LAUSR

BACKGROUND Ceftaroline is one of latest additions to the armamentarium for the treatment of community-acquired pneumonia (CAP). In this study, we aimed to describe the outcome of severe CAP (SCAP) in a cohort of hospitalized patients treated with ceftaroline. METHODS Retrospective, observational study of patients with SCAP treated with ceftaroline in two hospitals in Spain and Italy. The primary objective was to describe 30-day mortality after diagnosis of SCAP. RESULTS During study period we observed 89 cases of SCAP treated with ceftaroline, used in combination with other antibiotics in 53 cases (60%). Overall, 30-day mortality and clinical failure were 20% (18/89) and 36% (32/89), respectively. Independent predictors of 30-day mortality were increasing age (odds ratio [OR] for one year increase 1.0, 95% confidence intervals 1.0-1.1, P 0.043), presence of solid neoplasm (OR 4.0, 95% CI 1.0-15.1, P 0.044), and concomitant therapy with oseltamivir (OR 8.5, 95% CI 1.2-57.3, P 0.029). The only independent predictor of clinical failure was the time elapsing from SCAP diagnosis to ceftaroline therapy (OR for each passing day 1.5, 95% CI 1.1-1.9, P 0.003). The clinical success rate was 64% (57/89). In the subgroups of patients with proven S. pneumoniae, methicillin-susceptible Staphylococcus aureus, and methicillin-resistant S. aureus (MRSA) infection, clinical success was 83% (10/12), 75% (3/4), and 56% (5/9), respectively. CONCLUSIONS Considering its spectrum of activity, ceftaroline could represent an important therapeutic option for SCAP. Further studies are needed to delineate the precise clinical success rate against MRSA in a larger cohort of patients with SCAP.