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Ceftobiprole parenteral

Updated 2 Feb 2023 | Cephalosporins


Infusions of ceftobiprole

Drugs List

  • ceftobiprole 500mg powder for concentrate for solution for infusion
  • ZEVTERA 500mg powder for concentrate for solution for infusion
  • Therapeutic Indications


    Community acquired pneumonia
    Nosocomial pneumonia

    Ceftobiprole is indicated for the treatment of hospital-acquired pneumonia (HAP), excluding ventilator-associated pneumonia (VAP), and community-acquired pneumonia (CAP).

    Unlicensed Uses

    Complicated skin and soft tissue infections



    500 mg every 8 hours as a 2 hour intravenous infusion.

    When treating CAP, a switch to oral antibiotics may be considered after 3 days of ceftobiprole treatment depending on the patient's response.

    Patients with Renal Impairment

    Supra-normal creatinine clearance (greater than 150 ml/minute)
    Prolong the infusion duration to 4 hours.

    Moderate renal impairment (creatinine clearance 30 to less than 50 ml/minute)
    500 mg every 12 hours.

    Severe renal impairment (creatinine clearance less than 30 ml/minute)
    250 mg every 12 hours.

    End-stage renal disease with or without intermittent haemodialysis
    250 mg every 24 hours.

    Ceftobiprole is haemodialysable.


    Children under 18 years

    Precautions and Warnings

    Restricted sodium intake
    End stage renal disease
    Epileptic disorder
    History of seizures
    Renal impairment - creatinine clearance below 50ml/minute

    Reduce dose in patients with creatinine clearance below 50ml/min
    Sodium content of formulation may be significant
    Advise ability to drive/operate machinery may be affected by side effects
    Before initiating therapy enquire about previous hypersensitivity reactions
    Consult national/regional policy on the use of anti-infectives
    Creatinine clearance above 150ml/min: Prolong infusion duration to 4 hours
    Hypovolaemia occurring during therapy must be corrected
    Monitor periodically for overgrowth of non-susceptible organisms
    Consider pseudomembranous colitis if patient presents with diarrhoea
    May affect results of some laboratory tests
    Discontinue at once if pseudomembranous colitis occurs
    Discontinue if haemolytic anaemia occurs
    Discontinue if severe hypersensitivity reactions occur

    Ceftobiprole has not been shown to be effective in the treatment of VAP. The manufacturer suggests it should be used with caution in patients with HAP who subsequently require ventilation. Caution should also be used in CAP patients with HIV, neutropenia, myelosuppression and immunocompromised patients.

    Seizures have been associated with ceftobiprole use, most commonly in patients with existing CNS/seizure disorders. Therefore caution is advised in these patients.

    Pregnancy and Lactation


    Use ceftobiprole with caution during pregnancy.

    The manufacturer does not recommend using ceftobiprole during pregnancy. At the time of writing there is limited published information regarding the use of ceftobiprole during pregnancy. Potential risks are unknown.


    Use ceftobiprole with caution during breastfeeding.

    The manufacturer advises that the patient either discontinues ceftobiprole or discontinues breastfeeding. Animal data reports significant levels of ceftobiprole in breast milk, however presence in human milk is unknown.

    Side Effects

    Abdominal pain
    Elevated triglyceride levels
    Fungal infection
    Hypersensitivity reactions
    Increase in serum glucose
    Increases in hepatic enzymes
    Injection site reactions
    Muscle spasm
    Panic attack
    Peripheral oedema
    Pharyngolaryngeal pain
    Positive Coombs test
    Possible alteration of laboratory tests
    Pruritic rash
    Pseudomembranous colitis
    Renal failure
    Serum creatinine increased

    Effects on Laboratory Tests

    A positive direct antiglobulin test may occur during treatment with cephalosporins. Haemolytic anaemia cannot be ruled out during ceftobiprole treatment. Patients experiencing anaemia during or after treatment with ceftobiprole should be investigated.

    Some other cephalosporins interfere with the alkaline picrate assay to measure serum creatinine (Jaffe reaction), which may lead to erroneously high creatinine measurements. It is unknown if ceftobiprole interferes with this test. The manufacturer suggests an enzymatic method of measuring serum creatinine should be used.

    The manufacturer suggests an enzymatic methods to detect glucosuria should be used because of the potential interference with tests using the copper reduction technique.


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: June 2019

    Reference Sources

    Summary of Product Characteristics: Zevtera 500 mg powder for concentrate for solution for infusion. Basilea Medical Ltd. Revised February 2018.

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