, comorbid conditions, and relevant past medical history, admission, and discharge information.

Out of 70 patients enrolled with CAPB, 10 patients (mean age 68.5 years; range 52 to 85 years) had MRSA CABP. Nine patients had MRSA only and 1 patient had methicillin-sensitive Staphylococcus aureus (MSSA) and MRSA. All patients had comorbidities, including structural lung disease, prior pneumonia, history of smoking, cancer, congestive heart failure, gastroesophageal reflux disease, and cerebrovascular accident. Eight patients were treated with other antibacterial therapy prior to CPT. CPT was dosed at 600 mg every 12 hours for a median duration of 6.5 days (range 4 to 30); 3 patients received adjunctive antibacterial therapy. Clinical success was reported in 7 patients. The patient with MSSA and MRSA was discharged home after 9 days. Two of the 3 patients with treatment failure had end-stage cancer and both were transitioned to palliative care. The third patient was treated with multiple antibacterials, then changed to CPT, and later switched to clindamycin.

Limitations of this study include the bias associated with a retrospective cohort study and imprecise reporting of prior antimicrobial therapy dates and dates of cultures collection/results. Dr. Jandourek concluded by noting that despite the presence of significant comorbidities and severe disease, the good clinical outcomes in this study suggest that the use of CPT in MRSA CABP warrants further investigation.

• © 2012 MD Conference Express®