Mercuric dichloride induces DNA damage in human salivary gland tissue cells and lymphocytes

Amalgam is still one of the most frequently used dental filling materials. However, the possible adverse effects especially that of the mercuric component have led to continued controversy. Considering that mercury may be released from amalgam fillings into the oral cavity and also reach the circulating blood after absorption and resorption, it eventually may contribute to tumorigenesis in a variety of target cells. The present investigation focuses on genotoxic effects below a cytotoxic dose level of mercuric dichloride (HgCl₂) in human samples of salivary glands and lymphocytes to elucidate a possible role in tumor initiation. DNA migration due to single strand breaks, alkali labile sites and incomplete excision repair was quantified with the aid of the single cell microgel electrophoresis (Comet) assay. The concepts of Olive Tail Moment, percentage of DNA in the Tail and Tail Length were used as measures of DNA damage. To control for cytotoxic effects, the trypan blue exclusion test was applied. Human samples of the parotid salivary gland and lymphocytes of ten donors were exposed to HgCl₂ concentrations from 1 to 50 μM. N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) and dimethyl sulfoxide (DMSO) served as controls. Increasing dose-dependent DNA migration could be demonstrated after exposure to HgCl₂ in cells of the salivary glands and lymphocytes. In both cell types a significant increase in DNA migration could be shown starting from HgCl₂ concentrations of 5 μM in comparison to the negative control. The viability of the cell systems was not affected except at the highest concentration (50 μM) tested. These data indicate genotoxic effects of mercuric dichloride in human salivary glands and lymphocytes at concentrations not leading to cytotoxic effects or cell death. Consequently, a contributory role in oral salivary gland tumor initiation warrants further investigation. The authors declare that there is no conflict of interest.     

Metronidazole induces DNA strand-breaks in cultures of human lymphocytes and phytohemagglutinin-stimulated human lymphocytes

Metronidazole (CAS 443-48-1) induces DNA single strand-breaks in resting human cells (non-stimulated lymphocytes) and in proliferating human cells (phytohemagglutinin-(PHA-)stimulated lymphocytes). The DNA damage depends on metronidazole concentration and time of culture or stimulation. In proliferating lymphocytes the number of DNA single strand-breaks is higher than in resting lymphocytes. In non-stimulated lymphocytes the 3H-thymidine incorporation increases after incubation with metronidazole, possibly due to DNA repair processes. In PHA-stimulated lymphocytes 3H-thymidine incorporation is inhibited by metronidazole. This could be due to the inhibitory effect of DNA damage on cell proliferation. Vitality is not reduced by metronidazole, indeed it may be, as a consequence of DNA repair processes, higher than in controls. DNA repair processes can be also demonstrated after washing out metronidazole from the culture medium.     

Nicotine induces DNA damage in human salivary glands

The tobacco alkaloid nicotine is responsible for addiction to tobacco and supposed to contribute to tobacco carcinogensis, too. Recently, genotoxic effects of nicotine have been reported in human cells from blood and upper aerodigestive tract. Because of nicotine accumulation in saliva, the study of possible in vitro genotoxic effects of nicotine have been extended to human salivary gland cells. Specimens of parotid glands of 10 tumor patients were obtained from tumor-free tissue. Single cells were prepared by enzymatic digestion immediately after surgery and exposed for 1h to 0.125-4.0mM of nicotine. Possible genotoxic effects were determined by the Comet assay using the % DNA in tail (DT) as a reliable indicator of DNA damage. Nicotine induced a significant dose-dependent increase of DNA migration in parotid gland single-cells. The mean DT was 1.12-fold (0.125mM) to 2.24-fold (4.0mM) higher compared to control. The lowest concentration eliciting significant DNA damage within 1h, 0.25mM nicotine, is only 10-fold higher than maximal concentrations of nicotine reported in saliva after unrestricted smoking. Although conclusive evidence for a carcinogenic potential of nicotine is still lacking, the safety of long-term nicotine replacement therapy should be carefully monitored.     

DNA damage induced by ethoxyquin in human peripheral lymphocytes

Ethoxyquin (1,2-dihydro-6-ethoxy-2,2,4-trimethylquinoline, EQ) is widely used in various food products and in animal feeds because of its powerful antioxidant activity. This compound was recently found to cause not only many unfavourable side-effects in animals fed with feeds containing it, but also adverse effects in people exposed to it at work. In the present study, DNA damage induced by EQ in human lymphocytes has been assessed. The alkaline single cell gel electrophoresis assay (comet assay) was used to measure DNA damage. The cells were treated for 1 h with EQ doses ranging from 1 to 250 microM in the absence or in the presence of an exogenous metabolic activation system (S9mix). The obtained results showed that EQ-induced DNA damage in human lymphocytes in a dose-dependent manner; the observed DNA fragmentation induced by EQ in the presence of metabolic activation system was always significantly lower, as compared to cells treated with the same doses of EQ alone.     

