In vitro studies demonstrate that ceftaroline is not a substrate for Selleck EPZ5676 the cytochrome P450 system and it does not inhibit or induce the major cytochrome P450 isoenzymes. Therefore, there is minimal potential for drug–drug interactions between ceftaroline and drugs that are cytochrome P450 substrates, inhibitors, or inducers [5]. Clinical Efficacy The FOCUS Trials The FOCUS (ceFtarOline Community-acquired pneUmonia trial vS ceftriaxone in hospitalized patients) 1 and 2 studies (NCT00621504 and NCT00509106, respectively) were multinational, multicenter, phase 3, double-masked, randomized, active comparator-controlled trials,

designed to evaluate the safety and efficacy of ceftaroline fosamil 600 mg IV every 12 h compared with ceftriaxone 1 g IV every 24 h for 5–7 days for the treatment of typical CABP in patients requiring hospital admission [12, 13, 44, 45]. Renal dose adjustments were based on creatinine clearance. For subjects enrolled in FOCUS 1 (which included North American check details participants), clarithromycin was administered during the first 24 h based on established practice guidelines advocating empiric macrolide use [46]. The primary objective of the studies

was to determine whether the clinical cure rate of ceftaroline fosamil was non-inferior to that of ceftriaxone in the co-primary modified intent-to-treat efficacy (MITTE) and clinically evaluable (CE) populations at the test-of-cure (TOC) visit (8–15 days after completion of therapy). The non-inferiority margin was set at −10%. The MITTE population included all participants in the pneumonia risk category (PORT) III or IV who received any amount of study drug according to their randomized treatment group. The CE selleck chemicals llc population included participants in the MITTE population who demonstrated sufficient adherence to the protocol. Baseline characteristics and demographics were comparable between the two study

arms and between the two studies. The majority of participants were Caucasian males over the age of 50 years recruited from Eastern and Western Europe. The most common pathogens isolated were S. pneumoniae (41.7%) and S. aureus (16.5%), followed by Gram-negative organisms, of which H. influenzae was the most frequent [44]. Clinical cure rates favored ceftaroline in a priori-defined integrated CB-839 chemical structure analysis of the MITTE and CE populations (Table 3) [12–15, 44, 47]. Planned secondary analysis of the CE subjects with at least one typical pathogen identified at baseline showed clinical cure in 85.1% of participants compared with 75.5% of participants in the ceftaroline and ceftriaxone groups, respectively [difference 9.7%, 95% confidence interval (CI) 0.7–18.8%] [44]. Cure rates against S. pneumoniae, MDRSP and S. aureus favored ceftaroline, and were similar to ceftriaxone for Gram-negative pathogens [44].