Ceftaroline Fosamil vs. Vancomycin: Hospital Stay Compared in ABSSSI

Intravenous (IV) antibiotics such as CPT is indicated for ABSSSIs "but real world clinical comparative data is limited."

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SAN DIEGO—According to a study led by Trang D. Trinh, PharmD, from Wayne State University, Detroit MI, patients with acute bacterial skin and skin structure infection (ABSSSI) treated with ceftaroline fosamil (CPT) experienced a significantly shorter infection-related length of stay (LOSIR) compared to patients treated with vancomycin (VAN). 

A lack of effective therapy for ABSSSI has led to longer hospital stays and higher rates of recurrence. Intravenous (IV) antibiotics such as CPT is indicated for ABSSSIs “but real-world clinical comparative data is limited,” stated Dr. Trinh. Therefore, the research team sought to compare LOSIR between CPT and VAN in patients with ABSSSI through a retrospective, multi-center, propensity-matched cohort study.

Study patients aged ≥18 years were matched for time to study drug and presence of acute kidney injury on admission (AKI POA). Inclusion criteria included a confirmed ABSSSI diagnosis with ≥3 clinical signs requiring ≥72 hours of CPT or VAN initiated ≤120 hours of ABSSSI diagnosis, they reported. Exclusion criteria included osteomyelitis, other infection sources, irremovable hardware, or >120 hours prior ABSSSI treatment.

LOSIR, defined as LOS following ABSSSI diagnosis was calculated, multivariable linear regression was used to evaluate the independent relationship between type of treatment and LOSIR.

A total of 119 CPT patients were matched with 192 VAN patients. Mean age was 62 years in the ceftaroline group and 55 years in the vancomycin group (P<0.01). More patients in the ceftaroline group than the vancomycin group were Caucasian (77% vs. 52%; P<0.01). The median Charlson Comorbidity Index (CCI) was 2 with diabetes present in 41% of patients in the ceftaroline group vs. 1 with diabetes present in 35% in the vancomycin group.

Peripheral vascular disorder was noted in 26% and 29% of the ceftaroline and vancomycin groups, respectively. Chronic pulmonary disease was noted in 22% and 29%, respectively, and acute kidney injury at admission in 26% and 23%.

Additional research is needed to confirm the findings, they cautioned. Early initiation of CPT may be considered for patients who require IV antibiotics for ABSSSI treatment to help early hospital discharge, they suggested. 

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Trinh, TD. Ceftaroline Fosamil (CPT) versus Vancomycin (VAN) for Acute Bacterial Skin and Skin Structure Infections (ABSSSI). Poster presented at IDWeek; October 4–8, 2017; San Diego, CA. http://www.idweek.org