Infectious Disease Compendium

Ceftaroline (Teflaro)

Dosing

CrCl Formula

CrCl > 50: 600 mg iv q 12 h.

CrCl 50-30: 400 mg 12 h.

CrCl 15-30: 300 mg ivq 12 h.

CrCl < 10: 200 mg q 12 h.

Hemodialysis: 200 mg q 12 h.

Peritoneal dialysis:

Important side effects

Direct Coombs’ test seroconversion. If anemia develops during or after therapy, do an evaluation for drug-induced hemolytic anemia. Eosinophilic pneumonia (PubMed).

Neutropenia and Agranulocytosis, especially long term, high dose with clindamycin (PubMed).

Important drug interactions

Rants and Screeds

Pearls

Treatment of choice

What makes this class of cephlosporin unique is that it is active against MRSA. Given that all the current MRSA drugs stink on ice, it is good to have an anti-MRSA beta-lactam.

Use for

Anything you would use a third generation cephalosporin for.

Approved for community-acquired bacterial Pneumonia (CABP) and complicated skin and skin structure infections.

Don't use for

Not active against β-lactamase–producing, AMP C –derepressed Enterobacteriaceae or most nonfermentative gram-negative rods, including P. aerugenosa. Enterococcus is sensitive in test tubes, but no clinical trials and cephlosporins have a long history of not working for enterococcus. Oh, yeah, anaerobes not so good either.

Class

Fifth generation cephalosporin.