학술논문
FOCUS 1: a randomized, double-blinded, multicentre, Phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia
Document Type
Academic Journal
Author
File, Thomas M., Jr; Low, Donald E.; Eckburg, Paul B.; Talbot, George H.; Friedland, H. David; Lee, Jon; Llorens, Lily; Critchley, Ian A.; Thye, Dirk A.; Pullman, John; Giordano, Philip; Welker, James; Manos, Paul; Mehra, Purvi; File, Thomas, Jr; De Santo, Joseph; Venkateswaralu, Bhaskar; Gerald Schrock, Christian; Tillis, William; Winetz, Jan Alan; Gonzalez, J. Mario; Ramage, Anthony; Eisenhower, Dwight D.; Koegelenberg, Coenie; Engelbrecht, Ingrid; Jurgens, Jaco; Mitha, Ishmail; Breedt, Johannes; Gani, Mashra; Roos, Johannes; Basson, Matthys; Van Zyl, Louis; Meeding, Ronel; Fulat, Muhammed; Le Roux, Marius; Bonvehi, Pablo Eduardo; Ganaha, Maria Cristina; Gurini, Ana Leticia; Daniel Lopardo, Gustavo; Cristina, Lucia; Edwardo Prieto, Sergio; Rodiguez, Claudia Gabriela; Augusto Teijeiro, Ricardo; Carmen Pallone, Elida; Pryluka, Daniel Horacio; da Cunha, Clovis Arns; da Silva, Nilton Brandao; de Faria Freire, Antonio Tarcisio; Ferreira Starling, Carlos Ernesto; Costa Fiterman, Jussara; Góngora Rubio, Fernando; Carlos Losso, Luis; Patelli, Maria; Souza Lima, Juliani; Zimermann Teixeira, Paulo José; Carmo Moreira, Maria Auxiliadora; Abreu de Oliveira, Julio César; Roudas, Vsevolod; Gamal, Evgeny A.; Leschenko, Igor; Rudnov, Vladimir A.; Yevdokimova, Anna G.; Vertkin, Arkadiy L.; Ambalov, Yuriy M.; Dvoryashina, Irina V.; Zilber, Elmira; Khamitov, Rustem F.; Galustyan, Anna N.; Reshetko, Olga V.; Senior, Victoria Arama; Grosan, Mihaela Flavia; Jimborean, Gabriela; Lupse, Mihaela; Aron, Gheorgita; Olteanu, Dan; Puschita, Maria; Gavris, Claudia; Tudorache, Voicu Mircea; Youroukova, Vania; Petkova, Mila; Troshanova, Evelina; Dzhabalyan, Mari; Kavtaradze, George; Makhviladze, Manana; Tabukashvili, Revaz; Pons, Marco; Garbino, Jorge; Genne, Daniel; Rothen, Madeleine; de Saracho, Juan Oriz; Capelastegui, Alberto; Menendez, Rosario; Torres, Antoni; Shum, Conrado; Falco, Vincenç; Bouza, Emilio; Bru, Jean-Pierre; Misset, Benoit; Megarbane, Bruno; Sollet, Jean Pierre; Molina, Jean-Michel; Dalhoff, Klaus; Lorenz, Joachim; Petermann, Wolfgang; Rohde, Gernot; Schumann, Christian; Tasci, Selcuk; Zerbst, Joachim; Auch-Schwelk, Wolfgang; Suttorp, Norbert; Henrich, Rolf; Fertl, Andreas; Grohe, Christian; Jakobeit, Christian; Deppermann, Karl-Matthius; Batura-Gabryel, Halina; Pupek-Musialik, Danuta; Piotrowicz, Pawe; Marcisz, Czeslaw; Czarnobilski, Krzysztof; Jankowska, Renata; Janik, Krzysztof; Gutowska-Jablonska, Malgorzata; Hamankiewicz, Maciej; Kus, Jan; Rydzewski, Andrzej; Dulawa, Jan; Ziolko, Ewa; Baranska, Eliza; Wendland, Marian; Trebas-Pietras, Ewa; Tyszkiewic, Ireneusz; Bonelli, Johannes; Balikó, Zoltán; Bisits, Márta; Losonczy, Gyorgy; Mark, Zsuzsa; Albert, Istvan; Francovszky, Eva; Fonay, Karoly; Tetiana Pertseva, Tetiana; Yefimov, Volodymyr; Havrysyuk, Volodymyr; Melnyk, Vasyl; Yashyna, Lyudmyla; Monogarova, Nadiya; Kolchyn, Yuriy; Dutka, Roman; Smolyanyi, Oleksandr; Tryshchuk, Nadiya; Kaydashev, Igor; Rodionova, Victoria; Neyko, Vasyl; Chopey, Ivan; Alekniene, Birute; Kramilius, Ginataras; Naudziunas, Stanislovas; Miliauskas, Skaidrius; Nausediene, Vitalija; Valavicius, Arvydas; Mitic-Milikic, Marija; Celeketic, Dusica; Lazic, Zorica; Milinic, Nikola; Pejcic, Tatjana; Sukles, Kai; Jaanus, Martti; Meriste, Sulev; Ahmad Mahayiddin, Datin Hjh Aziah; Bin Abdul Muttalif, Abdul Pazak; Kuang Kiat, Kiew; Binte, Roslina; Manap, Abdul; bt Tarekh, Noor Aliza; Anekthananon, Thanomsak; Mootsikapun, Piroon; Intalapaporn, Poj; Pothirat, Chaicharn; Horsin, Pinyo; Churchottaworn, Charoen; Wattanathum, Anan; Dukat, Andrej; Plutinsky, Jan
