Does Rocephin (Ceftriaxone) have good coverage against Methicillin-Sensitive Staphylococcus aureus (MSSA)?

From the Guidelines

Yes, Rocephin (ceftriaxone) does provide good coverage against Methicillin-Sensitive Staphylococcus aureus (MSSA). According to the most recent and highest quality study available, which is the 2019 British Thoracic Society guideline for bronchiectasis in adults 1, ceftriaxone is listed as a recommended second-line treatment for Staphylococcus aureus (MSSA) infections. Ceftriaxone is a third-generation cephalosporin antibiotic that effectively targets MSSA infections with typical dosing of 1-2 grams intravenously once or twice daily, depending on the severity and site of infection.

Treatment duration typically ranges from 7-14 days for most infections, though complicated infections may require longer courses. While ceftriaxone works well against MSSA, it's essential to note that it does not cover Methicillin-Resistant Staphylococcus aureus (MRSA). The 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections also supports the use of ceftriaxone as an option for moderate to severe infections, including those caused by MSSA 1.

Some key points to consider when using ceftriaxone for MSSA infections include:

• Ceftriaxone's mechanism of action involves binding to penicillin-binding proteins to inhibit bacterial cell wall synthesis, which is effective against beta-lactamase-producing MSSA strains.
• For serious MSSA infections, clinicians sometimes prefer anti-staphylococcal penicillins like nafcillin or oxacillin due to their higher potency against MSSA, but ceftriaxone remains a reliable option, especially when broader coverage is needed or once-daily dosing is preferred for outpatient therapy.
• It is crucial to select the appropriate antibiotic regimen based on the severity of the infection, the suspected pathogens, and local resistance patterns.

In terms of specific dosing and treatment duration, ceftriaxone is typically administered at a dose of 1-2 grams intravenously every 12-24 hours, with treatment duration ranging from 7-14 days. However, the exact dosing and treatment duration may vary depending on the specific clinical scenario and the patient's individual needs.

Overall, ceftriaxone is a viable option for the treatment of MSSA infections, particularly in cases where broader coverage is needed or once-daily dosing is preferred. However, it is essential to consider the potential risks and benefits of ceftriaxone, as well as the specific clinical scenario and local resistance patterns, when selecting an antibiotic regimen.

From the FDA Drug Label

Ceftriaxone for Injection is indicated for the treatment of the following infections when caused by susceptible organisms: SKIN AND SKIN STRUCTURE INFECTIONS Caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Viridans group streptococci, Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Morganella morganii,1Pseudomonas aeruginosa, Serratia marcescens, Acinetobacter calcoaceticus, Bacteroides fragilis1or Peptostreptococcus species BACTERIAL SEPTICEMIA Caused by Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae or Klebsiella pneumoniae. BONE AND JOINT INFECTIONS Caused by Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae or Enterobacter species

Yes, Rocephin (Ceftriaxone) has good coverage against Methicillin-Sensitive Staphylococcus aureus (MSSA) as it is indicated for the treatment of infections caused by susceptible organisms, including Staphylococcus aureus. 2 2 2

From the Research

MSSA Coverage of Rocephin (Ceftriaxone)

• Rocephin (Ceftriaxone) has been studied as a potential treatment option for Methicillin-Sensitive Staphylococcus aureus (MSSA) infections, with some studies suggesting it may be an effective alternative to traditional therapies 3, 4, 5.
• A case series study found that ceftriaxone was effective in treating MSSA bacteremia, with clinical cure observed in 7 out of 15 patients and microbiological cure observed in all patients 3.
• A multicenter, retrospective study compared the safety and efficacy of ceftriaxone versus cefazolin for the treatment of MSSA bacteremia and found no difference in clinical cure rates between the two groups 4.
• A systematic review and meta-analysis found that ceftriaxone was associated with a lower risk of toxicity requiring therapy alteration compared to antistaphylococcal antibiotics, but found no difference in terms of 90-day all-cause mortality, hospital readmission, or infection recurrence 5.
• However, another study noted that current evidence does not support the use of once-daily treatment options, including ceftriaxone, for MSSA bacteremia, citing insufficient evidence to support their efficacy 6.

Key Findings

• Ceftriaxone may be considered a viable alternative for the treatment of MSSA infections, particularly in cases where traditional therapies are not feasible 3, 4, 5.
• The use of ceftriaxone for MSSA infections is supported by some studies, but more research is needed to fully establish its efficacy and safety compared to traditional therapies 4, 5.
• Ceftriaxone has been found to have a lower risk of toxicity requiring therapy alteration compared to antistaphylococcal antibiotics, which may make it a more attractive option for some patients 5.