Community-acquired pneumonia remains among the main causes of hospitalization and infant morbidity and mortality. The increase in resistance of Streptococcus pneumoniae and Staphylococcus aureus, including methicillin-resistant strains (MRSA), to conventional antimicrobials represents a growing clinical challenge. Ceftaroline fosamil, a fifth-generation cephalosporin with effective action against resistant Gram-positive pathogens, has been considered a promising alternative in the management of severe respiratory infections in pediatrics. This study aimed to evaluate the clinical efficacy and safety profile of ceftaroline in pediatric patients hospitalized with pneumonia.

Retrospective observational study conducted in a private tertiary hospital in Recife-PE, between January 2023 and December 2024. Patients between 2 months and 17 years with a diagnosis of community-acquired pneumonia (CAP) or complicated pneumonia who received ceftaroline as part of antibiotic treatment were included. Clinical data were obtained from electronic medical records, and outcomes assessed included: clinical response at the end of treatment, need to change the antibiotic regimen, and related adverse events. Statistical analysis was descriptive, with assessment of associations between clinical variables and therapeutic success.

34 children were included, with a mean age of 5.3 years, 67% over 4 years old. Ceftaroline was used in 100% of cases due to failure of initial empirical therapy. About 11% of patients had comorbidities or an admission diagnosis other than pneumonia. Clinical response was observed in 83% of cases, with resolution of fever and respiratory symptoms on average after 3.9 days of treatment. Switch to oral therapy was possible in 22.2% of patients, and 77.7% did not require antibiotic escalation. No serious adverse events were recorded. One death was reported in a patient admitted in septic shock, with unfavorable evolution in less than 72 hours.

Ceftaroline showed a favorable efficacy and safety profile in the treatment of severe pneumonia in children, especially in the failure of conventional empirical regimens and in suspected resistant pathogens. The findings support its use as a relevant therapeutic option in the pediatric hospital setting, highlighting the need for prospective studies for incorporation into clinical protocols.