ceftaroline revised 5

Efficacy of Ceftaroline Fosamil in a Patient with Community-acquired Pneumonia
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Abstract
There is huge interest in research for pneumonia treatment regimens. The microorganisms that cause the disease evolve rapidly and therefore the risk of drug resistance is very high. There is, therefore, a continuous need for the generation of newer treatments. Ceftaroline fosamil has emerged as a promising drug in this field. It is a fifth-generation cephalosporin that is usually reserved for patients with a very high risk of drug-resistant strains of pneumonia-causing microorganisms. Ceftaroline has the same mechanism of action as other β-lactams. It binds itself to penicillin-binding protein (PBP). Ceftaroline is able to act on more bacilli that other β-lactams because it has an ethoxyimino which imitates the bacterial cell wall. Results showed a difference of 10% at 95% confidence interval. When the results were controlled for patients with S. pneumoniae, the difference was even more drastic at the end of four days. The research concludes that ceftaroline is effective in treating community-acquired pneumonia with results amplified under various conditions.
Introduction
Pneumonia has been investigated intensively since the 19th century. This is a result of the magnitude of fatalities that result from the disease. Despite all the research applied towards prevention, management, and treatment of the disease, it continues to be a leading cause of mortalities, especially in the developing countries.

About 3.5 million people die annually from pneumonia-related complications [1]. Community-acquired Pneumonia (CAP) refers to a complication of the lungs that occurs in patients who have not been hospitalized in the recent past and who have not had regular interactions with a healthcare facility. Before the development of antibiotics, more than 95% of community-acquired pneumonia cases were attributed to Streptococcus pneumoniae [1]. Currently, only about 10-15% of the pneumonia infections are attributed to Streptococcus pneumoniae [1]. The reduction in the percentage of the disease that originates from these microbes can be attributed to the administration of pneumococcal polysaccharide vaccine and pneumococcal conjugate vaccine in adults and children respectively [2]. Other cases of pneumonia are caused by gram-negative bacteria such as Pseudomonas aeruginosa, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. Smoking is also a leading cause of pneumonia with COPD being a risk factor especially for attacks resulting from Mor. catarrhalis and H. Influenza [2]. When there is an influenza outbreak, the prevalent virus becomes the leading cause of community-acquired pneumonia. This paper discusses a patient who is admitted with symptoms that are similar to those of community-acquired pneumonia and are treated with Ceftaroline fosamil.
Case
A 63-year-old man with a four-month medical history of a chronic cough and dyspnea was admitted to the Emergency Unit. He complained about a high fever, extreme chest discomfort with recumbency and a persistent productive cough with yellow-green sputum and spots of blood.
In a primary investigation, audible crackles could be heard from both lungs. A chest x-ray was carried out and it revealed pleurisy at the bottom of the right lung.
The patient was thus moved to the infectious diseases unit for further investigation and the following vital measurements were recorded. The temperature was 39 °C (102F), heart rate at 118 beats per minute, and a 148/90 mmHg blood pressure. His white blood cells count was 4000 per cubic milliliter. The concentration of sodium in his serum was 135 mmol per liter, and the level of blood urea was at 8.5 mmol per liter. The levels of normal hemoglobin and platelets were within the range of a normal person.
The patient had a respiratory rate of 27 breaths per minute and at ambient air, his oxygen saturation was 90%. Upon investigation of blood gas parameters, the following levels were recorded: pH 7.35, PCO2 and PO2 values were 48 and 77 respectively.
A quantitative culture of bronchoscopic species was carried out a blood culture showed the presence of S. pneumoniae and various strains of gram-negative bacilli. The lab results were persistent with those of a patient with community-acquired pneumonia.
The physician administered a dose of Ceftaroline fosamil at 600mg dosage twice a day. The administration was done intravenously at an interval of 12 hours for the next seven days. The samples to be used for the analysis were collected on the fourth and seven days to investigate the results. The fourth day test results showed remarkable improvement, and most of the symptoms associated with community-acquired pneumonia were gone. By the time the results for the 7th day samples were analyzed, all the symptoms were gone, and there were no strains of the disease causing microorganisms in the patient’s serum. A post-test at the end of 15 days showed no sign of either the S. pneumoniae or gram-negative bacilli noticed earlier The patient had neither been hospitalized in the recent past not taken any antibiotics for a significant duration.
The image above shows evidence pf areas of consolidation on the upper right lobe which are indicatinve of pneumonia.
Discussion
Ceftaroline fosamil is registered with the food and drugs association (FDA) as a legitimate drug aministered to treat community-acquired pneumonia in adults [3]. It is a fifth-generation cephalosporin that is usually reserved for patients with a very high risk of drug-resistant strains of pneumonia-causing microorganisms. Ceftaroline has the same mechanism of action as other β-lactams. It binds itself to penicillin-binding protein (PBP). This is an enzyme that mediates a transpeptidation and peptidoglycan cross-linking. This is the terminal step towards the formation of the bacterial cell wall. Ceftaroline is able to act on more bacilli that other β-lactams because it has an ethoxyimino. This is a side-chain which mimics the cell wall and therefore allows the drug to access the PBP2a active site. The drug is not effective in treating infections caused by anaerobes [4]. Ceftaroline fosamil treats community-acquired pneumonia that results from both gram positive and gram negative microbes. Ceftaroline was at least equally effective as other drugs that were already used to treat community-acquired pneumonia [5]. It is sanctioned for use in medication of skin infections and community-acquired pneumonia [6].
Ceftaroline fosamil is among the most effective means of treating community-acquired pneumonia [7]. The results of an investigation to find out the efficacy of various drugs in curing pneumonia showed that ceftaroline was much more effective when compared to ceftriaxone with a risk ratio of 1.11 at a 95% confidence interval [8].
600mg dosed administered intravenously at an interval of 12 hours is the most effective dosage for the elimination of S. pneumoniae species [9]. Tests of cure (TOC) showed an 84.3% success in patients who received the ceftaroline treatment. This is significantly higher than the 77% record for those patients who received a ceftriaxone dose. When the treatment specifically targeted S. pneumoniae, the results of ceftaroline were 85.7% test of cure success while that of ceftriaxone was 69.5%. Obviously, the difference is even wider. This means that ceftaroline is more effective in treating S. pneumoniae infections which causes the majority of community-acquired pneumonia. This furthers the argument that ceftaroline is the best treatment for community-acquired pneumonia. A test to investigate the change observed in the patient at four days. This was essential because you did not have to wait for the entire dosing period to observe the results [10]. Results showed a difference of 10% at 95% confidence interval [3]. When the results were controlled for patients with S. pneumoniae, the difference was even more drastic at the end of four days. The ceftaroline cure had a success of 73%, and the ceftriaxone cure had 56% [3]. For patients with MSSA, the results were 58.3% for ceftaroline against 54.8% for ceftriaxone treatment [3].
The table below presents the results ceftaroline v ceftriaxone tests.

