Ceftobiprole is a new therapeutic option for bacterial pneumonia, with activity against most antimicrobial resistant gram-positive cocci, including methicillin-resistant Staphylococcus aureus. Data on the use of Ceftobiprole in real life are limited. We evaluated the efficacy and safety of Ceftobiprole in a context of real life hospital practice.
In a single center, observational, retrospective clinical study, we collected data of 29 patients undergoing Ceftobiprole therapy, with a focus on clinical outcomes and adverse events.
There was a high burden of comorbidities in the study cohort, including kidney dysfunction (38%) and cancer (24%), and high proportion of patients with sepsis/septic shock (72%), a central line (41%) or on mechanical ventilation (21%). Most infections were nosocomial (24, 82.8%). Ceftobiprole was mostly prescribed because of pneumonia (17 patients, 58.6%), and bloodstream infection (10 patients, 34.5%), both empirically (9 cases, 31%) and as targeted therapy (20, 69%, with Staphylococci as the dominant pathogens). It was the first-line drug in 15 cases (51.7%). Overall, a favorable clinical outcome was observed in the majority of cases (68.9%), with clinical cure in 3 (10.3%) and clinical improvement in 17 (58.6%). Failure of treatment occurred in 7 cases (24.1%). Three patients experienced a definite Ceftobiprole-related adverse event, with 2 cases of myoclonus. No major adverse effects on bone marrow, kidney and liver function were observed.
Ceftobiprole, even outside current indications, may be a safe and effective treatment for resistant gram-positive cocci infections where other molecules are inactive or poorly tolerated and for salvage therapy.

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