Impact on in-hospital mortality of ceftaroline versus standard of care in community-acquired pneumonia: a propensity-matched analysis

Eur J Clin Microbiol Infect Dis. 2022 Feb;41(2):271-279. doi: 10.1007/s10096-021-04378-0. Epub 2021 Nov 12.

Abstract

The purpose of this study is to evaluate the in-hospital mortality of community-acquired pneumonia (CAP) treated with ceftaroline in comparison with standard therapy. This was a retrospective observational study in two centers. Hospitalized patients with CAP were grouped according to the empiric regimen (ceftaroline versus standard therapy) and analyzed using a propensity score matching (PSM) method to reduce confounding factors. Out of the 6981 patients enrolled, 5640 met the inclusion criteria, and 89 of these received ceftaroline. After PSM, 78 patients were considered in the ceftaroline group (cases) and 78 in the standard group (controls). Ceftaroline was mainly prescribed in cases with severe pneumonia (67% vs. 56%, p = 0.215) with high suspicion of Staphylococcus aureus infection (9% vs. 0%, p = 0.026). Cases had a longer length of hospital stay (13 days vs. 10 days, p = 0.007), while an increased risk of in-hospital mortality was observed in the control group compared to the case group (13% vs. 21%, HR 0.41; 95% CI 0.18 to 0.62, p = 0.003). The empiric use of ceftaroline in hospitalized patients with severe CAP was associated with a decreased risk of in-hospital mortality.

Keywords: Antimicrobials; Ceftaroline; Community-acquired pneumonia; Pneumonia; Severe pneumonia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Ceftaroline
  • Cephalosporins / therapeutic use*
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality*
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Standard of Care*
  • Staphylococcal Infections / drug therapy

Substances

  • Anti-Bacterial Agents
  • Cephalosporins