Source
Journal of Antimicrobial Chemotherapy. Apr 01, 2011 66(suppl_3 Suppl 3):iii19-iii32
Subject
Language
English
ISSN
0305-7453
Abstract
OBJECTIVES: Ceftaroline, the active form of the prodrug ceftaroline fosamil, is a novel cephalosporin with bactericidal activity against important pathogens associated with community-acquired pneumonia (CAP), including Streptococcus pneumoniae and common Gram-negative pathogens. FOCUS 1 is a randomized, double-blinded, Phase III study that was conducted to evaluate the efficacy and safety of ceftaroline fosamil in treating patients with CAP. The primary objective was to determine non-inferiority [lower limit of 95% confidence interval (CI) ≥ −10%] in clinical cure rates achieved with ceftaroline fosamil compared with those achieved with ceftriaxone in the clinically evaluable (CE) and modified intent-to-treat efficacy (MITTE) populations. METHODS: Patients hospitalized in a non-intensive care unit setting with CAP of Pneumonia Outcomes Research Team (PORT) risk class III or IV requiring intravenous (iv) therapy were randomized (1:1) to receive 600 mg of ceftaroline fosamil iv every 12 h or 1 g of ceftriaxone iv every 24 h. Patients also received two 500 mg doses of oral clarithromycin every 12 h administered on day 1. Clinical cure, microbiological response, adverse events (AEs) and laboratory tests were assessed. FOCUS 1 registration number NCT00621504 (http://clinicaltrials.gov/ct2/show/NCT00621504). RESULTS: Of 613 enrolled patients, 298 received ceftaroline fosamil and 308 received ceftriaxone. Baseline characteristics between treatment groups were comparable. Clinical cure rates were as follows: CE population, 86.6% (194/224) for ceftaroline fosamil and 78.2% (183/234) for ceftriaxone [difference (95% CI), 8.4% (1.4, 15.4)]; and MITTE population, 83.8% (244/291) for ceftaroline fosamil and 77.7% (233/300) for ceftriaxone [difference (95% CI), 6.2% (−0.2, 12.6)]. Clinical cure rates for CAP caused by S. pneumoniae in the microbiological MITTE population were 88.9% (24/27) and 66.7% (20/30) for ceftaroline fosamil and ceftriaxone, respectively. Both agents were well tolerated, with similar rates of AEs, serious AEs, deaths and discontinuations because of an AE. The most common AEs for ceftaroline fosamil-treated patients were diarrhoea, headache, insomnia and nausea, and the most common AEs for ceftriaxone-treated patients were hypokalaemia, hypertension, nausea and diarrhoea. CONCLUSIONS: Ceftaroline fosamil demonstrated high clinical cure and microbiological response rates in hospitalized patients with CAP of PORT risk class III or IV. Ceftaroline fosamil was well tolerated, with a safety profile similar to that of ceftriaxone and consistent with the cephalosporin class. In this study, ceftaroline fosamil was an effective and well-tolerated treatment option for CAP.