Ceftobiprole: Difference between revisions

(Created page with " This is an example wiki page for the This is an emergency medicine antibiotic wiki example page that is on the wiki wikem.org ==General== *Type: Is Generation::1st generation Is DrugClass::Cephalosporin *Dosage Forms: powder for injection *Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g *Routes of Administration: IV, IM *Common Trade Names: Ancef ==Adult Dosing== ===General=== *Mild: 250-500mg IM/IV 8h *Mod-Severe: 500-1000mg IM/IV q6-8h *Life Threatening:...")
 
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This is an example wiki page for the
This is an emergency medicine antibiotic wiki example page that is on the wiki wikem.org
==General==
==General==
*Type: [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]]
*Type: [[Is Generation::5th generation]] [[Is DrugClass::Cephalosporin]]
*Dosage Forms: powder for injection
*Dosage Forms: powder for reconstitution
*Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g
*Dosage Strengths: 500mg (equivalent to 666.6mg ceftobiprole medocaril sodium)
*Routes of Administration: IV, IM
*Routes of Administration: IV
*Common Trade Names: Ancef
*Common Trade Names: Zevtera, Mabelio


==Adult Dosing==
==Adult Dosing==
===General===
===General===
*Mild: 250-500mg IM/IV 8h
*Administer as a 2-hour prolonged intravenous infusion
*Mod-Severe: 500-1000mg IM/IV q6-8h
*Standard: 500mg IV q8h
*Life Threatening: 1-1.5g IM/IV q6h
*Max: 1500mg/day
*Max: 12g/day
 
===[[Staphylococcus aureus]] Bacteremia (SAB)===
*500mg IV q8h x 14-42 days (depending on source/complications)


===[[UTI]], Uncomplicated===
===Acute Bacterial Skin and Skin Structure Infections (ABSSSI)===
*1g IM/IV q12
*500mg IV q8h x 5-14 days


===Pneumococcal [[Pneumonia]]===
===Community Acquired [[Pneumonia]] (CABP)===
*500mg IM/IV q12
*500mg IV q8h x 5-14 days


===[[Endocarditis]] Prophylaxis, Dental===
===Hospital Acquired [[Pneumonia]] (HAP)===
*1g IM/IV x1 (30-60 min before procedure)
*500mg IV q8h x 7-14 days (Excluding VAP)


==Pediatric Dosing==
==Pediatric Dosing==
===General (<7 Days)===
===General (3 months to <18 years)===
*40mg/kg/day IM/IV divided q12h
*Administer as a 2-hour prolonged intravenous infusion
*First Dose: 20mg/kg IM/IV x 1
*Adolescents (12 to <18 years): 500mg IV q8h
*Max 6g/day
*Children (6 to <12 years): 15mg/kg IV q8h
 
*Infants/Children (3 months to <6 years): 20mg/kg IV q8h
===General (>7 Days - 1 Month)===
*Max: 500mg/dose
*<2000g
**40mg/kg/day IM/IV divided q12h
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day
*>2000g
**60mg/kg/day IM/IV divided q8h
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day
 
===General (>1 Month)===
*25-100mg/kg/day IM/IV divided q6-8h
*First Dose: 20-33mg/kg IM/IV x 1
*Max 6g/day
 
===Community Acquired [[Pneumonia]] (>3 Months)===
*150mg/kg/day IM/IV divided q8h x 10 days
*First Dose: 50mg/kg IM/IV x 1
*May switch to PO regimen when able


