Ceftaroline

INTRODUCTION

Indications

Treatment of acute bacterial skin/skin structure infections and community-acquired pneumonia.

Action

Binds to bacterial cell wall membrane, causing cell death. Therapeutic Effects: Bactericidal action against susceptible bacteria. Spectrum: Treatment of skin/skin structure infections—Active against Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant strains), Streptococcus pyogenes, Str. agalactiae, Escherichia coli, Klebsiella pneumoniae, and K. oxytoca; Treatment of community-acquired pneumonia—Str. pneumoniae (including pneumonia with bacteremia), S. aureus (methicillin-susceptible strains only), Haemophilus influenzae, K. pneumoniae, K. oxytoca, and Escherichia coli.

Adverse Reactions/Side Effects

GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, nausea. Derm: rash. Hemat: hemolytic anemia. Local: phlebitis at injection site. Misc: HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor signs of pseudomembranous colitis, including diarrhea, abdominal pain, fever, pus or mucus in stools, and other severe or prolonged GI problems (nausea, vomiting, heartburn). Notify physician or nursing staff immediately of these signs.

• Monitor signs of hypersensitivity reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

• Monitor signs of hemolytic anemia, including unusual fatigue, shortness of breath, dizziness, headache, coldness in your hands and feet, pale skin, and chest pain. Notify physician or nursing staff immediately if these signs occur.

• Monitor IV injection-site for pain, swelling, and inflammation (phlebitis). Report prolonged or excessive injection-site reactions to the physician.

Interventions

• Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Employ universal precautions or isolation procedures as indicated for specific patients.

Patient/Client-Related Instruction

• Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged skin rash or GI problems (nausea, diarrhea).

Pharmacokinetics

Absorption: IV administration results in complete bioavailability of parent drug.

Distribution: Unknown.

Metabolism and Excretion: Ceftaroline fosamil is rapidly converted by plasma phosphatases to ceftaroline, the active metabolite; 88% excreted in urine, 6% in feces.

Half-life: 2.6 hr (after multiple doses)

Contraindications/Precautions

Contraindicated in: Known serious hypersensitivity to cephalosporins.

Use Cautiously in: Known hypersensitivity to other beta-lactams; Renal impairment (dosage reduction required for CCr ≤50 mL/min); Geri: dose adjustment may be necessary for age-related ↓ in renal function; OB: Use in pregnancy ...