Lounsbury Nicole, Reeber Mary G, Mina Georges, Chbib Christiane
Department of Pharmaceutical Sciences, Larkin University College of Pharmacy, 18301 North Miami Ave, Miami, FL 33169, USA.
Pharmacy department, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, FL 33136, USA.
Antibiotics (Basel). 2019 Mar 20;8(1):30. doi: 10.3390/antibiotics8010030.
The objective of this review is to describe the outcomes of patients treated with ceftaroline in the non-Food and Drug Administration (FDA) approved indication of methicillin-resistant (MRSA) infections in both pediatric and adult populations.
A systematic overview was conducted by searching PubMed, Medline, and The Cochrane Library up to January 2019.
All English-language clinical trials and case reports related to the efficacy of ceftaroline in new, not-yet-approved FDA indications in MRSA infections in pediatric or adult populations.
In the case of MRSA bacteremia (MRSAB) infections, three different randomized studies in pediatric patients showed effectiveness of ceftaroline. When used in the case of adult populations with MRSA bacteremia, a small trial of 16 patients showed 50% clinical success in patients with acute bacterial skin and skin structure infections versus 63% clinical success in patients with community-acquired bacterial pneumonia. Another case series of six refractory case reports showed 50% clinical success of ceftaroline in patients with MRSA.
Although there are few case reports and limited data to date, ceftaroline fosamil should continue to be studied as an alternative therapy in MRSA infections in both pediatric and adult populations. Clinical success rates of ceftaroline were, in most cases, considered high when treating patients with MRSA infection. More clinical trials need to be studied. In the specific case of MRSA bacteremia, the treatment options remain few and ceftaroline should be extensively studied for the salvage treatment of MRSAB.
本综述的目的是描述在儿科和成人人群中,使用头孢洛林治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染这一未获美国食品药品监督管理局(FDA)批准适应症时患者的治疗结果。
截至2019年1月,通过检索PubMed、Medline和考克兰图书馆进行了系统综述。
所有与头孢洛林在儿科或成人人群MRSA感染新的、尚未获FDA批准适应症中的疗效相关的英文临床试验和病例报告。
在MRSA菌血症(MRSAB)感染方面,三项针对儿科患者的不同随机研究显示了头孢洛林的有效性。在用于患有MRSA菌血症的成人人群时,一项16例患者的小型试验显示,急性细菌性皮肤和皮肤结构感染患者的临床成功率为50%,而社区获得性细菌性肺炎患者的临床成功率为63%。另一例包含六例难治性病例报告的病例系列显示,头孢洛林在MRSA患者中的临床成功率为50%。
尽管目前病例报告较少且数据有限,但头孢洛林磷霉素仍应作为儿科和成人人群MRSA感染的替代疗法继续进行研究。在治疗MRSA感染患者时,头孢洛林的临床成功率在大多数情况下被认为较高。需要开展更多临床试验。在MRSA菌血症的特定情况下,治疗选择仍然有限,头孢洛林应针对MRSAB的挽救治疗进行广泛研究。