S. aureus was the most common pathogen identified in clinical trials of ceftobiprole; approximately one-third of these were methicillin resistant. Gram-negative pathogens are also well represented, with E. coli (10.7%) and P. aeruginosa (6.6%) being the second and third most common pathogens when diabetic foot infections were included. That being said, ceftobiprole monotherapy is appropriate in polymicrobial cSSSIs, along with indications in which combination therapy traditionally has been used. Due to resistance concerns, vancomycin or linezolid may be more appropriate for suspected or documented gram-positive infections. Patients with more serious cSSSIs and those with renal dysfunction were excluded from clinical trials; therefore, other agents should be used in these patients until more data are available. Dosing regimens may be confusing and may complicate administration with other intravenous medications. A 2-hour infusion of ceftobiprole 500mg every 8 hours is mostly bactericidal against susceptible gram-positive pathogens and bacteriostatic against susceptible gram-negative isolates. This dosing regimen should be used in empiric therapy, although alternative dosing schemes need to be explored.
Ceftobiprole is a broad-spectrum addition to our antimicrobial arsenal that is unique in its activity against MRSA and VRSA and is well tolerated. However, resistance induction in gram-negative pathogens and a complicated dosing regimen may limit ceftobiprole's use to empiric therapy in cSSSIs including diabetic foot infections and combination therapy for the treatment of nosocomial pneumonia.
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The Annals of Pharmacotherapy. 2008;42(6):806-816. © 2008 Harvey Whitney Books Company
Cite this: Ceftobiprole: An Extended-Spectrum Anti–Methicillin-Resistant Staphylococcus aureus Cephalosporin - Medscape - Jun 01, 2008.