Comparison of the Efficacy and Safety of Ceftobiprole, Vancomycin, Daptomycin, and Linezolid in the Treatment of Bloodstream Infections and Skin and Skin Structure Infections: A Network Meta‐Analysis

Background This study conducted a network meta‐analysis to compare the efficacy and safety of ceftobiprole compared to vancomycin, daptomycin, and linezolid in the treatment of skin and skin structure infections, and compared to vancomycin and daptomycin in the treatment of bloodstream infections. Methods This study conducted a systematic search in the PubMed, Embase, Cochrane Library, and the China National Knowledge Infrastructure databases with a cutoff date of June 13, 2024. The quality of the included randomized controlled trials was evaluated using the Cochrane Risk of Bias Assessment Tool. Statistical analyses were performed using RevMan 5.3 and Stata 15.1. Results The results indicate that daptomycin is the most effective treatment for bloodstream infections (70.2%), whereas ceftobiprole demonstrates the highest microbiological success (81.7%). In terms of skin and skin structure infections, the effectiveness (intention‐to‐treat population: 92.0%; clinically evaluable population: 83.0%) and microbiological success rate (intention‐to‐treat population: 80.5%; clinically evaluable population: 90.2%) of linezolid are higher than those of other antibiotics. Linezolid exhibits a higher overall occurrence of adverse events and death events compared to other antibiotics, whereas ceftobiprole demonstrates a lower incidence of both adverse events and death events. Conclusions Ceftobiprole shows a comprehensive therapeutic balance in treating skin and skin structure infections. In terms of bloodstream infections, ceftobiprole demonstrates a notable superiority in microbiological success rate. Moreover, the safety profile of ceftobiprole underscores its potential relative therapeutic advantage.