Fifth-generation cephalosporin (anti-MRSA) Pregnancy: There are no adequate studies with ceftaroline fosamil in pregnant women that informed any drug-associated risks. In animal studies no malformations or other adverse developmental effects were seen in rats at up to 4 times the maximum recommended human dose through organogenesis and lactation, and no drug-induced fetal malformations were seen in rabbits at approximately the maximum recommended human dose despite maternal toxicity.

Ceftaroline fosamil

Brand names: Zinforo

Ceftaroline fosamil is a parenteral cephalosporin antibacterial notable for activity against meticillin-resistant Staphylococcus aureus (MRSA), used for complicated skin and soft-tissue infections and community-acquired pneumonia.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 600 mg

Route: Intravenous infusion over 5 to 60 minutes

Frequency: Every 12 hours

US labelling, adults 18 years and older. The only adult row that is legible in the fetched dosage table is acute bacterial skin and skin structure infections (ABSSSI): 600 mg every 12 hours, infused over 5 to 60 minutes, for 5 to 14 days. SOURCE DEFECT: the fetched dosage table is partly corrupted (the '<' and '≥' comparison characters have swallowed the weight/age bands), so the community-acquired bacterial pneumonia (CABP) row and all paediatric weight bands could not be read; the adverse-reactions section of the same label confirms adult trials used 600 mg IV every 12 hours in both ABSSSI and CABP, but the CABP duration and the paediatric regimens must be sourced by the clinician. PAEDIATRIC (non-numeric, from the same label): safety and effectiveness for ABSSSI are established in patients at least 34 weeks gestational age and 12 days postnatal age, and for CABP in patients 2 months to less than 18 years; patients less than 2 months are dosed every 8 hours by IV infusion over 30 to 60 minutes and only for ABSSSI; there is no information for dosing infants less than 34 weeks gestational age and less than 12 days postnatal age; the legible band for children weighing more than 33 kg is 400 mg every 8 hours OR 600 mg every 12 hours. Cerebrospinal fluid concentrations have not been evaluated. The per-kilogram paediatric doses are NOT readable in this bundle — obtain them from a children's formulary or the SPC. PREPARATION: the infusion solution concentration should not exceed 12 mg/mL; do not mix with, or physically add to, solutions containing other drugs. SOURCE: no UK SPC was fetched in this bundle — verify against the UK SPC.

Dose adjustments

Renal

US labelling, adults: CrCl greater than 50 mL/min — no dosage adjustment necessary; CrCl greater than 30 to 50 mL/min or less — 400 mg IV (over 5 to 60 minutes) every 12 hours; CrCl 15 to 30 mL/min or less — 300 mg IV (over 5 to 60 minutes) every 12 hours; end-stage renal disease including haemodialysis — 200 mg IV (over 5 to 60 minutes) every 12 hours. Creatinine clearance estimated using the Cockcroft-Gault formula. There is insufficient information to recommend a dosage regimen for paediatric patients with reduced renal function (paediatric eGFR estimated using the Schwartz equation).

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known serious hypersensitivity to ceftaroline or other members of the cephalosporin class (anaphylaxis has been reported with ceftaroline)

Side effects

Diarrhoea (most common, more than 2% of adults and at least 3% of paediatric patients)
Nausea (most common, more than 2% of adults and at least 3% of paediatric patients)
Rash (most common, more than 2% of adults and at least 3% of paediatric patients)
Vomiting and pyrexia (additional reactions occurring in at least 3% of paediatric patients)
Serious labelled reactions — hypersensitivity/anaphylaxis, Clostridioides difficile-associated diarrhoea, neurological adverse reactions (especially with renal impairment), and direct Coombs' test seroconversion with possible drug-induced haemolytic anaemia

Clinical monograph

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.

Reference: BSAC; UKHSA AMR; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways