Challenges to Adopting New Therapeutics: Familiarity, Diagnostics, and Real-World Use in Persistent Bacteremia

Despite strong clinical trial data supporting newer agents such as ceftobiprole, several practical barriers may influence how quickly it is adopted in routine practice. One of the most significant is clinician familiarity: most current prescribers have extensive experience with long-standing standards of care such as vancomycin and daptomycin, which continue to be deeply embedded in treatment protocols for Staphylococcus aureus infections.

Beyond habit and training, diagnostic infrastructure also plays a key role. Clinicians rely heavily on rapid and clear susceptibility reporting to guide therapy decisions, and broader uptake of ceftobiprole will depend on its inclusion in routine microbiology panels and automated testing systems. Without that visibility, adoption may be slower even in settings where the drug is available.

Another consideration is how the drug is positioned in clinical practice. While trials such as ERADICATE evaluated ceftobiprole as upfront therapy, real-world use may initially skew toward salvage situations—particularly in patients with persistent bacteremia who are not responding as expected after several days of treatment. In these cases, clinicians often escalate to combination therapy, and ceftobiprole may be incorporated as part of that strategy rather than as first-line therapy.

Finally, practical administration factors such as the potential for continuous infusion—common with other beta-lactams in hospitalized patients—may also influence how comfortable clinicians feel incorporating the drug into existing workflows. Taken together, these factors suggest that while ceftobiprole may be a valuable addition to the antimicrobial armamentarium, its adoption will likely be gradual and shaped as much by system-level and behavioral factors as by clinical efficacy alone.

Disclaimer: Holland was the Chair of Adjudication for the ERADICATE trial.

This video series has been produced independently by Contagion Live and supported through a educational grant by Innoviva Specialty Therapeutics inc