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Ceftobiprole: A New Cephalosporin for MRSA Infection

Ceftobiprole had clinical cure rates similar to vancomycin plus ceftazidime for skin and skin-structure infections due to gram-negative and gram-positive organisms, including methicillin-resistant Staphylococcus aureus.

Dealing with complicated skin and skin-structure infections has become more challenging because of the emergence of antibiotic-resistant bacterial strains (particularly methicillin- resistant Staphylococcus aureus [MRSA]). Ceftobiprole, a new cephalosporin with a high affinity for penicillin-binding protein 2a, may provide another option for treating such infections. Its MIC₉₀ for MRSA is 2 µg/mL and for Enterobacteriaceae is 4 µg/mL.

In a recent industry-sponsored, multinational, randomized, double-blind trial involving 828 patients with various complicated skin and soft-tissue infections, researchers compared intravenous ceftobiprole (500 mg every 8 hours for 7–14 days) to vancomycin (1000 mg every 12 hours) plus ceftazidime (1000 mg every 8 hours). Outcomes were assessed at a test-of-cure visit conducted 7 to 14 days after therapy was completed.

In intent-to-treat analysis, clinical cure rates were similar between study arms across the study population (82% for ceftobiprole vs. 81% for vancomycin plus ceftazidime). Rates were also similar between arms among patients with MRSA infections (90% vs. 86%). Adverse events were uncommon and were comparable between the two arms.

Comment: These data support the addition of ceftobiprole to our growing armamentarium of agents with activity against MRSA. As an editorialist notes, potential benefits of ceftobiprole include bactericidal activity, a broad general spectrum of antibacterial activity, and low potential for the development of resistance. However, more trials are needed before this agent receives unreserved endorsement.

— Neil M. Ampel, MD

Published in Journal Watch Infectious Diseases March 19, 2008

Citation(s):

Noel GJ et al. A randomized, double-blind trial comparing ceftobiprole medocaril with vancomycin plus ceftazidime for the treatment of patients with complicated skin and skin-structure infections. Clin Infect Dis 2008 Mar 1; 46:647.

• Medline abstract (Free)

Widmer AF. Ceftobiprole: A new option for treatment of skin and soft-tissue infections due to methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2008 Mar 1; 46:656.

• Medline abstract (Free)