Ceftobiprole for Treatment of Complicated Staphylococcus aureus Bacteremia

The ERADICATE trial was a randomized, double-blind, noninferiority study comparing ceftobiprole vs. daptomycin ± aztreonam in 390 adults with complicated Staphylococcus aureus bacteremia, including MRSA, soft-tissue infections, right-sided endocarditis, and osteomyelitis. Primary outcome at 70 days:

• Treatment success: 69.8% (ceftobiprole) vs. 68.7% (daptomycin)

• Adjusted difference: 2.0 percentage points (95% CI: -7.1 to 11.1) → noninferior Mortality: 9.0% vs. 9.1% Microbiologic eradication: 82.0% vs. 77.3% Adverse events: Comparable; ceftobiprole had more mild GI symptoms and hypokalemia MRSA subgroup: Similar clearance and complication rates despite higher MICs Authors conclude ceftobiprole is a viable, noninferior alternative to daptomycin in complicated S. aureus bacteremia, including right-sided native-valve endocarditis, supporting expanded treatment options beyond existing agents.

The ERADICATE trial was a randomized, double-blind, noninferiority study comparing ceftobiprole vs. daptomycin ± aztreonam in 390 adults with complicated Staphylococcus aureus bacteremia, including MRSA, soft-tissue infections, right-sided endocarditis, and osteomyelitis. Primary outcome at 70 days:

• Treatment success: 69.8% (ceftobiprole) vs. 68.7% (daptomycin)

• Adjusted difference: 2.0 percentage points (95% CI: -7.1 to 11.1) → noninferior Mortality: 9.0% vs. 9.1% Microbiologic eradication: 82.0% vs. 77.3% Adverse events: Comparable; ceftobiprole had more mild GI symptoms and hypokalemia MRSA subgroup: Similar clearance and complication rates despite higher MICs Authors conclude ceftobiprole is a viable, noninferior alternative to daptomycin in complicated S. aureus bacteremia, including right-sided native-valve endocarditis, supporting expanded treatment options beyond existing agents.