Infectious Diseases II
| (2) | Tedizolid once daily for 7 days was compared with linezolid twice daily for 10 days |
|---|
for the treatment of gram-positive hospital-acquired or ventilator-associated bacterial
pneumonia and was found to be noninferior for day 28 all-cause mortality, but did not
meet noninferiority for clinical response at test of cure.
| (e) | Application: Place in therapy among critically ill patients is limited, but tedizolid use may |
|---|
be warranted in patients that experience linezolid-associated adverse effects.
ii.
Ceftaroline
| (a) | Antimicrobial class: Fifth-generation cephalosporin |
|---|---|
| (b) | Spectrum of activity: Enterobacterales (similar to third-generation cephalosporins) |
and gram-positive pathogens, including MRSA, drug-resistant S. pneumoniae, and
vancomycin-intermediate and vancomycin-resistant staphylococci
| (c) | PK and dosing |
|---|---|
| (1) | Activity against MRSA mediated through enhanced affinity to penicillin-binding- |
protein 2a
| (2) | Half-life: 2.7 hours |
|---|---|
| (3) | Excretion: 88% urine |
| (4) | Dosing: |
| (A) | 600 mg intravenously every 12 hours is the FDA label-approved dosing. Reports |
of using 600 mg intravenously every 8 hours for severe infections
| (B) | Adjustments necessary for patients with renal impairment |
|---|---|
| (d) | Studies: |
| (1) | Evaluated in a noninferiority trial compared with ceftriaxone, both in conjunction |
with clarithromycin, for the treatment of community-acquired bacterial pneumonia.
Results indicated noninferiority, with numerically higher cure rates in those
randomized to ceftaroline. Clinical response by day 4 of therapy was also higher in
the ceftaroline group.
| (2) | Evaluated in a noninferiority trial compared with vancomycin plus aztreonam for the |
|---|
treatment of skin and skin structure infection. Ceftaroline cure rates were within the
a priori–determined margin, thus satisfying the criteria for noninferiority.
| (e) | Application: |
|---|---|
| (1) | FDA approved for acute bacterial skin and skin structure infections and community- |
acquired bacterial pneumonia
| (2) | Despite its FDA approvals, the main role of ceftaroline is the availability of an |
|---|
additional agent with activity against MRSA. May be an option when vancomycin
therapy is suboptimal and other treatment options may lead to unwanted adverse
effects. May also be a reasonable option for the treatment of community-acquired
pneumonia in institutions where community-acquired MRSA is common and for the
salvage treatment of MRSA bacteremia
iii.
Ceftobiprole
| (a) | Cephalosporin antibiotic |
|---|---|
| (b) | FDA approved in 2024 for the treatment of S. aureus bacteremias (including those with |
right-sided endocarditis), SSIs, and community-acquired pneumonia
| (c) | Has activity against MRSA and Enterobacterales (similar to third-generation |
|---|
cephalosporins)
| (d) | Studies |
|---|---|
| (1) | Showed noninferiority to daptomycin plus aztreonam for MRSA bacteremia |
| (2) | Showed noninferiority to vancomycin plus aztreonam for SSIs |
| (3) | Showed noninferiority to ceftriaxone plus optional linezolid for community-acquired |
pneumonia