Real-life experience with ceftobiprole in Canada; results from the CLEAR (Canadian LEadership on Antimicrobial Real-life usage) registry

Abstract Objectives Ceftobiprole is an advanced-generation cephalosporin with a favorable safety profile. Published data on the clinical use of ceftobiprole are limited. We report the use of ceftobiprole in Canadian patients using data captured by the CLEAR registry. Methods The CLEAR registry uses the web-based research data management program, REDCapTM (online survey, https://is.gd/CLEARceftobiprole ) to facilitate clinicians entering details associated with their clinical experiences using ceftobiprole. Results Data were available for 38 patients treated with ceftobiprole. The most common infections treated were endocarditis (42.1% of patients), bone/joint infection (23.7%), and hospital-associated bacterial pneumonia (15.8%). 92.1% of patients had bacteremia and 21.1% were in intensive care. Ceftobiprole was used because of failure of (71.1%), resistance to (18.4%), or adverse effects from (10.5%) previously prescribed antimicrobial agents. Ceftobiprole was primarily used as directed therapy for methicillin-resistant Staphylococcus aureus-MRSA infections (94.7% of patients). Ceftobiprole susceptibility testing was performed in isolates from 47.4% of patients. It was used concomitantly with daptomycin in 55.3% of patients and with vancomycin in 18.4% of patients. Treatment duration was primarily >10 days (65.8% of patients) with microbiological success in 97.0% and clinical success in 84.8% of patients. 2.6% of patients had gastrointestinal adverse effects. Conclusions In Canada to date, ceftobiprole is used as directed therapy to treat a variety of severe infections caused by MRSA. It is primarily used in patients failing previous antimicrobials, is frequently added to, and thus used in combination with daptomycin or vancomycin with high microbiological and clinical cure rates, along with an excellent safety profile.