Jansen Jeffrey W, Moenster Ryan P
1 SCL Saint Vincent Healthcare, Billings, MT, USA.
2 VA Saint Louis Health Care System, Saint Louis, MO, USA.
Ann Pharmacother. 2018 Mar;52(3):235-239. doi: 10.1177/1060028017735629. Epub 2017 Oct 5.
Ceftaroline is a broad-spectrum, methicillin-resistant Staphylococcus aureus (MRSA)-active β-lactam approved for acute bacterial skin and skin structure infections (ABSSSIs) and community-acquired pneumonia. Because of its favorable spectrum and pharmacokinetics, ceftaroline is frequently utilized for infections such as osteomyelitis and endocarditis. Ceftaroline has been associated with neutropenia, but evaluation of other adverse events remains limited.
To describe the rates and types of ceftaroline-associated adverse events and determine if patients' baseline allergies affect the rates of an adverse event.
A single-center, retrospective, observational analysis was conducted of all patients who received ceftaroline between November 4, 2011, and March 28, 2017, at the VA Saint Louis Health Care System. The Naranjo algorithm was utilized as a standardized method to evaluate likelihood that the adverse events were caused by ceftaroline therapy. Ceftaroline dose, duration, indication, and baseline allergy information were collected for all patients.
There were 75 patients who received 78 courses of ceftaroline identified for inclusion. The most common indications were osteomyelitis (51.3%) and ABSSSI (16.7%). Overall, 13/75 (17.3%) patients developed an adverse event, and 10/75 (13.3%) required discontinuation of ceftaroline. Rash was the most common adverse reaction and occurred in 7/75 (9.3%) patients, followed by neutropenia in 3/75 (4.0%) patients. There were no differences in baseline allergy characteristics between patients who experienced an adverse reaction to ceftaroline and those who did not.
When compared with clinical trials, ceftaroline use appears to be associated with an increased rate of overall adverse events, which is driven by cutaneous reactions.
头孢洛林是一种广谱、对耐甲氧西林金黄色葡萄球菌（MRSA）有效的β-内酰胺类药物，已被批准用于治疗急性细菌性皮肤及皮肤结构感染（ABSSSI）和社区获得性肺炎。由于其良好的抗菌谱和药代动力学特性，头孢洛林常被用于治疗骨髓炎和心内膜炎等感染。头孢洛林与中性粒细胞减少有关，但对其他不良事件的评估仍然有限。
描述头孢洛林相关不良事件的发生率和类型，并确定患者的基线过敏情况是否会影响不良事件的发生率。
对2011年11月4日至2017年3月28日期间在圣路易斯退伍军人医疗保健系统接受头孢洛林治疗的所有患者进行单中心回顾性观察分析。采用纳伦霍算法作为评估不良事件由头孢洛林治疗引起的可能性的标准化方法。收集所有患者的头孢洛林剂量、疗程、适应证和基线过敏信息。
共纳入75例接受78个疗程头孢洛林治疗的患者。最常见的适应证是骨髓炎（51.3%）和ABSSSI（16.7%）。总体而言，13/75（17.3%）的患者发生了不良事件，10/75（13.3%）的患者需要停用头孢洛林。皮疹是最常见的不良反应，7/75（9.3%）的患者出现皮疹，其次是中性粒细胞减少，3/75（4.0%）患者出现该症状。发生头孢洛林不良反应的患者与未发生不良反应的患者在基线过敏特征方面没有差异。
与临床试验相比，使用头孢洛林似乎与总体不良事件发生率增加有关，这主要由皮肤反应导致。