==Special Populations==
==Special Populations==
*Pregnancy: B
*Pregnancy: Safety not established; studies in animals showed no harm. Use if benefit outweighs risk.
*Lactation: Safe
*Lactation: Unknown excretion; use with caution.
*Renal
*Renal
**Adult
**Adult
***CrCl 35-54: give q8
***CrCl 30-50: 500mg q12h
***CrCl 11-34: give usual dose x1, then decrease dose 50% and give q12h
***CrCl 15-29: 250mg q12h
***CrCl <10: give usual dose x1, then decrease dose 50% and give q18-24h
***CrCl <15 (ESRD) or intermittent hemodialysis: 250mg q24h
***Hemodialysis: give 0.5-1g supplement
***NOTE: Dosing for patients receiving hemodialysis should be administered after the dialysis session.
***Peritoneal dialysis: 500mg q12h
**Pediatric
**Pediatric
***CrCl 40-70: give usual dose x 1, then decrease daily dose 40% and give q12h
***Renal impairment requires adjustment based on adult principles but specific pediatric nomograms should be consulted.
***CrCl 20-39: give usual dose x 1, then decrease daily dose 75% and give q12h
*Hepatic
***CrCl 5-19: give usual dose x 1, the decerase daily dose 90% and give q24h
**No adjustment necessary
***CrCl <5: not defined
***Hemodialysis: give supplement
***Peritoneal dialysis: no supplement
*Hepatic (Adult & Pediatric)
**Not defined


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Severe hypersensitivity to Ceftobiprole or other Cephalosporins
*History of severe anaphylaxis to other Beta-lactams


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Neutropenia
*[[Thrombocytopenia]]
*[[Anaphylaxis]]
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Clostridium difficile]] associated diarrhea
*Nephrotoxicity
*[[Seizures]] (risk increases in renal impairment without adjustment)
*[[Seizures]]
*Hyponatremia
*[[Clostridium difficile]]


===Common===
===Common===
*Dysgeusia (Metallic taste)
*[[Nausea and Vomiting]]
*[[Diarrhea]]
*[[Diarrhea]]
*[[Rash]]
*Headache
*[[Nausea and Vomiting]]
*Infusion site reactions
*[[Abdominal Pain]]
*Hepatic enzyme elevation
*Anorexia
*Transaminitis
*Urticaria
*Thrombophlebitis


==Pharmacology==
==Pharmacology==
*Half-life: 1.8h (3.7 ESRD)
*Half-life: 3h
*Metabolism: minimally metabolized in liver; CYP450
*Metabolism: Converted rapidly from prodrug (ceftobiprole medocaril) to active drug in plasma by type A esterases; minimal hepatic metabolism.
*Excretion: Urine
*Excretion: Urine (89% unchanged)
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis.
**High affinity for PBP2a (confers activity against [[MRSA]]).
**High affinity for PBP2x (confers activity against Penicillin-Resistant [[Strep. Pneumoniae]]).


