Ceftaroline fosamil

How it works

Its active form is a beta-lactam that binds penicillin-binding proteins, including PBP2a in MRSA, to inhibit cell-wall synthesis and produce a bactericidal effect.

Prescribing in practice

• Avoid in patients with a history of immediate hypersensitivity to penicillins or other beta-lactams because of the risk of cross-reactivity.
• Its anti-MRSA activity is a key distinguishing feature, but use should be guided by susceptibility data and antimicrobial stewardship.
• Dose adjustment is required in renal impairment, in line with the SPC.

Monitoring

Monitor renal function, clinical response and full blood count, with awareness of direct antiglobulin (Coombs) test seroconversion during therapy.

Counselling the patient

• This antibiotic is given by infusion under clinical supervision.
• Report any rash, swelling, breathing difficulty, or severe or persistent diarrhoea.

Evidence & guidelines

Efficacy in complicated skin infection and community-acquired pneumonia was established in the CANVAS and FOCUS phase III trial programmes.