Difference between revisions of "Ceftaroline"

(Pharmacology)
 
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==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
 +
*[[C. diff]]
 +
*Elevated ALT/SGPT, hepatitis
 +
*[[Anaphylaxis]], hypersensitivity reaction
 +
*[[Seizure]]
 +
*[[Renal failure]]
  
 
===Common===
 
===Common===
 +
*[[Nausea/vomiting]], [[diarrhea]]
 +
*[[Rash]]
 +
*[[Fever]]
  
 
==Pharmacology==
 
==Pharmacology==

Latest revision as of 09:01, 27 May 2019

General

  • Type: Antibiotic, Cephalosporin (fifth generation)
  • Dosage Forms: IV
  • Common Trade Names: Teflaro

Adult Dosing

  • Pneumonia, Community-acquired: IV: 600 mg every 12 hours for 5 to 7 days
  • Skin and skin structure infection: IV: 600 mg every 12 hours for 5 to 14 days

Pediatric Dosing

  • Cystic Fibrosis pulmonary exacerbation, MRSA:
    • Children ≥ 6 years old - IV 15 mg/kg/dose every 8 hours (max dose 600 mg/dose)
  • Pneumonia, community acquired:
    • ≥ 2 months - < 2 years age - IV 8 mg/kg/dose every 8 hours for 5-14 days
    • ≥ 2 years - < 18 years
      • ≤ 33 kg: IV 12 mg/kg/dose every 8 hours for 5-14 days
      • > 33 kg: IV 400 mg every 8 hours OR 600 mg every 12 hours for 5-14 days
  • Skin and skin structure infection:
    • ≥ 2 months - < 2 years age - IV 8 mg/kg/dose every 8 hours
    • ≥ 2 years - < 18 years
      • ≤ 33 kg: IV 12 mg/kg/dose every 8 hours
      • > 33 kg: IV 400 mg every 8 hours OR 600 mg every 12 hours

Special Populations

  • Pregnancy Rating:
    • Adverse events have been observed in animal studies
  • Lactation:
    • Unknown if excreted in breast milk. Manufacturer recommends to use caution when giving to nursing women.
  • Renal Dosing
    • Adult
      • CrCl > 50 mL/minute: No dosage adjustment necessary
      • CrCl > 30 to ≤ 50 mL/minute: 400 mg every 12 hours
      • CrCl ≥ 15 to ≤ 30 mL/minute: 300 mg every 12 hours
      • CrCl < 15 mL/minute: 200 mg every 12 hours
      • ESRD patients on hemodialysis: 200 mg every 12 hours; dose given after hemodialysis on dialysis days
    • Pediatric
      • ≥ 2 months to < 18 years of age
        • CrCl > 50 mL/minute/1.73 m²: No adjustment necessary
        • CrCl ≤ 50 mL/minute/1.73 m²: Insufficient data, use with caution, dosing adjustment may be necessary
      • ≥ 18 years of age - same as adult dosing
  • Hepatic Dosing
    • Adult
      • No dosage adjustment in manufacturer's labeling. Has not been studied.
    • Pediatric
      • No dosage adjustment in manufacturer's labeling. Has not been studied.

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
    • 1.6 ± 0.38 hours (single dose), 2.66 ± 0.4 hours (multiple doses)
  • Metabolism:
  • Excretion:
    • Urine 88%, Feces 6%
  • Mechanism of Action:
    • Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp X1
Enterococcus faecalis S
Enterococcus faecium X1
MSSA S
MRSA S
CA-MRSA S
Staph. Epidermidis S
C. jeikeium X1
L. monocytogenes X1
Gram Negatives N. gonorrhoeae I
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos R
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii X1
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. X1
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica X1
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. X1

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014

Ceftaroline: Drug information. UpToDate. www.uptodate.com. Accessed April 1, 2019.