The effect of brevenal on brevetoxin-induced DNA damage in human lymphocytes

Brevenal is a nontoxic short-chain trans-syn polyether that competes with brevetoxin (PbTx) for the active site on voltage-sensitive sodium channels. The PbTxs are highly potent polyether toxins produced during blooms of several species of marine dinoflagellates, most notably Karenia brevis. Blooms of K. brevis have been associated with massive fish kills, marine mammal poisoning, and are potentially responsible for adverse human health effects such as respiratory irritation and airway constriction in beach-goers. Additionally, the consumption of shellfish contaminated with PbTxs results in neurotoxic shellfish poisoning (NSP). The purpose of the present study was to determine whether PbTx could induce DNA damage in a human cell type, the lymphocyte, and if so, whether the damage could be antagonized or ameliorated by brevenal, a brevetoxin antagonist. The DNA damage may occur through both endogenous and exogenous physiological and pathophysiological processes. Unrepaired or erroneously repaired DNA damage may result in gene mutation, chromosome aberration, and modulation of gene regulation, which have been associated with immunotoxicity and carcinogenesis. A single-cell gel electrophoresis assay, or comet assay, was used to determine and compare DNA damage following various treatments. The data were expressed as tail moments, which is the percentage of DNA in the tail multiplied by the length between the center of the head and center of the tail (in arbitrary units). The negative control tail moment was 29.2 (SE=±0.9), whereas the positive control (hydrogen peroxide) was 72.1 (1.5) and solvent (ethanol) was 24.2 (2.1). The PbTx-2 (from Sigma, St. Louis, MO, USA), 10^–8 M was 41.3 (3.6), PbTx-9 (Sigma), 10^–8 M was 57.0 (5.3), PbTx-2 (from University of North Carolina at Wilmington, UNCW), 10^–8 M was 49.4 (9.9), and PbTx-3 (UNCW), 10^–8 M was 64.0 (6.4). 1.0 g/ml brevenal applied 1 h before the PbTxs protected the lymphocytes from DNA damage; PbTx-2 (Sigma), 31.3 (2.1); PbTx-9 (Sigma), 35.5 (2.9); PbTx-2 (UNCW), 33.9 (1.4); PbTx-3 (UNCW), 34.9 (1.25). The tail moment for 1.0 g/ml brevenal alone was 30.8 (2.6). The results indicate that extensive genotoxic damage is induced by PbTx-2 and 9 (Sigma), and PbTx-2 and 3 (UNCW) in normal human lymphocytes, which is fully antagonized by brevenal. This suggests that the immune systems of individuals exposed to PbTx during harmful algal bloom (HAB) events may be at risk.     

Evaluation of DNA damage induced by norcantharidin in human cultured lymphocytes

Norcantharidin (NCTD) is currently used in the treatment of several cancers such as leukemia, melanoma and hepatoma. The mechanism of action of NCTD is suggested to involve induction of apoptosis of cancer cells via production of reactive oxygen species. In this study, the genotoxic effect of different concentrations of NCTD (1, 10 and 20?μm) in human lymphocytes was investigated using sister chromatid exchanges (SCEs) and chromosomal aberrations (CAs) assays. The results revealed that NCTD significantly increased the rate of SCEs (p?<?0.05) in a dose-dependent manner. In addition, NCTD significantly increased the number of high-frequency cells (SCEs?≥?8, p?<?0.05). However, NCTD did not have any significant effect on the rate of CAs (p?>?0.05). In addition, no significant differences were detected in the mitotic index or proliferative index at examined doses (up to 20?μm). In conclusion, NCTD is genotoxic to human cultured lymphocytes as measured by SCE assay.     

