Abstract：
BACKGROUND: Managing health care acquired and device-associated intracranial infections in young children can be challenging given adverse antibiotic side effects and difficulties in achieving adequate central nervous system (CNS) antibiotic concentrations. Ceftaroline is a cephalosporin with a favorable safety profile and activity against methicillin-resistant Staphylococci and several Gram-negative organisms. Published data on the use of ceftaroline for CNS infections in children and adults are limited.
METHODS: We describe a 2-month-old infant with ventriculo-subgaleal shunt-associated methicillin-resistant Staphylococcus epidermidis ventriculitis, which was successfully treated with ceftaroline, in addition to vancomycin and rifampin. We conducted a scoping review of English-language literature retrieved from PubMed, EMBASE and Web of Science that assessed the use of ceftaroline for CNS infections.
RESULTS: We identified 22 articles for inclusion in our review, which described 92 unique patients, of whom 2 were <21 years old. Ceftaroline was commonly used in conjunction with other antibiotics to treat infections caused by Staphylococcus aureus , coagulase-negative Staphylococci and Streptococcus pneumoniae . Most case reports described clinical success with ceftaroline, though small case series and cohort studies yielded mixed efficacy assessments. Adverse effects attributed to ceftaroline were rare and included reversible myelosuppression, eosinophilia, hepatotoxicity and nephrotoxicity. Pharmacokinetic/pharmacodynamic studies suggested similar CNS penetration through inflamed meninges as other beta lactam antibiotics.
CONCLUSIONS: We identified a growing body of published evidence supporting the use of ceftaroline in combination with other agents for the treatment of CNS infections. In absence of clinical trials, additional real-world data are needed to define the efficacy and safety of ceftaroline for children and adults with CNS infections.
METHODS: We describe a 2-month-old infant with ventriculo-subgaleal shunt-associated methicillin-resistant Staphylococcus epidermidis ventriculitis, which was successfully treated with ceftaroline, in addition to vancomycin and rifampin. We conducted a scoping review of English-language literature retrieved from PubMed, EMBASE and Web of Science that assessed the use of ceftaroline for CNS infections.
RESULTS: We identified 22 articles for inclusion in our review, which described 92 unique patients, of whom 2 were <21 years old. Ceftaroline was commonly used in conjunction with other antibiotics to treat infections caused by Staphylococcus aureus , coagulase-negative Staphylococci and Streptococcus pneumoniae . Most case reports described clinical success with ceftaroline, though small case series and cohort studies yielded mixed efficacy assessments. Adverse effects attributed to ceftaroline were rare and included reversible myelosuppression, eosinophilia, hepatotoxicity and nephrotoxicity. Pharmacokinetic/pharmacodynamic studies suggested similar CNS penetration through inflamed meninges as other beta lactam antibiotics.
CONCLUSIONS: We identified a growing body of published evidence supporting the use of ceftaroline in combination with other agents for the treatment of CNS infections. In absence of clinical trials, additional real-world data are needed to define the efficacy and safety of ceftaroline for children and adults with CNS infections.
摘要：
背景：鉴于抗生素的不良副作用和难以达到足够的中枢神经系统（CNS）抗生素浓度，管理幼儿的医疗保健获得性和设备相关颅内感染可能具有挑战性。头孢洛林是一种头孢菌素，对耐甲氧西林葡萄球菌和几种革兰氏阴性生物体具有良好的安全性和活性。关于使用头孢洛林治疗儿童和成人中枢神经系统感染的公开数据有限。
方法：我们描述了一个2个月大的婴儿，患有脑室下分流相关的甲氧西林耐药表皮葡萄球菌脑室炎，用头孢洛林成功治疗，除了万古霉素和利福平。我们对从PubMed检索到的英语文献进行了范围审查，EMBASE和WebofScience评估头孢洛林用于中枢神经系统感染。
结果：我们确定了22篇文章纳入我们的综述，描述了92个独特的病人，其中2人<21岁。头孢洛林通常与其他抗生素一起用于治疗金黄色葡萄球菌引起的感染，凝固酶阴性葡萄球菌和肺炎链球菌。大多数病例报告描述了头孢洛林的临床成功，尽管小型病例系列和队列研究得出了混合的疗效评估。头孢洛林的不良反应很少见，包括可逆性骨髓抑制，嗜酸性粒细胞增多,肝毒性和肾毒性。药代动力学/药效学研究表明，与其他β内酰胺抗生素一样，中枢神经系统通过发炎的脑膜渗透相似。
结论：我们发现越来越多的公开证据支持使用头孢洛林与其他药物联合治疗中枢神经系统感染。在没有临床试验的情况下,需要更多的真实世界数据来确定头孢洛林对患有中枢神经系统感染的儿童和成人的疗效和安全性.
方法：我们描述了一个2个月大的婴儿，患有脑室下分流相关的甲氧西林耐药表皮葡萄球菌脑室炎，用头孢洛林成功治疗，除了万古霉素和利福平。我们对从PubMed检索到的英语文献进行了范围审查，EMBASE和WebofScience评估头孢洛林用于中枢神经系统感染。
结果：我们确定了22篇文章纳入我们的综述，描述了92个独特的病人，其中2人<21岁。头孢洛林通常与其他抗生素一起用于治疗金黄色葡萄球菌引起的感染，凝固酶阴性葡萄球菌和肺炎链球菌。大多数病例报告描述了头孢洛林的临床成功，尽管小型病例系列和队列研究得出了混合的疗效评估。头孢洛林的不良反应很少见，包括可逆性骨髓抑制，嗜酸性粒细胞增多,肝毒性和肾毒性。药代动力学/药效学研究表明，与其他β内酰胺抗生素一样，中枢神经系统通过发炎的脑膜渗透相似。
结论：我们发现越来越多的公开证据支持使用头孢洛林与其他药物联合治疗中枢神经系统感染。在没有临床试验的情况下,需要更多的真实世界数据来确定头孢洛林对患有中枢神经系统感染的儿童和成人的疗效和安全性.
