Abstract
<jats:p>In Vitro assessment of Ceftaroline against Methicillin-Resistant Staphylococcus aureus (MRSA) isolates Background Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a significant global public health concern due to its resistance to conventional β-lactam antibiotics and the rising prevalence of multidrug-resistant strains. Ceftaroline, a fifth-generation cephalosporin with a strong affinity for Penicillin-Binding Protein 2a (PBP2a), has emerged as a promising therapeutic option. However, regional data on Ceftaroline susceptibility are still limited against MRSA. Therefore, this study was conducted to evaluate in-vitro activity of Ceftaroline on MRSA isolates and to compare its efficacy with commonly used anti-MRSA agents like vancomycin and linezolid. Methods A retrospective cross-sectional study was conducted at at a tertiary-care hospital in Pakistan, from January 2023 to December 2024. Clinical specimens that yielded MRSA isolates were cultured on standard media and identified using standard phenotypic methods (Gram stain, catalase, coagulase, and DNase tests). Antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method. For Vancomycin and Teicoplanin, Minimal-inhibitory concentrations (MIC) testing were performed on VITEK® 2 Compact, in accordance with the CLSI standards. The antibiotics tested included Ceftaroline, Vancomycin, Teicoplanin, Linezolid, Doxycycline, Ciprofloxacin, Erythromycin, Clindamycin, And Cotrimoxazole. Additionally, pre- and post-culture antibiotic prescribing patterns were analyzed. Results A total of 363 MRSA isolates were analyzed. Overall, the highest susceptibility rates were observed with linezolid (100%), doxycycline (100%), vancomycin (100%), and teicoplanin (97.2%). Ceftaroline also showed a susceptibility of 100%, with none displaying complete resistance. Resistance rates were notably high for erythromycin (71.1%) and ciprofloxacin (60.4%). After the culture results, there was a significant decrease in the use of broad-spectrum β-lactams, while the use of aminoglycosides and tetracyclines increased. Conclusions Ceftaroline showed strong in vitro effectiveness against MRSA isolates, similar to vancomycin and linezolid. In addition to its promising in vitro activity, Ceftaroline could offer a favorable safety profile compared to traditional anti-MRSA agents. Vancomycin is associated with nephrotoxicity and requires therapeutic drug monitoring, while linezolid has been linked to hematological toxicity, particularly thrombocytopenia with prolonged use. The significant resistance profile of frequently used antibiotics such as erythromycin and ciprofloxacin highlight the importance of ongoing antimicrobial stewardship and continuous regional monitoring.</jats:p>