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Ceftaroline Fosamil (CPT-F) for the Treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) in Obese Patients

Abstract

Background.  Obesity rates are increasing in the US and the treatment of ABSSSI in these patients is often challenging. CPT-F is approved for the treatment of ABSSSI and community-acquired bacterial pneumonia in the US, and for similar indications in the EU. CAPTURE is a multicenter retrospective study evaluating patients (pts) treated with CPT-F in the US. Data on the treatment of obese pts with CPT-F for ABSSSI are presented. Methods.  Data were collected at participating centers by randomly ordered chart review between September 2011 and February 2014 which included demographics, disease characteristics, antibiotic use, pathogens, location of care, and clinical response. Obesity was defined as a body mass index ≥ 30 kg/m2. Pts with a clinical outcome determined were evaluable. Results.  Of evaluable pts treated for ABSSSI, 883/1735 (51%) were obese. The mean age was 58.5 years (SD ± 15.8), 49% were male, 53% had diabetes and 39% were morbidly obese (BMI ≥ 40 kg/m2). Infection types included deep/extensive cellulitis (67%), major abscesses (15%), and infected ulcers (13%). The most common infection sites were the leg/thigh (59%) and foot (24%). Most pts, 807 (91%), were treated in a general hospital ward. Pathogens were recovered in 47% of pts, most commonly MRSA (20%) and MSSA (11%). MRSA and MSSA were isolated mainly from the ABSSSI site (> 96%), also from blood (< 9%) or both ABSSSI and blood (< 7%). Other antibiotics were used prior to CPT-F therapy in 80% of pts, most commonly vancomycin (53%) and piperacillin-tazobactam (24%). Concurrent antibiotics were used in 33% of pts, most commonly clindamycin (19%) and vancomycin (13%). The mean duration of CPT-F therapy was 5.8 days (SD ± 4.2). Clinical success was 91% in obese pts overall, and 90% in the morbidly obese. In pts with diabetes, clinical success was 89%. Clinical success for CPT-F monotherapy was 92% and for concurrent therapy, was 89%. In patients with MRSA and MSSA, clinical success rates were 88% and 93%, respectively. Conclusion.  In obese pts, clinical success with CPT-F therapy was high, including pts with diabetes. These data support the use of CPT-F as a treatment option for ABSSSI in pts with obesity, including those with diabetes. Disclosures.   K. Kaye, Forest Laboratories, Inc.: Consultant, Grant Investigator and Speaker's Bureau, Consulting fee, Grant recipient and Speaker honorarium D. Guervil, Forest Laboratories, Inc.: Investigator, Research support A. Ramani, Forest Laboratories, Inc.: Investigator and Speaker's Bureau, Research support and Speaker honorarium A. Jandourek, Cerexa, Inc.: Employee, Salary H. D. Friedland, Forest Laboratories, Inc.: Employee and Shareholder, Salary