New cephalosporins for the treatment of pneumonia in internal medicine wards

Lupia, Tommaso; Corcione, Silvia; Pinna, Simone Mornese; Rosa, Francesco Giuseppe De

doi:10.21037/jtd-20-417

Cited by 14 publications

(23 citation statements)

References 159 publications

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Section: Discussionmentioning

confidence: 99%

“…Initial empiric monotherapy with ceftobiprole in pneumonia can be put to use wherever possible in cases of low to medium risk of the growth of MDR bacteria [ 15 , 16 , 29 ]. Ceftobiprole blends an excellent spectrum for HAP pathogens with low to medium MDR risk with β-lactam safety in frail hospital inpatients, who may be at significant risk of adverse effects triggered by MRSA and anti-MRSA coverage, including oxazolidinones or glycopeptides [ 15 , 16 , 29 ]. Moreover, in severe adult CAP and post-influenza bacterial pneumonia or COVID-19 pulmonary superinfections, this novel cephalosporin may be a suitable option, notably in subjects at risk for MRSA or P. aeruginosa isolates [ 15 , 16 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…GPB are the most common pathogens that cause community-acquired pneumonia co-infections in COVID-19 subjects, although there is an increasing ratio of infections with GNB among hospital-acquired lung superinfections [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Ceftobiprole may fit within a monotherapy stewardship intervention in patients with CAP or HAP at risk for MRSA or Pseudomonas aeruginosa [ 29 ], with or without subsequent de-escalation ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Ceftobiprole Perspective: Current and Potential Future Indications

et al. 2021

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Ceftobiprole combines an excellent spectrum for community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) pathogens, with a low/medium MDR risk, and the β-lactams’ safety in frail patients admitted to the hospital in internal medicine wards which may be at high risk of adverse events by anti-MRSA coverage as oxazolidinones or glycopeptides. We aimed to report the available evidence regarding ceftobiprole use in pneumonia and invasive bacterial infections, shedding light on ceftobiprole stewardship. The clinical application and real-life experiences of using ceftobiprole for bloodstream infections, including infective endocarditis, are limited but nevertheless promising. In addition, extended-spectrum ceftobiprole activity, including Enterococcus faecalis, Enterobacteriaceae, and Pseudomonas aeruginosa, has theoretical advantages for use as empirical therapy in bacteremia potentially caused by a broad spectrum of microorganisms, such as catheter-related bacteremia. In the future, the desirable approach to sepsis and severe infections will be administered to patients according to their clinical situation, the intrinsic host characteristics, the susceptibility profile, and local epidemiology, while the “universal antibiotic strategy” will no longer be adequate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ceftobiprole Perspective: Current and Potential Future Indications

et al. 2021

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“…It has limited activity against enterococci, while it is inactive against Gram-negative bacteria that express ESBLs or AmpC. Ceftaroline is approved for the treatment of community-acquired pneumonia and complicated skin and soft-tissue infections [ 111 , 112 ].…”

Section: Overcoming Resistance Through Novel Antibioticsmentioning

confidence: 99%

Mechanisms of Antibiotic Resistance in Important Gram-Positive and Gram-Negative Pathogens and Novel Antibiotic Solutions

et al. 2021

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Multidrug-resistant bacteria have on overwhelming impact on human health, as they cause over 670,000 infections and 33,000 deaths annually in the European Union alone. Of these, the vast majority of infections and deaths are caused by only a handful of species—multi-drug resistant Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., Acinetobacter spp. and Klebsiella pneumoniae. These pathogens employ a multitude of antibiotic resistance mechanisms, such as the production of antibiotic deactivating enzymes, changes in antibiotic targets, or a reduction of intracellular antibiotic concentration, which render them insusceptible to multiple antibiotics. The purpose of this review is to summarize in a clinical manner the resistance mechanisms of each of these 6 pathogens, as well as the mechanisms of recently developed antibiotics designed to overcome them. Through a basic understanding of the mechanisms of antibiotic resistance, the clinician can better comprehend and predict resistance patterns even to antibiotics not reported on the antibiogram and can subsequently select the most appropriate antibiotic for the pathogen in question.

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“…In medicine, we must always look to the past with an eye to the future. From this perspective, this paper evaluates and discusses the available data on novel cephalosporins (i.e., ceftobiprole, ceftaroline, ceftolozane/tazobactam [C/T], ceftazidime/avibactam [C/A], and cefiderocol) (5) in the antimicrobial management of sepsis and severe infections to assess whether these new molecules can provide innovative answers to ancient questions (6).…”

Section: Introductionmentioning

confidence: 99%

Novel Cephalosporins in Septic Subjects and Severe Infections: Present Findings and Future Perspective

2021

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In past decade, cephalosporins have developed significantly, and data regarding novel cephalosporins (i.e., ceftobiprole, ceftaroline, ceftolozane/tazobactam, ceftazidime/avibactam, and cefiderocol) within septic and bacteremic subjects are rising. These compounds generally offer very promising in vitro microbiological susceptibility, although the variability among gram-negative and -positive strains of different cohorts is noticed in the literature. We require further pharmacological data to measure the best dose in order to prevent sub-therapeutic drug levels in critically ill patients. These new compounds in theory are the sparing solution in the Enterobacteriales infection group for different antimicrobial classes such as aminoglycosides notably within endovascular and GNB-bacteremias, as well as colistin and carbapenem-sparing strategies, favoring good safety profile molecules. Moreover, new cephalosporins are the basis for the actual indications to open up new and exciting prospects for serious infections in the future. In future, patients will be addressed with the desirable approach to sepsis and serious infections in terms of their clinical situation, inherent features of the host, the sensitivity profile, and local epidemiology, for which evidence of the use of new cephalosporin in the treatment of severe infections will fill the remaining gaps.

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New cephalosporins for the treatment of pneumonia in internal medicine wards

Cited by 14 publications

References 159 publications

Ceftobiprole Perspective: Current and Potential Future Indications

Ceftobiprole Perspective: Current and Potential Future Indications

Mechanisms of Antibiotic Resistance in Important Gram-Positive and Gram-Negative Pathogens and Novel Antibiotic Solutions

Novel Cephalosporins in Septic Subjects and Severe Infections: Present Findings and Future Perspective

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