Clinical Outcomes of Ceftaroline Fosamil in the Treatment of Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia A Case Series

Background: Limited evidence exists in the management of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with ceftaroline as salvage therapy. This retrospective study aims to evaluate the use of ceftaroline as salvage therapy in the treatment of persistent MRSA bacteremia (MRSAB). Methods: Electronic medical charts of patients who received ceftaroline for the treatment of persistent MRSAB at an academic, quaternary care medical center from January 1, 2015, to December 31, 2021, were reviewed for clinical cure, reinfection, prior antibiotic use, source of infection, microbiological culture clearance, patient mortality, and adverse effects. Primary endpoints included clinical and microbiological success, and secondary endpoints were recurrence of infection and 60-day all-cause mortality. Results: Nineteen patient charts were identified, and 9 patients met the inclusion criteria for this analysis. Vancomycin or daptomycin was given for a median of 7 +/- 2.3 days, respectively, before the initiation of ceftaroline. The total daily dose of ceftaroline ranged from 400 to 1800 mg depending on the patients' kidney function. Five patients achieved clinical cure and 4 patients died. No patients experienced a recurrence. Three patients (33%) experienced adverse effects while on ceftaroline therapy. Conclusions: The use of ceftaroline in persistent MRSAB demonstrated microbiological cure, clinical cure, and minimal reinfection in the reviewed patient population. Ceftaroline may be a potential treatment option for patients with persistent MRSAB as salvage therapy.