ERADICATE
Trial question
Is ceftobiprole noninferior to daptomycin in patients with complicated S. aureus bacteremia?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
31.0% female
69.0% male
N = 387
387 patients (119 female, 268 male).
Inclusion criteria: adult patients with complicated S. aureus bacteremia.
Key exclusion criteria: unremovable endovascular prosthetic material; pneumonia; receipt of potentially effective antibiotics for > 48 hours within 7 days before randomization.
Interventions
N=189 ceftobiprole (at a dose of 500 mg IV every 6 hours for 8 days and every 8 hours thereafter).
N=198 daptomycin (at a dose of 6-10 mg/kg of body weight IV every 24 hours).
Primary outcome
Overall treatment success at day 70
69.8%
68.7%
69.8 %
52.3 %
34.9 %
17.4 %
0.0 %
Ceftobiprole
Daptomycin
Difference not exceeding
non-inferiority
margin ✓
Difference not exceeding non-inferiority margin in overall treatment success at day 70 (69.8% vs. 68.7%; AD 2%, 95% CI -7.1 to 11.1).
Secondary outcomes
No significant difference in death through the post-treatment evaluation visit (9% vs. 9.1%; AD -0.5%, 95% CI -6.2 to 5.2).
No significant difference in microbiologic eradication at the post-treatment evaluation visit (82% vs. 77.3%; AD 5.1%, 95% CI -2.9 to 13).
No significant difference in the rate of new metastatic foci or other complications of S. aureus bacteremia after day 7 (5.8% vs. 5.6%; AD 0.1%, 95% CI -4.6 to 4.8).
Safety outcomes
No significant difference in adverse events.
Conclusion
In adult patients with complicated S. aureus bacteremia, ceftobiprole was noninferior to daptomycin with respect to overall treatment success at day 70.
Reference
Thomas L Holland, Sara E Cosgrove, Sarah B Doernberg et al. Ceftobiprole for Treatment of Complicated Staphylococcus aureus Bacteremia. N Engl J Med. 2023 Oct 12;389(15):1390-1401.
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