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Ceftaroline

Class
Antibiotics
Subclass
Cephalosporins
Substance name
Ceftaroline fosamil
Brand names
Teflaro®
Common formulations
Powder
Dosage and administration
Adults patients
Community-acquired pneumonia
•
600 mg IV q12h for 5 to 7 days
SSTIs • Acute
•
600 mg IV q12h for 5-14 days
Indications for use
Labeled indications
Adults
•
Treatment of community-acquired pneumonia
•
Treatment of SSTIs (acute)
Safety risks
Contraindications
Hypersensitivity to ceftaroline fosamil or any of its components or to other cephalosporins
Warnings and precautions
Antimicrobial resistance
•
Maintain a high level of suspicion, as the use of ceftaroline fosamil in the absence of a proven or strongly suspected bacterial infection increases the risk of developing drug-resistant bacteria.
C. difficile infection
•
Maintain a high level of suspicion, as nearly all antibiotics, including ceftaroline fosamil, are associated with an increased risk of C. difficile-associated diarrhea.
Drug hypersensitivity reaction
•
Use caution in patients with a history of penicillin allergy due to the risk of cross-hypersensitivity.
Neurotoxicity
•
Maintain a high level of suspicion, as cephalosporins including ceftaroline fosami have been associated with an increased risk of neurotoxicity, including encephalopathy, aphasia, myoclonus, seizures, and nonconvulsive status epilepticus, mostly occurring in patients with renal impairment who did not receive appropriate dosage adjustment.
Positive direct Coombs test
•
Maintain a high level of suspicion, as positive direct Coombs tests with or without hemolysis have been reported during treatment with ceftaroline fosamil.
Specific populations
Renal impairment
CrCl 30-50 mL/min
•
Reduce dose. Maximal dose of 400 mg. Do not exceed frequency of q12h. Monitor serum concentrations.
CrCl 15-30 mL/min
•
Reduce dose. Maximal dose of 300 mg. Do not exceed frequency of q12h. Monitor serum concentrations.
CrCl < 15 mL/min
•
Reduce dose. Maximal dose of 200 mg. Do not exceed frequency of q12h. Monitor serum concentrations.
Renal replacement therapy
Continuous renal replacement
•
Reduce dose. Dose as in eGFR 15-30 mL/min/1.73 m². Maximal dose of 300 mg. Maximal frequency of q12h. Monitor serum concentrations.
Intermittent hemodialysis
•
Reduce dose. Dose as in eGFR < 15 mL/min/1.73 m². Maximal dose of 200 mg. Maximal frequency of q12h. Monitor serum concentrations.
Peritoneal dialysis
•
Reduce dose. Dose as in eGFR < 15 mL/min/1.73 m². Maximal dose of 200 mg. Maximal frequency of q12h. Monitor serum concentrations.
Hepatic impairment
Any severity
•
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B1
•
Use only if benefits outweigh potential risks.
Breastfeeding
Acceptable for use during breastfeeding.
•
Unlikely to have adverse effects in breastfed infants.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
•
Anaphylactic shock, anemia, bradycardia, ↓ blood neutrophil count, ↓ platelet count, ↓ serum potassium, ↑ blood eosinophil count, ↑ blood glucose, ↑ liver enzymes, ↑ serum potassium, phlebitis, pseudomembranous colitis, renal failure, abdominal pain, constipation, diarrhea, dizziness, fever, headache, itching, nausea, palpitations, seizure, skin rash, vomiting, urticaria
Unknown frequency
•
Agranulocytosis, ↓ WBC count, encephalopathy
Interactions
Drug(s)
Check Interactions
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