High Incidence of Discontinuations Due to Adverse Events in Patients Treated with Ceftaroline

Jain, Rupali; Chan, Jeannie D.; Rogers, Lisa; Dellit, Timothy H.; Lynch, John B.; Pottinger, Paul S.

doi:10.1002/phar.1435

Cited by 42 publications

(33 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9,25,26 Indeed, in the one report that included patients similar to ours (i.e., comorbid patients, long duration of therapy, off-label indications), among 12 inpatients treated with ceftaroline, 9 patients (75%) discontinued ceftaroline because of an ADR. 22 Reported ADRs similarly included cutaneous and hematologic findings.…”

Section: Discussionmentioning

confidence: 99%

“…However, some reports suggest that ceftaroline may be associated with more ADRs than identified in premarketing studies. 16–22 Previously reported ceftaroline ADRs include neutropenia, thrombocytopenia, anemia, rashes, eosinophilic pneumonia, and AIN. 16–19,21,22 We aimed to retrospectively describe ceftaroline’s pattern of use and resultant ADRs and HSRs in two large academic hospitals.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adverse Drug Reactions Associated with Ceftaroline Use: A 2-Center Retrospective Cohort

Blumenthal

Kuhlen

Weil

et al. 2016

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

Background Ceftaroline fosamil is a cephalosporin approved for treating skin and soft tissue infections (SSTIs), including those caused by methicillin-resistant Staphylococcus aureus (MRSA) and community acquired pneumonia (CAP). Objective We aimed to study ceftaroline use and associated adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs), among inpatients. Methods We performed a retrospective electronic health record review of inpatients from Massachusetts General Hospital and Brigham and Women’s Hospital who received ceftaroline between May 2012 and February 2015. ADRs diagnosed by clinical providers during the course of clinical care were subsequently verified and classified. Risk factors for ADRs were identified. Results Among 96 patients (median age 57 years, 54% female) who received a median of 28 [IQR 6, 63] ceftaroline doses, 54% were being treated for MRSA and treatment indications other than SSTI and CAP comprised 59% of care. There were 31 ADRs observed in 20 (21%) of patients; hematologic (n=15) and cutaneous (n=9) findings were most common. Observed HSRs included rash with mucosal lesions (n=1), rash with skin desquamation (n=1) and possible organ specific HSRs (n=2). Patients who suffered an ADR received more doses of ceftaroline (median 46 vs. 21, p=0.013). There was no increased risk of ceftaroline ADR among patients with prior reported beta-lactam allergy (p >0.5). Conclusions Ceftaroline is used to treat a range of infections beyond SSTI and CAP. We observed a high rate of ADRs from ceftaroline, including signs of severe HSRs. More data are needed to understand the frequency and predictors of ceftaroline ADRs and HSRs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adverse Drug Reactions Associated with Ceftaroline Use: A 2-Center Retrospective Cohort

Blumenthal

Kuhlen

Weil

et al. 2016

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

show abstract

“…Sık görülen yan etkisi C. difficile ile ilişkili ishaldir. Hematolojik toksisite ve kızarıklıklar çok sayıda hastada görülmüştür (25) . Son dönemde yapılan bir çalışmada, seftobiprol'ün toplum kökenli pnömoni tedavisinde seftriakson ve linezolid kadar etkili olduğu gösterilmiştir (26) .…”

Section: Iic Sefalosporinlerunclassified

New Antibacterials

Akbal¹,

Çoban²,

Durupinar³

2018

TMCD

View full text Add to dashboard Cite

ÖZAntibiyotik direncinin artması ve yaygınlaşması bireyleri ve toplumu tehdit eden enfeksiyonların riskini daha da artırmaktadır. Enfeksiyonlara ve dirençli patojenlere karşı yeni antibiyotiklere gereksinim duyulmaktadır. Son yıllarda antibakteriyellerin geliştirilmesinde yeni ve başarılı çalışmalar dikkati çekmektedir. Glikopeptid ve lipopeptit (oritavancin, telavancin, dalbavancin ve surotomisin), oksazolidinon (tedizolid, radezolid, kadazolid ve MRX-I), makrolid/ketolid (modithromisin ve solitromisin), aminoglikozit (plazomisin), kinolon (nemonoksasin, delafloksasin ve avarofloksasin) ve tetrasiklin (omadasiklin ve eravasiklin) gruplarında yoğun çalışmaların yapıldığı görülmektedir. Bu derleme makalede, antibakteriyellerdeki son yıllardaki gelişmeler gözden geçirilmiştir. ABSTRACT New AntibacterialsThe increase and spread of antibiotic resistance further increase the risk of infections threatening the individual and the society. New antibiotics active against infections and resistant pathogens are needed. In recent years, new and successful studies in development of new antibacterials have been attracting attention. It has been observed that intensive studies have been carried out in glycopeptides and lipopeptides (oritavancin, telavancin, dalbavancin and surotomycin), oxazolidinones (tedizolid, radezolide, cadazolide and MRX-I), macrolides/ketolides (modithromycin and solitromycin), aminoglycosides (plasomycin), quinolones (nemonoxacin, delafloxacin and avarofloxacin), tetracyclines (omadacycline and eravacycline). In this review, the developments in antibacterials in recent years have been reviewed.

