Division of Infectious Diseases, Cleveland Clinic Akron General, Akron, OH, USA; Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
Division of Infectious Diseases, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
J Glob Antimicrob Resist. 2018 Jun;13:146-151. doi: 10.1016/j.jgar.2018.01.001. Epub 2018 Jan 11.
Infections of the spine lead to considerable morbidity and a high cost to the global healthcare system. Currently, evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited.
Describing Infections of the Spine treated with Ceftaroline (DISC) is a multicentre, retrospective, cohort study that evaluated ceftaroline for treating spine infections. Patients were included if they were aged ≥18 years, diagnosed with a spine infection and treated with ceftaroline for ≥28 days. A control group was identified with the same inclusion criteria as the study population except they were treated with a comparator antibiotic for ≥28 days.
Thirty-seven patients were included each in the ceftaroline and control groups. MRSA was the most commonly identified pathogen. With no differences between groups in age, sex, race or co-morbidities (with the exception of chronic kidney disease), treatment with ceftaroline led to similar clinical success compared with the control group. Multivariate regression analysis did not show a significant difference between the two groups in terms of clinical success after controlling for other covariates (adjusted odds ratio=1.49; P=0.711). More patients who received ceftaroline were discharged to an extended-care or rehabilitation facility than home compared with controls (81% vs. 54%, respectively; P=0.024). Side effects and toxicities were rare, including one case of eosinophilic pneumonia in the ceftaroline group.
Ceftaroline appears to be a safe and effective therapy for infections of the spine, including from MRSA.
脊柱感染会导致相当大的发病率和全球医疗保健系统的高成本。目前，关于使用头孢洛林（一种对耐甲氧西林金黄色葡萄球菌（MRSA）有效的新型头孢菌素）治疗脊柱感染的证据有限。
描述用头孢洛林治疗的脊柱感染（DISC）是一项多中心、回顾性、队列研究，评估了头孢洛林治疗脊柱感染的效果。患者年龄≥18 岁，诊断为脊柱感染，接受头孢洛林治疗≥28 天，即可纳入研究。如果患者符合研究人群的相同纳入标准，但接受了比较抗生素治疗≥28 天，则确定为对照组。
每组各纳入 37 例患者。MRSA 是最常见的病原体。两组在年龄、性别、种族或合并症（除慢性肾脏病外）方面无差异，与对照组相比，接受头孢洛林治疗的患者临床疗效相似。多变量回归分析显示，在控制其他协变量后，两组在临床疗效方面无显著差异（调整优势比=1.49；P=0.711）。与对照组相比，接受头孢洛林治疗的患者出院后更多地被送往长期护理或康复机构，而不是回家（分别为 81%和 54%；P=0.024）。副作用和毒性罕见，包括头孢洛林组有一例嗜酸性肺炎病例。
头孢洛林似乎是治疗脊柱感染（包括耐甲氧西林金黄色葡萄球菌感染）的一种安全有效的治疗方法。
