Background and importance Ceftaroline is approved for treating complicated skin and skin structure infections (cSSSI), and community acquired pneumonia (CAP). However, there is growing evidence that other severe methicillin resistant staphylococcal infections could be treated with ceftaroline.

Aim and objectives To evaluate the use of ceftaroline in a tertiary hospital in Spain, as well as its effectiveness and safety.

Material and methods A retrospective observational study including all patients treated with ceftaroline in our hospital (November 2017–September 2019) was carried out. Demographic, clinical and safety variables were collected. Effectiveness was assessed by the clinical and microbiological resolution of the infection, and the absence of hospital admissions for the same infection after receiving ceftaroline.

Results Thirty patients received treatment (76.7% men, n=23). All patients were adults except one. Mean age of the adults was 68.4.1±17.6 years (the paediatric patient was 3 months old).

The most common indication for ceftaroline was bacteraemia (60.7%, n=20): 8 were due to cSSSI, in 8 its origin was unknown, 2 were due to CAP and 2 were due to catheter associated infections. The other indications were endocarditis (13.2%, n=4), cSSSI (10%, n=3), hospital acquired pneumonia (6.7%, n=2) and osteomyelitis (3.2%, n=1). Infections were caused by Staphylococcus aureus (93.2%, n=28) and Staphylococcus epidermidis (n=2). In 76.7% (n=23) of cases the infections were caused by methicillin resistant microorganisms.

Dosage was: 600 mg/8 hours (63.2%, n=19), 400 mg/8 hours (20%, n=6), 600 mg/12 hours (6.7%, n=2), 600 mg/6 hours (3.2%, n=1), 200 mg/12 hours (3.2%,n=1) and in the paediatric patient 8 mg/kg/8 hours. Median duration of treatment was 11.7 (5.2–14.7) days.

A total of 76.7% of patients (n=23) presented clinical and microbiological resolution of the infection. However, four patients were readmitted for treatment of the same infection during the follow-up period.

Serious adverse effects related to ceftaroline were reported in one patient: it was necessary to withdraw treatment because of severe thrombopenia, with a platelet count of 84×1000/µL (previously 149×1000/µL).

Conclusion and relevance In most of our patients, ceftaroline was used in infections caused by methicillin resistant microorganisms although there were some ‘off-label’ indications. Our results suggest that ceftaroline is safe and effective in severe methicillin resistant infections with few treatment options due to multiresistance.

References and/or acknowledgements No conflict of interest.