[11]
The results support the argument for the efficacy of ceftaroline in the treatment of community-acquired pneumonia. The difference between the results of the treatments reduces the progression of the infection. This implies that ceftaroline is more effective when the diagnoses are made early. When properly diagnosed, demonstrate that ceftaroline is more effective than all the other treatments regardless of age, sex, previous antibiotic use and Pneumonia Patient Outcomes Research Team (PORT) risk level [12].
According to these results, it is evident that ceftaroline has a higher efficacy when treating community-acquired pneumonia. This is especially the case for S. pneumoniae strains which are the most prevalent. Even more encouraging is the performance of the drug on a four-day test. Due to the fast response of a ceftaroline treatment, patients can be discharged earlier. This is not only important for patient’s but also for healthcare systems. Earlier discharge frees up resources for other patients and saves the health care systems millions of dollars.
Conclusion
This research continues to support the evidence that ceftaroline fosamil is an effective treatment for community-acquired pneumonia. Pneumonia is often regarded as the forgotten killer. 3.5milliom people of whom 50000 are Americans still die from pneumonia-related complications every year. This has prompted new research on the viability of the available cures for the disease. Ceftaroline is one of the most recent cures and is so far the most promising. The treatment regimen is especially effective when treating pneumonia resulting from an S. pneumoniae infection. It is also effective on other gram-negative bacilli strains. This regimen is especially effective when the diagnosis occurs earlier in the disease’s development stage. It has a faster response mechanism which means that patients can be discharged faster. The recommended dosage for the drug is 600mg administered intravenously at an interval of 12 hours for seven days.
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