J Glob Antimicrob Resist. 2021 Dec 19:S2213-7165(21)00280-0. doi: 10.1016/j.jgar.2021.12.008. Online ahead of print.
OBJECTIVES: Vancomycin remains a first line treatment for methicillin-resistant Staphylococcus aureus (MRSA) mediated acute pulmonary exacerbations (APE) in adult cystic fibrosis (CF) patients; however, optimal alternatives remain poorly defined. The goal of this study was to determine the safety and efficacy of ceftaroline in adults with CF.
METHODS: We conducted a retrospective observational cohort study comparing ceftaroline to vancomycin for the treatment of MRSA mediated APE in adult CF patients. The primary endpoint was the return to at least 90% of baseline lung function measured by discharge FEV1% predicted in comparison to baseline FEV1% predicted.
RESULTS: Fifty-five patients were included in the analysis (22 ceftaroline; 33 vancomycin). Thirteen (59%) patients in the ceftaroline group and 24 (73%) in the vancomycin group met the primary outcome (P = 0.38). FEV1 measurements at baseline, admission, and discharge were not different between treatments. Secondary outcomes including 30-day readmission rate, 30-day mortality, treatment duration, or adverse events (neutropenia, Clostridioides difficile infection, and acute kidney injury) were similar between groups.
CONCLUSION: Our small cohort study supports ceftaroline as an alternative treatment option for MRSA mediated APE of CF in adults.