Abstract
Background: Ceftobiprole is an advanced-generation cephalosporin approved in Europe in 2013 for various indications, and in the United States (US) in 2024 for community-acquired bacterial pneumonia (CABP), acute bacterial skin and skin structure infections, and Staphylococcus aureus bacteremia, including right-sided endocarditis. Methods: The in vitro activity of ceftobiprole and comparators was evaluated against 2793 Streptococcus pneumoniae causing lower respiratory tract infections in 32 US sites (2016-2020), including against subsets from various geographic regions, resistance phenotypes and prevalent serotypes. Results: Ceftobiprole inhibited 99.5% of all S. pneumoniae at the MIC of ≤0.5 mg/L (MIC(50/90), 0.015/0.25 mg/L). Susceptibilities of 98.2% to 100% were observed for ceftobiprole against isolates originating from each surveyed year or each US Census Division. Ceftobiprole retained activity against isolates resistant to macrolides (98.8%), tetracycline (98.2%), oral penicillin (95.4%), against multidrug-resistant isolates (97.0%), and various serotypes (93.8-100%). Ceftriaxone (97.4%) and amoxicillin-clavulanate (95.1%) also showed elevated susceptibilities overall, but inconsistent results and lower than those observed for ceftobiprole were noted against isolates with elevated penicillin MIC or specific serotypes (i.e., 19A). Conclusions: These in vitro results, coupled with documented clinical efficacy, indicate that ceftobiprole is a valuable option to treat CABP caused by S. pneumoniae in the US.