Intravenous Ceftaroline in Extremely Premature Neonates With Coagulase-Negative Staphylococci Septicemia: A Report of 2 Cases

Sepsis is one of the primary causes of newborn morbidity and mortality, particularly in preterm infants, and coagulase-negative staphylococci (CoNS) is a major cause of bacterial infections in the neonatal intensive care unit (NICU). The treatment of late-onset neonatal staphylococcal sepsis is challenging owing to increased minimum inhibitory concentrations and the potential side effects of vancomycin. Herein, we describe 2 cases of extremely preterm newborns treated with intravenous (IV) ceftaroline (6 mg/kg/dose every 8 hours) for late-onset neonatal staphylococcal sepsis. Both cases were diagnosed with bacteremia and treated with ceftaroline. However, one of the patients died, most likely from sepsis or other factors, including chronic lung illness and prematurity, despite sterile blood cultures after starting the ceftaroline treatment. Large-scale randomized studies are required to examine the optimal dosing, safety, and effectiveness of IV ceftaroline for sepsis caused by CoNS in neonates.