In Vitro Activity of Tedizolid, Dalbavancin, and Ceftobiprole Against Clostridium difficile

Abstract

<b>Background:</b><i>Clostridium difficile</i> (<i>C. difficile</i>) is a major nosocomial pathogen that colonizes in the human gut. Recently, the U.S. FDA approved three new antimicrobial agents against gram-positive bacteria: Tedizolid, Dalbavancin, and Ceftobiprole. The efficacy of these antibiotics for treatment of <i>C. difficile</i> infection has not been thoroughly examined. The current study aimed to examine the <i>in vitro</i> activity of these antibiotics against <i>C. difficile</i>. In addition, to compare between Dalbavancin and Ceftobiprole to antibiotics from the same class: Vancomycin and Ceftriaxone, respectively. <b>Methods:</b> Eighty-four <i>C. difficile</i> isolates were tested for susceptibility to Tedizolid, Dalbavancin, Ceftobiprole, Vancomycin, and Ceftriaxone by Etest technique in order to determine the minimum inhibitory concentration (MIC). <b>Results:</b> Upon comparison of the novel antibiotic agents, Dalbavancin demonstrated the lowest MIC values and ceftobiprole the highest at MIC₅₀ (0.016, 0.38, and 1.5 μg/mL, for Dalbavancin, Tedizolid, and Ceftobiprole, respectively) and MIC₉₀ (0.03, 0.78, and 3.17 μg/mL, respectively). Dalbavancin demonstrated significantly lower MIC₅₀ and MIC₉₀ values compared to Vancomycin (0.016 vs. 0.38 and 0.03 vs. 3.5, respectively) (<i>p</i> < 0.001) and ceftobiprole had significantly lower MIC values compare to ceftriaxone (1.5 vs. 32 and 3.17 vs. 28.8, respectively) (<i>p</i> < 0.001). <b>Conclusion:</b> Dalbavancin and Tedizolid may play a role as potential therapeutic agents for treatment of <i>C. difficile</i> infection. Examination of antibiotic effect on the intestinal microbiome and clinical trials are needed for more accurate results.