Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Building 15, Via Gramsci 14, 43126, Parma, Italy.
AbbVie, Madison, NJ, USA.
Paediatr Drugs. 2021 Nov;23(6):549-563. doi: 10.1007/s40272-021-00468-w. Epub 2021 Aug 31.
Community-acquired pneumonia (CAP)/community-acquired bacterial pneumonia (CABP) and complicated skin and soft tissue infection (cSSTI)/acute bacterial skin and skin structure infection (ABSSSI) represent major causes of morbidity and mortality in children. β-Lactams are the cornerstone of antibiotic treatment for many serious bacterial infections in children; however, most of these agents have no activity against methicillin-resistant Staphylococcus aureus (MRSA). Ceftaroline fosamil, a β-lactam with broad-spectrum in vitro activity against Gram-positive pathogens (including MRSA and multidrug-resistant Streptococcus pneumoniae) and common Gram-negative organisms, is approved in the European Union and the United States for children with CAP/CABP or cSSTI/ABSSSI. Ceftaroline fosamil has completed a pediatric investigation plan including safety, efficacy, and pharmacokinetic evaluations in patients with ages ranging from birth to 17 years. It has demonstrated similar clinical and microbiological efficacy to best available existing treatments in phase III-IV trials in patients aged ≥ 2 months to < 18 years with CABP or ABSSSI, with a safety profile consistent with the cephalosporin class. It is also approved in the European Union for neonates with CAP or cSSTI, and in the US for neonates with ABSSSI. Ceftaroline fosamil dosing for children (including renal function adjustments) is supported by pharmacokinetic/pharmacodynamic modeling and simulations in appropriate age groups, and includes the option of 5- to 60-min intravenous infusions for standard doses, and a high dose for cSSTI patients with MRSA isolates, with a ceftaroline minimum inhibitory concentration of 2-4 mg/L. Considered together, these data suggest ceftaroline fosamil may be beneficial in the management of CAP/CABP and cSSTI/ABSSSI in children.
社区获得性肺炎(CAP)/社区获得性细菌性肺炎(CABP)和复杂性皮肤和软组织感染(cSSTI)/急性细菌性皮肤和皮肤结构感染(ABSSSI)是儿童发病率和死亡率的主要原因。β-内酰胺类药物是治疗儿童许多严重细菌感染的基础抗生素;然而,这些药物大多数对耐甲氧西林金黄色葡萄球菌(MRSA)没有活性。头孢洛林酯是一种具有广泛体外活性的β-内酰胺类药物,对革兰氏阳性病原体(包括 MRSA 和多药耐药肺炎链球菌)和常见的革兰氏阴性菌具有活性,已在欧盟和美国获得批准,用于治疗 CAP/CABP 或 cSSTI/ABSSSI 的儿童。头孢洛林酯已完成一项儿科研究计划,包括对出生至 17 岁的患者进行安全性、疗效和药代动力学评估。在 2 个月至<18 岁的 CABP 或 ABSSSI 患者的 III-IV 期试验中,它与最佳现有治疗药物具有相似的临床和微生物学疗效,安全性与头孢菌素类一致。它还在欧盟获得批准,用于治疗 CAP 或 cSSTI 的新生儿,在美国获得批准,用于治疗 ABSSSI 的新生儿。头孢洛林酯在儿童中的剂量(包括肾功能调整)得到了适当年龄组的药代动力学/药效学模型和模拟的支持,包括标准剂量 5-60 分钟静脉输注的选择,以及对 MRSA 分离株的 cSSTI 患者的高剂量,头孢洛林最低抑菌浓度为 2-4mg/L。综合考虑,这些数据表明头孢洛林酯可能有益于儿童 CAP/CABP 和 cSSTI/ABSSSI 的治疗。