Clinical Medicine Reviews in Therapeutics

On October 29, 2010, the U.S. FDA approved ceftaroline fosamil, a new cephalosporin with extended Gram positive coverage, for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia (CABP). Unlike the currently available cephalosporins, ceftaroline maintains bactericidal activity against multi-drug resistant Gram positive pathogens like MRSA and drug-resistant S. pneumoniae due to its high affinity to PBP-2a and PBP-2x respectively. Its antimicrobial spectrum also includes Gram negative respiratory pathogens like H. influenzae, M. catarrhalis, and certain non-ESBL producing Enterobacteriaceae. The pharmacokinetic profile of ceftaroline is linear and directly proportional to underlying renal function. Similar to other -lactams, the pharmacodynamic profile that best determines its antimicrobial activity is %T > MIC. The results from two large randomized double-blind phase III trials (FOCUS 1 and FOCUS 2) for the treatment of adult patients with CABP, demonstrated comparable clinical cure rates between ceftaroline fosamil and ceftriaxone. Finally, ceftaroline fosamil has demonstrated an excellent safety and tolerability profile, making it an attractive option for its approved indications. The following article provides an in-depth, but focused review of the literature as it relates to the use of ceftaroline fosamil for the treatment of CABP.