Use of Ceftaroline in Hospitalized Patients with and without COVID-19: A Descriptive Cross-Sectional Study.

Daniele Roberto Giacobbe,Michele Mirabella,Mauro Giacomini,Chiara Dentone,Silvia Dettori,Sara Mora,Chiara Russo,Federica Portunato,Matteo Bassetti,Marco Berruti,Veronica Martini,Federica Briano

doi:10.3390/antibiotics10070763

Daniele Roberto Giacobbe, Michele Mirabella + Show 10 more

Open Access

https://doi.org/10.3390/antibiotics10070763

Copy DOI

Abstract

A single-center cross-sectional study was conducted to describe the use of ceftaroline in a large teaching hospital in Northern Italy, during a period also including the first months of the coronavirus disease 2019 (COVID-19) pandemic. The primary objective was to describe the use of ceftaroline in terms of indications and characteristics of patients. A secondary objective was to describe the rate of favorable clinical response in patients with bloodstream infections (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA-BSI) receiving ceftaroline. Overall, 200 patients were included in the study. Most of them had COVID-19 (83%, 165/200) and were hospitalized in medical wards (78%, 155/200). Included patients with COVID-19 pneumonia were given empirical ceftaroline in the suspicion of bacterial co-infection or superinfection. Among patients with MRSA-BSI, ceftaroline was used as a first-line therapy and salvage therapy in 25% (3/12) and 75% (9/12) of cases, respectively, and as a monotherapy or in combination with daptomycin in 58% (7/12) and 42% (5/12) of patients, respectively. A favorable response was registered in 67% (8/12) of patients. Improving etiological diagnosis of bacterial infections is essential to optimize the use of ceftaroline in COVID-19 patients. The use of ceftaroline for MRSA-BSI, either as a monotherapy or in combination with other anti-MRSA agents, showed promising rates of favorable response.

Highlights

A single-center cross-sectional study was conducted to describe the use of ceftaroline in a large teaching hospital in Northern Italy, during a period including the first months of the coronavirus disease 2019 (COVID-19) pandemic
A clear picture of how ceftaroline is used in real life is still unavailable, as is information regarding its possible use for the treatment of invasive bacterial superinfections in patients with acute respiratory failure due to coronavirus disease 2019 (COVID-19)
A secondary objective was to describe the rate of clinical response at the end of ceftaroline treatment in a longitudinal observational prospective subgroup analysis of patients with bloodstream infections (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA) (MRSA-BSI)

Summary

Introduction

A single-center cross-sectional study was conducted to describe the use of ceftaroline in a large teaching hospital in Northern Italy, during a period including the first months of the coronavirus disease 2019 (COVID-19) pandemic. A clear picture of how ceftaroline is used in real life (e.g., proportion of patients receiving ceftaroline for on-label vs off-label indications, empirical vs targeted therapy, monotherapy vs combination) is still unavailable, as is information regarding its possible use for the treatment of invasive bacterial superinfections in patients with acute respiratory failure due to coronavirus disease 2019 (COVID-19). Such a descriptive picture may help to identify the precise current real-life use of ceftaroline to guide and focus the design of dedicated randomized clinical trials. This would improve the quality of evidence on the best possible place published maps and institutional affiliations

Methods

Results

Conclusion