==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy / FDA Prescribing Information</ref>==
{| class="wikitable"
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Group'''
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| ||[[Viridans strep]]||'''S'''
| ||[[Viridans strep]]||'''S'''
|-
|-
| ||Strep. anginosus gp||X1
| ||Strep. anginosus gp||'''S'''
|-
|-
| ||[[Enterococcus faecalis]]||R
| ||[[Enterococcus faecalis]]||'''S'''
|-
|-
| ||[[Enterococcus faecium]]||X1
| ||[[Enterococcus faecium]]||R
|-
|-
| ||[[MSSA]]||'''S'''
| ||[[MSSA]]||'''S'''
|-
|-
| ||[[MRSA]]||R
| ||[[MRSA]]||'''S'''
|-
|-
| ||[[CA-MRSA]]||R
| ||[[CA-MRSA]]||'''S'''
|-
|-
| ||[[Staph. Epidermidis]]||I
| ||[[Staph. Epidermidis]]||'''S''' (Including MRSE)
|-
|-
| ||[[C. jeikeium]]||R
| ||[[C. jeikeium]]||I
|-
|-
| ||[[L. monocytogenes]]||R
| ||[[L. monocytogenes]]||I
|-
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
|-
| ||[[N. meningitidis]]||R
| ||[[N. meningitidis]]||'''S'''
|-
|-
| ||[[Moraxella catarrhalis]]||I
| ||[[Moraxella catarrhalis]]||'''S'''
|-
|-
| ||[[H. influenzae]]||'''S'''
| ||[[H. influenzae]]||'''S'''
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| ||E coli/Klebsiella KPC+||R
| ||E coli/Klebsiella KPC+||R
|-
|-
| ||[[Enterobacter]] sp, AmpC neg||R
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
|-
|-
| ||[[Enterobacter]] sp, AmpC pos||R
| ||[[Enterobacter]] sp, AmpC pos||'''S'''
|-
|-
| ||[[Serratia]] sp||R
| ||[[Serratia]] sp||'''S'''
|-
|-
| ||Serratia marcescens||X1
| ||Serratia marcescens||'''S'''
|-
|-
| ||[[Salmonella]] sp||X1
| ||[[Salmonella]] sp||'''S'''
|-
|-
| ||[[Shigella]] sp||X1
| ||[[Shigella]] sp||'''S'''
|-
|-
| ||[[Proteus mirabilis]]||'''S'''
| ||[[Proteus mirabilis]]||'''S'''
|-
|-
| ||[[Proteus vulgaris]]||R
| ||[[Proteus vulgaris]]||'''S'''
|-
|-
| ||[[Providencia sp.]]||R
| ||[[Providencia sp.]]||'''S'''
|-
|-
| ||[[Morganella sp.]]||R
| ||[[Morganella sp.]]||'''S'''
|-
|-
| ||[[Citrobacter freundii]]||R
| ||[[Citrobacter freundii]]||'''S'''
|-
|-
| ||[[Citrobacter diversus]]||R
| ||[[Citrobacter diversus]]||'''S'''
|-
|-
| ||[[Citrobacter sp.]]||R
| ||[[Citrobacter sp.]]||'''S'''
|-
|-
| ||[[Aeromonas sp]]||R
| ||[[Aeromonas sp]]||'''S'''
|-
|-
| ||[[Acinetobacter sp.]]||R
| ||[[Acinetobacter sp.]]||I
|-
|-
| ||[[Pseudomonas aeruginosa]]||R
| ||[[Pseudomonas aeruginosa]]||'''[[Has Antipseudomonal::S]]'''
|-
|-
| ||[[Burkholderia cepacia]]||R
| ||[[Burkholderia cepacia]]||R
Line 184: Line 155:
| ||[[Stenotrophomonas maltophilia]]||R
| ||[[Stenotrophomonas maltophilia]]||R
|-
|-
| ||[[Yersinia enterocolitica]]||R
| ||[[Yersinia enterocolitica]]||'''S'''
|-
|-
| ||[[Francisella tularensis]]||X1
| ||[[Francisella tularensis]]||X1
Line 192: Line 163:
| ||[[Legionella sp.]]||R
| ||[[Legionella sp.]]||R
|-
|-
| ||[[Pasteurella multocida]]||X1
| ||[[Pasteurella multocida]]||'''S'''
|-
|-
| ||[[Haemophilus ducreyi]]||X1
| ||[[Haemophilus ducreyi]]||X1
Line 198: Line 169:
| ||[[Vibrio vulnificus]]||X1
| ||[[Vibrio vulnificus]]||X1
|-
|-
| Misc||[[Chlamydophila sp]]||X1
| Misc||[[Chlamydophila sp]]||R
|-
|-
| ||[[Mycoplasm pneumoniae]]||X1
| ||[[Mycoplasm pneumoniae]]||R
|-
|-
| ||[[Rickettsia sp]]||X1
| ||[[Rickettsia sp]]||R
|-
|-
| ||[[Mycobacterium avium]]||X1
| ||[[Mycobacterium avium]]||R
|-
|-
| Anaerobes||[[Actinomyces]]||X1
| Anaerobes||[[Actinomyces]]||X1
Line 210: Line 181:
| ||[[Bacteroides fragilis]]||R
| ||[[Bacteroides fragilis]]||R
|-
|-
| ||[[Prevotella melaninogenica]]||X1
| ||[[Prevotella melaninogenica]]||I
|-
|-
| ||[[Clostridium difficile]]||X1
| ||[[Clostridium difficile]]||X1
|-
|-
| ||[[Clostridium (not difficile)]]||X1
| ||[[Clostridium (not difficile)]]||I
|-
|-
| ||[[Fusobacterium necrophorum]]||X1
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
|-
| ||[[Peptostreptococcus sp.]]||X1
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
|}


