CEFTO-CURE study: CEFTObiprole Clinical Use in Real-lifE - a multi-centre experience in Italy.

Adult Humans Male Middle Aged Aged Anti-Bacterial Agents / therapeutic use Retrospective Studies Cross Infection / drug therapy Cephalosporins / therapeutic use Pneumonia / drug therapy Italy Sepsis / drug therapy

Bloodstream infection Ceftobiprole MRSA Pneumonia

Journal

International journal of antimicrobial agents

ISSN: 1872-7913

Titre abrégé: Int J Antimicrob Agents

Pays: Netherlands

ID NLM: 9111860

Informations de publication

Date de publication:
Jul 2023

Historique:

received: 05 10 2022

revised: 03 04 2023

accepted: 07 04 2023

medline: 19 6 2023

pubmed: 16 4 2023

entrez: 15 4 2023

Statut: ppublish

Résumé

Ceftobiprole is approved in Europe for treatment of community-acquired pneumonia and non-ventilator-associated hospital-acquired pneumonia (HAP) in adults. Real-world data are limited. This multi-centre, observational, ambispective investigator-initiated study was undertaken in Italy from January 2018 to December 2019 in order to evaluate the use of ceftobiprole in a real-world setting. Overall, 195 patients from 10 centres were evaluated (68% retrospectively). Male sex was prevalent (n=121, 62%). Median age was 67 [interquartile range (IQR) 53-75] years. Median Charlson Comorbidity Index score was 5 (IQR 3-7). The most common indication was pneumonia (151/195, 77%), especially HAP. Other uses were skin and soft tissue infections (5%), endocarditis (4%) and bone infections (4%). Ceftobiprole was usually an empiric choice (65%), in combination with other drugs (66%) and as second-line therapy (58%). A causative agent was found in 39% of cases. A diagnosis of sepsis was made in 59 cases (30%). Success in the clinically evaluable population (excluding 12 cases due to isolation of pathogens outside ceftobiprole's spectrum of activity) was obtained in 79% of cases, with all-cause mortality of 20%. On multi-level analysis, three predictors were positively associated with clinical success: male gender, pneumonia and detection of causal agent. Sepsis was a negative predictor. Nine factors were independently associated, favourably or unfavourably, with fatal outcome. Ceftobiprole is a safe and effective therapeutic choice, even in a real-world setting. More data are needed to establish its efficacy in patients with sepsis.

Sections du résumé

BACKGROUND BACKGROUND

Ceftobiprole is approved in Europe for treatment of community-acquired pneumonia and non-ventilator-associated hospital-acquired pneumonia (HAP) in adults. Real-world data are limited.

METHODS METHODS

This multi-centre, observational, ambispective investigator-initiated study was undertaken in Italy from January 2018 to December 2019 in order to evaluate the use of ceftobiprole in a real-world setting.

RESULTS RESULTS

Overall, 195 patients from 10 centres were evaluated (68% retrospectively). Male sex was prevalent (n=121, 62%). Median age was 67 [interquartile range (IQR) 53-75] years. Median Charlson Comorbidity Index score was 5 (IQR 3-7). The most common indication was pneumonia (151/195, 77%), especially HAP. Other uses were skin and soft tissue infections (5%), endocarditis (4%) and bone infections (4%). Ceftobiprole was usually an empiric choice (65%), in combination with other drugs (66%) and as second-line therapy (58%). A causative agent was found in 39% of cases. A diagnosis of sepsis was made in 59 cases (30%). Success in the clinically evaluable population (excluding 12 cases due to isolation of pathogens outside ceftobiprole's spectrum of activity) was obtained in 79% of cases, with all-cause mortality of 20%. On multi-level analysis, three predictors were positively associated with clinical success: male gender, pneumonia and detection of causal agent. Sepsis was a negative predictor. Nine factors were independently associated, favourably or unfavourably, with fatal outcome.

CONCLUSIONS CONCLUSIONS

Ceftobiprole is a safe and effective therapeutic choice, even in a real-world setting. More data are needed to establish its efficacy in patients with sepsis.

Identifiants

DOI: 10.1016/j.ijantimicag.2023.106817 PMID: 37061102

pubmed: 37061102

pii: S0924-8579(23)00096-1

doi: 10.1016/j.ijantimicag.2023.106817

pii:

doi:

Substances chimiques

ceftobiprole 5T97333YZK

Anti-Bacterial Agents 0

Cephalosporins 0

Types de publication

Multicenter Study Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

106817