Multicenter Cohort Study of Ceftaroline Versus Daptomycin for Treatment of Methicillin-Resistant Staphylococcus aureus Bloodstream Infection. (23rd December 2021)

• Record Type: Journal Article
• Authors: Zasowski, Evan J; Trinh, Trang D; Claeys, Kimberly C; Lagnf, Abdalhamid M; Bhatia, Sahil; Klinker, Kenneth P; Veve, Michael P; Estrada, Sandy J; Johns, Scott T; Sawyer, Adam J; Huang, Vanthida; LaFrance, Brandi; Levine, Donald P; Kaye, Keith S; Davis, Susan L; Rybak, Michael J
• Is Part Of: Open forum infectious diseases. Volume 9:Number 3(2022)
• Publication Date: 2021-12-23
• Subjects: bacteremia -- β-lactam -- infective endocarditis -- lipoglycopeptide -- MRSA; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofab606
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Observational data suggest ceftaroline may be effective for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI), but comparative data with standard of care are limited. This analysis compares the outcomes of MRSA BSI treated with ceftaroline or daptomycin. Methods: Multicenter, retrospective, observational cohort study of adult patients with MRSA BSI from 2010 to 2017. Patients treated with ≥72 hours of ceftaroline or daptomycin were included. Those clearing BSI before study drug and those with a pneumonia source were excluded. The primary outcome was composite treatment failure, defined as 30-day mortality, BSI duration ≥7 days on study drug, and 60-day MRSA BSI recurrence. Inverse probability of treatment weighted risk difference in composite failure between daptomycin and ceftaroline groups was computed and 15% noninferiority margin applied. Results: Two hundred seventy patients were included; 83 ceftaroline and 187 daptomycin. Ceftaroline was noninferior to daptomycin with respect to composite failure (39% daptomycin, 32.5% ceftaroline; weighted risk difference, 7.0% [95% confidence interval, –5.0% to 19.0%]). No differences between treatment groups was observed for 30-day mortality or other secondary efficacy outcomes. Creatine phosphokinase elevation was significantly more common among daptomycin patients (5.3% vs 0%, P = .034). Rash was significantly more common among ceftaroline patients (10.8 vs 1.1%, P = .001). Conclusions: No difference in treatment failure or mortality was observed between MRSA BSI treated with ceftaroline or daptomycin. These data support future study of ceftaroline as a primary MRSA BSI treatment and current use of ceftaroline when an alternative to vancomycin and daptomycin is required. Abstract : No difference in treatment failure or mortality was observed between methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) treated with ceftaroline or daptomycin. These data support future study of ceftaroline as a primary MRSA BSI treatment and use when a vancomycin and daptomycin alternative is required.