. 2016 Feb 9;33(2):151–166. doi: 10.1007/s12325-016-0293-x

Table 2.

HAP treatment options that have recently become available

Treatment	Countries/regions in which approved	Current indication^a (Europe)	Dosing	Dose adjustments	Notes and comments
Telavancin [45]	Europe USA	Treatment of adults with nosocomial pneumonia, including VAP, known or suspected to be caused by MRSA Use only when it is known or suspected that other alternatives are not suitable	HAP 10 mg/kg i.v. once every 24 h, for 7–21 days	HAP Patients with renal impairment CL_CR 30–50 mL/min 7.5 mg/kg every 24 h	Potent against Gram-positive pathogens (including MRSA, vancomycin-intermediate S. aureus, and penicillin-resistant S. pneumoniae) Once-daily dosing Not effective against Gram-negative bacteria Not indicated for patients with severe renal impairment Risk of nephrotoxicity: requires constant monitoring of renal function
Ceftobiprole medocaril [46]	13 European countries (Austria, Belgium, Denmark, Finland, France, Germany, Italy, Luxembourg, Norway, Spain, Sweden, Switzerland, and the UK) and Canada	Treatment of adults with HAP (excluding VAP) and CAP	HAP (excluding VAP) and CAP 500 mg administered as a 2-h i.v. infusion every 8 h	HAP (excluding VAP) and CAP Patients with renal impairment Moderate impairment (CL_CR 30 to <50 mL/min) 500 mg administered as a 2-h i.v. infusion every 12 h Severe impairment (CL_CR <30 mL/min) 250 mg administered as a 2-h i.v. infusion every 12 h Patients with ESRD 250 mg once every 24 h	Activity against a broad spectrum of Gram-negative and Gram-positive pathogens Highly potent activity against MRSA Reduced activity against ESBL-producing strains Not indicated for VAP Dose adjustments required for patients with renal impairment Not approved in the USA; the Food and Drug Administration raised Good Clinical Practice concerns in 2008 regarding some ceftobiprole study data, but in a different indication (complicated skin infections)

Treatment

Countries/regions in which approved

Current indication^a (Europe)

Dosing

Dose adjustments

Notes and comments

Telavancin [45]

Europe

USA

Treatment of adults with nosocomial pneumonia, including VAP, known or suspected to be caused by MRSA

Use only when it is known or suspected that other alternatives are not suitable

HAP

10 mg/kg i.v. once every 24 h, for 7–21 days

HAP

Patients with renal impairment

CL_CR 30–50 mL/min 7.5 mg/kg every 24 h

Potent against Gram-positive pathogens (including MRSA, vancomycin-intermediate S. aureus, and penicillin-resistant S. pneumoniae)

Once-daily dosing

Not effective against Gram-negative bacteria

Not indicated for patients with severe renal impairment

Risk of nephrotoxicity: requires constant monitoring of renal function

Ceftobiprole medocaril [46]

13 European countries (Austria, Belgium, Denmark, Finland, France, Germany, Italy, Luxembourg, Norway, Spain, Sweden, Switzerland, and the UK) and Canada

Treatment of adults with HAP (excluding VAP) and CAP

HAP (excluding VAP) and CAP

500 mg administered as a 2-h i.v. infusion every 8 h

HAP (excluding VAP) and CAP

Patients with renal impairment

Moderate impairment (CL_CR 30 to <50 mL/min) 500 mg administered as a 2-h i.v. infusion every 12 h

Severe impairment (CL_CR <30 mL/min) 250 mg administered as a 2-h i.v. infusion every 12 h

Patients with ESRD 250 mg once every 24 h

Activity against a broad spectrum of Gram-negative and Gram-positive pathogens

Highly potent activity against MRSA

Reduced activity against ESBL-producing strains

Not indicated for VAP

Dose adjustments required for patients with renal impairment

Not approved in the USA; the Food and Drug Administration raised Good Clinical Practice concerns in 2008 regarding some ceftobiprole study data, but in a different indication (complicated skin infections)

CAP community-acquired pneumonia, CL _CR creatinine clearance, ESBL extended-spectrum β-lactamase, ESRD end-stage renal disease, HAP hospital-acquired pneumonia, i.v. intravenous, MRSA methicillin-resistant Staphylococcus aureus, VAP ventilator-associated pneumonia

^aConsideration should be given to official guidance on the appropriate use of antibacterial agents