ceftaroline fosamil: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
ceftaroline fosamil: clinical details
Prescribing considerations
- Use microbiology, susceptibility results and local antimicrobial guidance; activity is unreliable against organisms producing ESBL, carbapenemase or AmpC enzymes.
- Clinical efficacy against MRSA is supported for complicated skin and soft-tissue infection, but MRSA community-acquired pneumonia was not studied.
- Assess previous beta-lactam hypersensitivity carefully.
- Renal function materially affects exposure and must inform prescribing; haemodialysis removes ceftaroline.
Contraindications and cautions
- Hypersensitivity to ceftaroline fosamil or an excipient.
- Hypersensitivity to cephalosporin antibacterials.
- Previous immediate, severe hypersensitivity to another beta-lactam, including a penicillin or carbapenem.
Monitoring
- Check renal function at baseline and during treatment when it may change.
- Review cultures, susceptibility and clinical response, including possible superinfection.
- Monitor for immediate hypersensitivity and severe skin reactions.
- Assess significant diarrhoea during or after treatment for Clostridioides difficile-associated disease.
- Investigate anaemia arising during or after treatment, including possible haemolysis.
- Consider ceftaroline-associated encephalopathy if neurological symptoms develop, particularly with renal impairment.
Clinical pharmacology
Ceftaroline fosamil is an intravenous prodrug rapidly converted by plasma phosphatases to ceftaroline. Ceftaroline is bactericidal through penicillin-binding protein binding. It has low protein binding, little CYP450 metabolism and predominantly renal elimination.
Formulation and product differences
- The UK product is a powder for concentrate for intravenous infusion and contains arginine as its listed excipient.
- It must be reconstituted with water for injections and diluted using a compatible infusion fluid under aseptic conditions.
- The vial is for single use and must not be mixed with other medicines except as specified in the product information.
ceftaroline fosamil preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 600 mg
ceftaroline fosamil interactions
Formal clinical interaction studies have not been performed, but interaction potential is expected to be low. The clinical team should review all prescribed, non-prescribed and herbal products.
CYP450 inhibitors, inducers or substrates
A clinically important metabolic interaction is considered unlikely because ceftaroline neither depends substantially on CYP450 metabolism nor inhibits or induces these enzymes in vitro.
Probenecid and medicines affecting OCT2, OAT1 or OAT3 transporters
A transporter-mediated interaction is not expected because ceftaroline is not a substrate or inhibitor of these renal uptake transporters in vitro.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.