Journal of clinical orthopaedics and trauma · 2025
Use of Ceftaroline for prosthetic joint infections and spinal hardware infections.
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Doub James B, Cain Alexander R
Аннотация
BACKGROUND: Ceftaroline is an alternative antibiotic for the treatment of prosthetic joint infections (PJI) and spinal hardware infections (SHI) given its broad spectrum of activity. Yet there is a paucity of data on the use of ceftaroline in the treatment of these infections. Consequently, the aim of this study was to conduct a retrospective cohort study evaluating the use of ceftaroline to treat PJI and SHI.
METHODS: Identification of patients was conducted through a query of the hospital's antibiotic stewardship database for inpatient use of ceftaroline from 1/1/2020-1/1/2024. Patients were included if ceftaroline was used to treat PJI or SHI for longer than 14 days. The primary outcomes were adverse drug reactions to ceftaroline use and recurrence of infection.
RESULTS: There were 16 PJI and 19 SHI who were treated with long term ceftaroline. The rate of adverse drug reactions was 15.8 % in the SHI cohort and 12.5 % in the PJI cohort and recurrence rates were 15.8 % and 12.5 % in the SHI and PJI cohort respectively. Moreover, successful outcomes occurred in 80 % of patients with daptomycin and/or vancomycin intermediate/resistant S. aureus isolates.
DISCUSSION: Ceftaroline is a viable alternative antibiotic in the treatment of complex Gram-positive, such as methicillin resistant Staphylococcus aureus isolates that are daptomycin resistant or vancomycin intermediate/resistant, as well as culture negative SHI and PJI. However, follow up studies are needed to determine the proper dosing regimens to mitigate adverse drug reactions.
METHODS: Identification of patients was conducted through a query of the hospital's antibiotic stewardship database for inpatient use of ceftaroline from 1/1/2020-1/1/2024. Patients were included if ceftaroline was used to treat PJI or SHI for longer than 14 days. The primary outcomes were adverse drug reactions to ceftaroline use and recurrence of infection.
RESULTS: There were 16 PJI and 19 SHI who were treated with long term ceftaroline. The rate of adverse drug reactions was 15.8 % in the SHI cohort and 12.5 % in the PJI cohort and recurrence rates were 15.8 % and 12.5 % in the SHI and PJI cohort respectively. Moreover, successful outcomes occurred in 80 % of patients with daptomycin and/or vancomycin intermediate/resistant S. aureus isolates.
DISCUSSION: Ceftaroline is a viable alternative antibiotic in the treatment of complex Gram-positive, such as methicillin resistant Staphylococcus aureus isolates that are daptomycin resistant or vancomycin intermediate/resistant, as well as culture negative SHI and PJI. However, follow up studies are needed to determine the proper dosing regimens to mitigate adverse drug reactions.