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==References==
==References==
<references/>
<references/>
*Epocrates


[[Category:Pharmacology]] [[Category:ID]]
[[Category:Pharmacology]] [[Category:ID]]
please create a new wiki page formatted in the same way as the wikitext in the example but for this antibiotic  Ceftobiprole and don't forget to put the [[Category:Pharmacology]] [[Category:ID]] at the end.  Make sure you use the semantic mediawiki text for the cephalosporin type such as *Type: [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]] if it applies. If it is sensitive to pseudomonus make sure it has '''[[Has Antipseudomonal::S]]'''

Latest revision as of 20:21, 28 January 2026

General

  • Type: 5th generation Cephalosporin
  • Dosage Forms: powder for reconstitution
  • Dosage Strengths: 500mg (equivalent to 666.6mg ceftobiprole medocaril sodium)
  • Routes of Administration: IV
  • Common Trade Names: Zevtera, Mabelio

Adult Dosing

General

  • Administer as a 2-hour prolonged intravenous infusion
  • Standard: 500mg IV q8h
  • Max: 1500mg/day

Staphylococcus aureus Bacteremia (SAB)

  • 500mg IV q8h x 14-42 days (depending on source/complications)

Acute Bacterial Skin and Skin Structure Infections (ABSSSI)

  • 500mg IV q8h x 5-14 days

Community Acquired Pneumonia (CABP)

  • 500mg IV q8h x 5-14 days

Hospital Acquired Pneumonia (HAP)

  • 500mg IV q8h x 7-14 days (Excluding VAP)

Pediatric Dosing

General (3 months to <18 years)

  • Administer as a 2-hour prolonged intravenous infusion
  • Adolescents (12 to <18 years): 500mg IV q8h
  • Children (6 to <12 years): 15mg/kg IV q8h
  • Infants/Children (3 months to <6 years): 20mg/kg IV q8h
  • Max: 500mg/dose

Special Populations

  • Pregnancy: Safety not established; studies in animals showed no harm. Use if benefit outweighs risk.
  • Lactation: Unknown excretion; use with caution.
  • Renal
    • Adult
      • CrCl 30-50: 500mg q12h
      • CrCl 15-29: 250mg q12h
      • CrCl <15 (ESRD) or intermittent hemodialysis: 250mg q24h
      • NOTE: Dosing for patients receiving hemodialysis should be administered after the dialysis session.
    • Pediatric
      • Renal impairment requires adjustment based on adult principles but specific pediatric nomograms should be consulted.
  • Hepatic
    • No adjustment necessary

Contraindications

  • Severe hypersensitivity to Ceftobiprole or other Cephalosporins
  • History of severe anaphylaxis to other Beta-lactams

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 3h
  • Metabolism: Converted rapidly from prodrug (ceftobiprole medocaril) to active drug in plasma by type A esterases; minimal hepatic metabolism.
  • Excretion: Urine (89% unchanged)
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis.
    • High affinity for PBP2a (confers activity against MRSA).
    • High affinity for PBP2x (confers activity against Penicillin-Resistant Strep. Pneumoniae).

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium R
MSSA S
MRSA S
CA-MRSA S
Staph. Epidermidis S (Including MRSE)
C. jeikeium I
L. monocytogenes I
Gram Negatives N. gonorrhoeae S
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp S
Serratia marcescens S
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii S
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. I
Pseudomonas aeruginosa S
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica S
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp R
Mycobacterium avium R
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica I
Clostridium difficile X1
Clostridium (not difficile) I
Fusobacterium necrophorum S
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy / FDA Prescribing Information
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