科研之友
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摘要
IntroductionThe only clinically available cephalosporin with invivo and invitro activity against methicillin-resistant Staphylococcus aureus is ceftaroline, which is approved for the treatment of soft tissue infection and community-acquired pneumonia in doses of 600mg intravenously every 12hours for 2weeks or less. However, many clinicians use ceftaroline to treat more serious infections and dose more frequently (every 8hours) for longer periods of time. MethodsA retrospective medication safety assessment was performed at two centers where agranulocytosis was observed in four patients (two at each center) who were treated with ceftaroline. The cases were reviewed by the treating physicians for common features, and the frequency of agranulocytosis was calculated based on the total number of treated patients. ResultsWe report four cases of agranulocytosis associated with ceftaroline use, highlighted by prolonged use (more than 14days) and 8-hour dosing intervals or 12-hour dosing intervals with concomitant clindamycin therapy. When ceftaroline (600mg every 12hours) and clindamycin (900mg every 8hours) were coadministered for more than 2weeks, the frequency of agranulocytosis was 18% (2 of 18 patients treated). When ceftaroline alone was administered for more than 2weeks at 600mg every 8hours, agranulocytosis occurred in 5.4% (2 of 37 treated patients). No cases of ceftaroline-related agranulocytosis were seen that did not have these features. In these patients, granulocyte-colony stimulating factor therapy usually resulted in rapid myeloid recovery. ConclusionsClinicians should have a heightened awareness of agranulocytosis when using ceftaroline in such settings and monitor complete blood counts at least once/week.
- 出版日期2015-6
