Resistance and the management of complicated skin and skin structure infections: the role of ceftobiprole

Figures & data

Figure 1 Trends in resistance among Gram-positive pathogens (1975–2004). MRSE: methicillin-resistant S. epidermidis. VRE: vancomycin-resistant Enterococcus. VI SA: vancomycin-intermediate S. aureus. VRSA: vancomycin-resistant S. aureus. Reprinted with permission from Lee SY, Kuti JL, Nicolau DP. Antimicrobial management of complicated skin and skin structure infections in the era of emerging resistance. Surg Infect (Larchmt). 2005;6:283–295.¹² Copyright © 2005 Mary Ann Liebert, Inc. publishers.

Figure 2 Mean ceftobiprole concentration in plasma (circles), free plasma (dashed line), skeletal muscle (squares), and s.c. adipose tissue (triangles) over 12 h. Reprinted with permission from Barbour A, Schmidt S, Sabarinath SN, et al. Soft-tissue penetration of ceftobiprole in healthy volunteers determined by in vivo microdialysis. Antimicrob Agents Chemother. 2009;53:2773–2776.⁵⁴ Copyright © 2009 American Society for Microbiology.

Table 1 Most common adverse events (AEs) in healthy volunteers and patients.^55,63,64,66

	Healthy volunteers	Patients
Total No. of subjects	42	932
Total No. of subjects with at least one AE	21	507
Total No. of subjects with at least one serious AE	0	63
Dysgeusia	17	30
Nausea	10	113
Headache	10	68
Abdominal pain	2	*
Vomiting	1	61
Diarrhea	1	62
Constipation	0	33
Hypersensitivitya	0	49
Infusion-site reaction	1	48

a Including rash and pruritus.

Reprinted with permission from Barbour A, Schmidt S, Rand KH, Derendorf H. Ceftobiprole: a novel cephalosporin with activity against Gram-positive and Gram-negative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA). Int J Antimicrob Agents. 2009;34:1–7.⁵⁶ Copyright © 2009 Elsevier.

Table 2 In vitro susceptibility determined from isolates collected from cSSSIs from phase II trials with ceftobiprole⁶⁸

	MIC90 (mg/L)	MIC range (mg/L)
MSSA	0.5	0.12–1
MRSA	2	0.25–4
Pseudomonas aeruginosa*	>64	0.25–>64
Enterococcus faecalis	0.5	0.12–0.5
Enterococcus faecium#	#	2–>64
Escherichia coli	0.12	0.015–>64
Enterobacter cloacae	>64	0.03–>64
Klebsiella pneumonia	32	0.03–>64
Streptococcus pyogenes	0.015	0.008–0.25
Streptococcus agalactiae	0.12	0.015–0.12
CoNS methicillin susceptible	0.5	0.015–1
CoNS methicillin-resistant	2	0.06–4
Proteus mirabilis	0.12	0.015–>64

* Pseudomonas aeruginosa ceftazidime-susceptible MIC₉₀-16.⁷⁰

# Three isolates collected.

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