Vanadyl sulfate can differentially damage DNA in human lymphocytes and HeLa cells

Using the comet assay, we showed that vanadyl sulfate induced DNA damage in human normal lymphocytes and in HeLa cells. Vanadyl at 0.5 and 1 mM produced DNA single- and double-strand breaks (SSBs and DSBs) in lymphocytes, whereas in HeLa cells we observed only SSBs. Post-treatment of vanadyl-damaged DNA from lymphocytes with formamidopyrimidine-DNA glycosylase (Fpg), an enzyme recognizing oxidized purines, gave rise to a significant increase in the extent of DNA damage. A similar effect was observed in HeLa cells, but, using endonuclease III, we also detected oxidized pyrimidines in DNA of these cells. There were no differences in the extent of DNA damage in the lymphocytes and HeLa cells in the pH >13 and pH 12.1 conditions of the comet assay, which indicates that strand breaks, and not alkali-labile sites, contributed to the measured DNA damage. Study of DNA repair, determined in the comet assay as an ability of cells to decrease of DNA damage, revealed that HeLa cells retained the ability to repair vanadyl-damaged DNA induced at a ten-fold higher concentration than that in lymphocytes. Incubation of the cells with nitrone spin traps DMPO, POBN and PBN decreased the extent of DNA damage, which might follow from the production of free radicals by vanadyl sulfate. The presence of vitamins A, C or E caused an increase of DNA damage in HeLa cells whereas in lymphocytes such an increase was observed only for vitamin C. Our data indicate that vanadyl sulfate can be genotoxic for normal and cancer cells. It seems to have a higher genotoxic potential for cancer cells than for normal lymphocytes. Vitamins A, C and E can increase this potential.     

A comet assay study reveals that aluminium induces DNA damage and inhibits the repair of radiation-induced lesions in human peripheral blood lymphocytes

Although it is known that many metals induce DNA damage and inhibit DNA repair, information regarding aluminium (Al) is scarce. The aim of this study was to analyze the level of DNA damage in human peripheral blood lymphocytes treated with Al and the impact of Al on the repair of DNA damage induced by ionizing radiation. Cells were treated with different doses of aluminium chloride (1, 2, 5, 10 and 25 microg/ml AlCl(3)) for 72 h. The level of DNA damage and of apoptosis was determined by the comet assay. The level of oxidative damage was determined by the application of endonuclease III and formamidopyrimidine DNA glycosylase. The results on apoptosis were confirmed by flow cytometry. Based on the fluorescence intensity, cells were divided into cohorts of different relative DNA content that corresponds to G(1), S and G(2) phases of the cell cycle. Our results revealed that Al induces DNA damage in a dose-dependent manner, however, at the dose of 25 microg/ml the level of damage declined. This decline was accompanied by a high level of apoptosis indicating selective elimination of damaged cells. Cells pre-treated with Al showed a decreased repair capacity indicating that Al inhibits DNA repair. The possible mechanisms by which Al induces DNA damage and inhibits the repair are discussed.     

Evaluation of catechol-induced DNA damage in human lymphocytes: a comparison between freshly isolated lymphocytes and T-lymphocytes from extended-term cultures.

Extended-term cultures of proliferating human T-lymphocytes (ETC) may be a practical alternative to freshly isolated non-proliferating peripheral blood lymphocytes (PBL) when studying genotoxicity in vitro. To investigate if the pattern of DNA damage differs between the two in vitro systems, catechol-induced DNA damage was evaluated in PBL and ETC derived from the same blood sample, using three different donors. DNA damage was monitored using the comet assay. Whereas 3 h of exposure to 0.5 mM catechol was found to be without DNA damaging effects, 3 mM was found to induce significant damage both in the PBL and the ETC (the latter being clearly less sensitive). The level of reactive oxygen species (ROS) was also measured in the ETC using the fluorescent probe carboxy-H2DCFA. ROS was found to be considerably increased both at 0.5 and 3 mM catechol. The demonstrated difference in sensitivity towards catechol-induced DNA damage between PBL and ETC may be due to their different proliferative status, but despite this difference both in vitro systems were able to identify catechol as a DNA damaging agent at the same concentration.     

Selenite induces DNA damage and specific mitochondrial degeneration in human bladder cancer cells

We have investigated the cytotoxicity and specific effects of selenite in human bladder cancer cell line RT-112 and its clonogenic variant RT-112 HB. Selenite inhibited cell growth and proliferation in both cell lines. Treated cells developed extensive vacuolization which was dose independent but occurring in differing time frames. Ultrastructure analysis revealed that the observed vacuoles are damaged mitochondria and potentially other subcellular compartments. Selenite-specific effects on mitochondria were further confirmed by mitochondrial membrane potential analysis, changes in ATP production and generation of superoxide. Simultaneously, selenite induced DNA damage in treated cells with activation of p53, PARP-1 and JNK and suppressed autophagy. Cells ultimately died via a combination of apoptosis, necrosis and a distinct type of cell death featuring “vacuolar shrinkage”, loss of adherence and absence of secondary necrosis as well as other classical markers of either apoptosis or autophagy. The significant presence of so called necroptosis was also not confirmed as the specific inhibitor necrostatin-1 could not prevent cell death. These results thus confirm the toxicity of selenite in bladder cancer cells while pointing at potentially new mechanism of action of this compound in this model.     

