Ceftaroline Fosamil Highly Effective for Skin Infections in Patients with Diabetes or PVD
SAN FRANCISCO, CA—Patients with diabetes mellitus (DM) and/or peripheral vascular disease (PVD) experienced high clinical success when treated with ceftaroline fosamil (CPT-F) for acute bacterial skin and skin structure infections (ABSSSI), according to a presentation at IDWeek 2013.
This included patients with DM and obesity and/or foot infections, Paul Santos, PharmD, Lakes Region General Hospital in Laconia, NH and colleagues reported.
CAPTURE (Clinical Assessment Program and Teflaro Utilization Registry), a retrospective multicenter US study, is evaluating the routine clinical use of intravenous CPT-F, a novel cephalosporin antibiotic, in patients with DM and/or PVD treated for ABSSSI.
Data were collected between August 2011 and February 2013 from 38 study centers by random selection and chart review. A total of 1030 patients treated for ABSSSI were evaluable; 527 (51%) had DM and/or PVD; 471 (46%) had DM alone; and 178 (17%) had PVD alone.
Mean age of the patients with DM and/or PVD was 63 years. Mean body mass index was 36 kg/m2 (SD ± 12) for those with DM and 33 kg/m2 (SD ± 10) for those with PVD. Sixty percent of the patients with DM were obese, as were 52% of those with PVD.
The majority of patients (91%) with DM and/or PVD were treated with CPT-F in general hospital wards and 9% were treated in the ICU; 72% were discharged home and 26% to another care facility. Eight patients (2%) died.
Infections in patients with DM were deep/extensive cellulitis (53%), major abscesses (17%), infected ulcers (17%), infected surgical wounds (10%), and infected traumatic wounds (5%) and, among those with PVD, deep/extensive cellulitis (53%), major abscesses (10%), infected ulcers (26%), infected surgical wounds (13%), and infected traumatic wounds (6%).
The most common infection sites in patients were the leg/thigh and foot; 45% and foot 34% for those with DM and 53% and 49% for those with PVD, respectively. MRSA (26%) and MSSA (13%) were the most common pathogens recovered in these patients. Among all patients with DM and/or PVD, 77% used other antibiotics prior to CPT-F, most commonly glycopeptides (43%), semisynthetic penicillins (29%), and cephalosporins (23%). Concurrent antibiotics were used in 38% of patients; most commonly, lincosamides (9%) and glycopeptides (8%).
Mean duration of CPT-F therapy was 7 days (SD ± 6). Overall clinical success was 83% in patients with DM and/or PVD; 83% in those with DM alone; 78% in PVD alone; 87% in those with DM and obesity; and 79% in patients with DM with foot infection. Clinical success for CPT-F monotherapy and concurrent therapy was 84% and 82%, respectively. When used as first-line therapy, CPT-F success rate was 81% and, when used as second-line therapy, 84%. In patients with DM and/or PVD and MRSA or MSSA, clinical success rates were 81% and 76%, respectively.
CPT-F is already approved for the treatment of acute skin and skin structure infections and community-acquired bacterial pneumonia.