Title:
Confronting the Therapeutic Challenge of Severe Neutropenia and Extensive Desquamation from Ceftaroline

Authors:
Nidha Shapoo MD*, FNU Ziauddin MD, Noella Boma MD, USA

Abstract:

Ceftaroline is a new-generation cephalosporin used for methicillin-resistant and vancomycin-resistant Staphylococcus aureus (MRSA and VRSA) with a favorable safety profile. Recent studies have shown an increased incidence of neutropenia and rash with ceftaroline, especially when used at a higher dose and for a longer duration. However, concurrent severe neutropenia and extensive desquamation have been rarely described. Herein, we report a 65-year-old male who was treated with a combination of ceftaroline and daptomycin for MRSA bacteremia, osteomyelitis, and endocarditis. The patient developed severe neutropenia with an absolute neutrophil count of four and extensive desquamation involving more than 50% of the body surface area after more than three weeks of ceftaroline use. The patient required discontinuation of ceftaroline, and four doses of filgrastim were given for neutrophil recovery. The desquamation was treated with topical corticosteroids. This case highlights a challenge in treating patients with underlying serious infections complicated by the serious adverse effects of a drug. Early vigilance and careful monitoring are required in patients on long-term ceftaroline to reduce the associated morbidity and mortality.

DOI: http://dx.doi.org/10.51505/ijmshr.2025.9101