show abstract

“…However, adverse effects related to ceftaroline use are rarely described. Multiple observational and case report studies have suggested that ceftaroline exposure is associated with higher rates of neutropenia than seemingly listed in the product package insert . The prolonged use of ceftaroline in off‐label, difficult‐to‐treat clinical scenarios may potentiate the risk of neutropenia and contribute to additional patient morbidity and mortality, particularly if adequate follow‐up laboratory monitoring is not performed …”

mentioning

confidence: 99%

“…Prolonged durations of high‐dose ceftaroline (i.e., 600 mg 3times daily) are typically prescribed for serious infections such as endocarditis or osteomyelitis . Although neutropenia is a known adverse effect of β‐lactam antibiotics, the number of reports suggesting ceftaroline‐associated neutropenia is concerning . Whereas the causal relationship of this association remains unclear when comparing ceftaroline to other β‐lactams, the potential effects of non–chemotherapy‐associated neutropenia could lead to an increased propensity for severe infection, hospital readmission, prolonged hospitalization length of stay (LOS), increased cost, and increased patient mortality …”

mentioning

confidence: 99%

Comparison of Neutropenia Associated with Ceftaroline or Ceftriaxone in Patients Receiving at Least 7 Days of Therapy for Severe Infections

2019

View full text Add to dashboard Cite

STUDY OBJECTIVE Ceftarolinefosamil is a cephalosporin with broad clinical utility; however, limited data suggest that prolonged ceftaroline exposure may be associated with neutropenia. The objective was to determine drug and patient factors associated with neutropenia in patients receiving ceftaroline or ceftriaxone for deep-seated infections. DESIGN Retrospective, ratio-matched cohort study. SETTING Four acute-care hospitals within an urban health care system. PATIENTS A total of 176 hospitalized adults who received definitive ceftaroline (44 patients) or ceftriaxone (132 patients) therapy for at least 7 days between January 2013 and April 2017 for any of the following indications: bone and joint infections (BJI), infective endocarditis (IE), or bloodstream infections (BSI). MEASUREMENTS AND MAIN RESULTS The primary outcome was development of neutropenia while receiving cephalosporin therapy, defined as an absolute neutrophil count (ANC) <1500 cells/mm 3 . Neutropenia severity and patient characteristics were described and compared between the ceftaroline and ceftriaxone groups. The median (interquartile range [IQR]) antibiotic prescription duration was 41 (29-44) days for the ceftaroline group and 40 (28-44) days for the ceftriaxone group (p=0.9). Cephalosporin indications were 112 (64%) BJI, 27 (15%) BSI, 16 (9%) IE, and 21 (12%) multiple infections; ceftaroline was more commonly used in BJI (p=0.03), and ceftriaxone was more commonly used in IE (p=0.01). Neutropenia developed in 16 (9%) patients: 8 (18%) in the ceftaroline group and 8 (6%) in the ceftriaxone group (p=0.03). Median (IQR) onset to neutropenia was 22 (15-28) days, and median (IQR) change in ANC was 2.86 (1.50-4.08) cells/mm 3 ; most cases of neutropenia were mild (12 patients [75%]). The median (IQR) time to mild or moderate-severe neutropenia was not significantly different (p=0.68): 22 (14-28) and 22 (21-36) days, respectively. Treatment was discontinued in 4 (25%) patients due to neutropenia. Ceftaroline use was independently associated with neutropenia (adjusted odds ratio 3.2, 95% confidence interval 1.2-10.5) after adjusting for lower body mass index strata (18.5-25 kg/m 2 ).

show abstract

High Incidence of Discontinuations Due to Adverse Events in Patients Treated with Ceftaroline

Abstract: When given for off-label indications to 12 patients at our institutions, ceftaroline was associated with an unexpectedly high rate (75%) of discontinuation due to perceived adverse events, including hematologic toxicities and rash.

Cited by 42 publications

References 17 publications

Adverse Drug Reactions Associated with Ceftaroline Use: A 2-Center Retrospective Cohort

Adverse Drug Reactions Associated with Ceftaroline Use: A 2-Center Retrospective Cohort

New Antibacterials

Comparison of Neutropenia Associated with Ceftaroline or Ceftriaxone in Patients Receiving at Least 7 Days of Therapy for Severe Infections

Contact Info

Product

Resources

About