Real-World Experience of Ceftobiprole for Community- and Hospital-Acquired Pneumonia from a Stewardship Perspective

• Published in: Microorganisms (Basel) Vol. 12; no. 4; p. 725
• Main Authors: Corcione, Silvia, De Benedetto, Ilaria, Carlin, Massimiliano, Pivetta, Emanuele Emilio, Scabini, Silvia, Grosso, Cecilia, Shbaklo, Nour, Porta, Massimo, Lupia, Enrico, De Rosa, Francesco Giuseppe
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.04.2024
• Subjects: Age; Antibiotics; antimicrobial stewardship; Bacteria; Bacterial pneumonia; Blood pressure; carbapenem-sparing; Carbapenems; ceftobiprole; Cephalosporins; Chronic obstructive pulmonary disease; Comorbidity; COVID-19; Data collection; Diabetes; Drug therapy; glycopeptide-sparing; Gram-negative bacteria; Gram-positive bacteria; Health services; Hospitalization; Hospitals; Infectious diseases; Influenza; internal medicine; Linezolid; Mortality; Nosocomial infections; Pathogens; Patients; Pneumonia; Sepsis; Staphylococcus infections; Streptococcus infections; Ulcers; Vancomycin; Variables; β-Lactam antibiotics; Italy; internal medicine; antimicrobial stewardship; ceftobiprole; glycopeptide-sparing; carbapenem-sparing
• ISSN: 2076-2607; 2076-2607
• DOI: 10.3390/microorganisms12040725

Ceftobiprole is a fifth-generation cephalosporin approved by European and American regulatory agencies for the treatment of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). Ceftobiprole administration is useful in severe CAP as well as HAP where the potential is to save other β-lactams including carbapenems or linezolid/vancomycin in clinical practice. The aim of this study was to report the real-world evidence of ceftobiprole in patients with CAP and HAP in a single center. In this retrospective study, we included 159 patients with CAP or HAP: 105 (66%) had CAP and 54 (34%) had HAP. The median age was 70 years (IQR 60-77), the median Charlson Comorbidity Index was 5 (IQR 3-7.5) and baseline INCREMENT ESBL score was 8 (IQR 6-11). Ceftobiprole was mostly given as a combination treatment (77%) or as a carbapenem-sparing strategy (44%). There were no differences in mortality between shorter and longer duration of treatment (<7 days compared with ≥7 days (HR 1.02, C.I. 0.58-1.77, = 0.93) or between first-line (HR 1.00, C.I. 0.46-2.17, = 0.989) and second-line therapy. Ceftobiprole use in CAP or HAP in the real world is effective as a first- and second-line treatment as well as a carbapenem-sparing strategy. Further studies are needed to explore the full potential of ceftobiprole, including its real-world use in antimicrobial stewardship programs.