Ceftaroline is the first fifth-generation cephalosporin that is used to treat the following conditions:

• Community-acquired bacterial pneumonia caused by:

  • Streptococcus pneumoniae,
  • Methicillin-susceptible Staphylococcus aureus
  • Haemophilus influenzae,
  • Klebsiella pneumoniae,
  • Klebsiella oxytoca, and
  • Escherichia coli.

• Skin and soft tissue infections caused by the following organisms:

  • methicillin-susceptible and methicillin-resistant isolates Staphylococcus aureus
  • Streptococcus pyogenes,
  • Streptococcus agalactiae,
  • Escherichia coli,
  • Klebsiella pneumoniae, and
  • Klebsiella oxytoca.

Ceftaroline Dose in Adults

Use of Ceftaroline for community acquired Pneumonia:

• 600 mg intravenously two times each day for five to seven days

Use of Ceftaroline for treatment of Skin and soft tissue infections:

• For 5 to 14 days, take 600 mg twice day.

Ceftaroline Dose in Children

Ceftaroline use for pulmonary exacerbations in Cystic fibrosis:

• Children older than 6 years and Adolescents:
  • 15 mg/kg/dose intravenous thrice daily to a maximum dose of 600 mg/dose.

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Use of Ceftaroline for the treatmnet of community-acquired Pneumonia:

• Infants older than 2 months and Children less than 2 years:
  • 8 mg/kg/dose intravenously three times per day for five to fourteen days
• Children older than 2 years and Adolescents less than 18 years of age:
  • less than 33 kgs:
    • 12 mg/kg/dose intravenously three times each day for five to fourteen days
  • more than 33 kgs:
    • 400 mg intravenous thrice daily or 600 mg twice daily for 5 to 14 days
• Adolescents older than 18 years:
  • 600 mg intravenously two times each day for five to seven days

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Use of Ceftaroline for the treatment of Skin and soft tissue infections:

• Infants older than 2 months and Children less than 2 years:
  • 8 mg/kg/dose intravenous thrice daily.
• Children older than 2 years and Adolescents less than 18 years:
  • less than 33 kg:
    • 12 mg/kg/dose intravenous thrice daily
  • more than 33 kgs:
    • 400 mg intravenous thrice daily or 600 mg twice daily
• Adolescents older than 18 years of age:
  • 600 mg intravenous twice daily

Pregnancy Risk Factor B

• Some animal studies have shown adverse effects, including skeletal deformities.
• Ceftaroline use duringBreastfeeding:
• It is unknown if ceftaroline can be found in breastmilk. Lactating mothers should avoid it.

Ceftaroline Dose in Renal Disease:

Ceftaroline dose in patients with kidney disease:

• CrCl of more than 50 mL/minute:  Dose adjustment not required.
• CrCl of 30 to 50 mL/minute: 400 mg every twice daily
• CrCl 15 to 30 mL/minute: 300 mg every twice daily
• CrCl less than 15 mL/minute: 200 mg every twice daily
• ESRD patients receiving hemodialysis: 200 mg twice daily. The dose should be given after hemodialysis.

Ceftaroline Dose in Liver Disease:

The manufacturer has not recommended any dose adjustment in patients with liver disease. 

Common Side Effects of Ceftaroline include:

• Hematologic & oncologic:
  • Positive direct Coombs test

Less Common Side Effects of Ceftaroline include:

• Cardiovascular:
  • Bradycardia
  • Palpitations
  • Phlebitis
• Central nervous system:
  • Insomnia
  • Headache
  • Dizziness
  • Seizure
• Dermatologic:
  • Skin rash
  • Puritus
  • Urticaria
• Endocrine & metabolic:
  • Hypokalemia
  • Hyperglycemia
  • Hyperkalemia
• Gastrointestinal:
  • Diarrhea
  • Vomiting
  • Nausea
  • Constipation
  • Abdominal pain
  • Pseudomembranous colitis
• Hematologic & oncologic:
  • Anemia
  • Eosinophilia
  • Neutropenia
  • Thrombocytopenia
• Hepatic:
  • Increased serum transaminases including ALT and AST
  • Hepatitis
• Hypersensitivity:
  • Anaphylaxis
  • Hypersensitivity
• Renal:
  • Renal failure
• Miscellaneous:
  • Fever

Contraindications to Ceftaroline include:

• Allergy/ Anaphylactic reactions to ceftaroline or other cephalosporins or any component of the formulations

Warnings and Precautions

• Hemolytic anemia
  • Coombs Positive has been associated with autoimmune hemolytic anemia. It is important to stop using this therapy.
• Hypersensitivity
  • Patients who are allergic to penicillins, cephalosporins, penicillins, or carbapenems should not use it.
  • If severe allergic reactions are observed, therapy should be stopped.
• Superinfection
  • Ceftaroline treatment for longer periods (over 2 months) can lead to superinfections, including fungal or bacterial superinfections. C. difficile-associated diarrhea, (CDAD), and pseudomembranous collitis can occur.
• Renal impairment
  • Patients with a CrCl lower than 50 ml/min should not use the drug. The dose should be adjusted.

Ceftaroline: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring Parameters:

• Renal functions
• Clincal indicators of anaphylaxis and allergic reactions
• Prior to administering the drug, obtain appropriate cultures.

How to Administer Ceftaroline?

Give the medication intravenously during a 5- to 1-hour period in a gradual infusion.

Mecahnism of action of Ceftaroline:

• A fifth-generation cephalosporin called ceftaroline prevents the construction of bacterial cell walls by attaching to penicillin-binding proteins (PBPs), which causes autolytic enzymes to destroy the bacteria.
• Because of its strong affinity to PBP2a (a modified PBP found in MRSA) and PBP2x, it covers resistant Strep.pneumoniae.

Proteins bind 20% of the medication.

Initial activation of the inactive prodrug in plasma is followed by hydrolysis to create inactive metabolites. The Half-life eliminationThe time taken to complete a task can vary from 1.6 hours to 2.6 hours. TheTime to reach peak plasma concentrationIt takes one hour. It isexcretedIt is mainly found in the urine.  

International Brands of Ceftaroline:

• Xafromil
• Zinforo
• Teflaro

Ceftaroline Brands in Pakistan:

No brands available in Pakistan   

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