Therapeutic challenges are emerging globally due to serious infections caused by both Gram-positive and Gram-negative bacteria [1]. Although the causative pathogens of these infections have remained relatively constant over the past several decades, the approach for selecting therapy for the treatment of patients with potentially serious infections has been altered due to the emergence of resistant strains such as Methicillin resistance Staphylococcus aureus and Pseudomonas aeruginosa [1,2].

At the time of decision making for the treatment of serious infections caused by both Gram-positive and Gram-negative pathogens, the use of at least two antibiotics is recommended to provide a broad range of activity [3,4]. As a result, this has led to a significant necessity for the development of a novel antibiotic that encompasses both P. aeruginosa and MRSA.

Ceftobiprole is a fifth-generation intravenous cephalosporin and the active moiety of the pro-drug ceftobiprole medocaril. It provides a potent activity against both Gram-positive and Gram-negative bacteria. Its spectrum of activity, especially against resistance strains, is considered unique among commercially available antibiotics [5].

In contrast to other broad-spectrum cephalosporins, ceftobiprole shows in vitro activity against Staphylococcus aureus that has resistant to vancomycin, linezolid and daptomycin [6] as well as against commonly encountered Gram-negative pathogens such as Escherichia coli, Klebsiella spp and Serratia spp [7,8].

It has an MIC90 of 0.5 mg/L for Methicillin-susceptible S. aureus and 2 mg/L for MRSA [9], [10], [11], [12], [13], [14]. Furthermore, it has a MIC90 of 4 mg/L for Enterobacterales (non-extended-spectrum β-lactamases), and 16 mg/L for P. aeruginosa [15,16].

Ceftobiprole has been approved in several European countries, as well as Canada for the treatment of hospital-acquired pneumonia (excluding ventilator-acquired pneumonia) and community-acquired pneumonia in adults [17]. Moreover, It is still under assessment by the Food and Drug Administration as a potential therapy for S. aureus bacteremia (SAB), including right-sided infective endocarditis and acute bacterial skin and skin structure infection, including diabetic foot infection in adults [18].

Therefore, this meta-analysis of randomized controlled trials performed to evaluate the potential clinical efficacy and safety of ceftobiprole alone against a combination or non-combination regimen of other antibiotics for the treatment of serious infections caused by a wide range of bacterial pathogens.