2-Hydroxyestradiol induces oxidative DNA damage and apoptosis in human mammary epithelial cells

Catechol estrogens, the hydroxylated metabolites of 17beta-estradiol (E2), have been considered to be implicated in estrogen-induced carcinogenesis. 2-Hydroxyestradiol (2-OHE2), a major oxidized metabolite of E2 formed preferentially by cytochrome P-450 1A1, reacts with DNA to form stable adducts and exerts genotoxicity. 2-OHE2 can be oxidized to quinone, which is accompanied by generation of reactive oxygen species (ROS). In the present study, 2-OHE2 induced strand scission in phiX174 phage DNA and oxidative base modifications in calf thymus DNA in the presence of cupric ion. In cultured human mammary epithelial (MCF-10A) cells, 2-OHE2 treatment produced ROS accumulation, 8-oxo-7,8-dihydroxy-2'-deoxyguanosine formation, cytotoxicity, and disruption of mitochondrial transmembrane potential, all of which were prevented by N-acetylcysteine. These findings, taken together, suggest that 2-OHE2-induced oxidative DNA damage and apoptosis in MCF-10A cells might be mediated by ROS generated via the redox cycling of this catechol estrogen.     

Effects of pesticides on human peripheral lymphocytes in vitro: induction of DNA damage

Because of the widespread use of pesticides for domestic and industrial applications the evaluation of their genotoxic effects is of major concern to public health. Although various experimental data have provided evidence that pesticides can possess genotoxic properties in animals and in in vitro test systems after acute and chronic exposure, the information on the genotoxic effects of some of pesticides is limited and inconsistent. In the present study, the genotoxic potential of commonly used pesticides (i.e., dimethoate and methyl parathion from the organophosphate class, propoxur and pirimicarb from carbamates, and cypermethrin and permethrin from pyrethroids) have been evaluated. The genotoxic effects of these substances were examined using the single cell gel electrophoresis (comet) assay in freshly isolated human peripheral lymphocytes. The cells were incubated with 10, 50, 100 and 200 µg/ml concentrations of the test substances for 0.5 h at 37°C and DNA damage was compared with that obtained in lymphocytes from the same donor not treated with substances. Hydrogen peroxide, 100 µM, was used as a positive control. Within the concentration ranges studied, no significant cytotoxic effects were observed. Dimethoate and methyl parathion at 100 and 200 µg/ml; propoxur at 50, 100 and 200 µg/ml, and pirimicarb, cypermethrin and permethrin at 200 µg/ml significantly increased DNA damage in human lymphocytes.     

1,2,4-trihydroxybenzene induces stress granule formation and causes DNA damage in human keratinocytes

Household chemical products are typically evaluated for toxicity through ingestion and inhalation, with limited information on skin absorption. Furthermore, current research focuses on the long-term toxic effects of harmful substances contained in these household chemical products, however not much is known about their acute toxic effects. In this study, the effects of 1,2,4-trihydroxybenzene (THB) in human keratinocytes by examining its effects on stress granule (SG) formation, a marker of acute stress response, and DNA double strand breaks caused by repeated exposure. THB effectively induced SG formation via endoplasmic reticulum stress-mediated eIF2α phosphorylation in keratinocytes. Furthermore, repeated exposure to THB causes apoptotic cell death due to DNA double strand breaks. Collectively, THB exposure leads to skin toxicity, suggesting precautions for the use of THB-containing household chemical products.     

Microcystin-LR induces oxidative DNA damage in human hepatoma cell line HepG2.

Microcystins are naturally occurring hepatotoxins produced by strains of Microcystis aeruginosa. They are involved in promoting primary liver tumours and a previous study showed that they might also be tumour initiators. In this study we demonstrate that microcystin-LR (MCLR) at doses that were not cytotoxic (0.01-1 microg/ml), induced dose and time dependent DNA strand breaks in human hepatoma cell line HepG2. These DNA strand breaks were transient, reaching a maximum level after 4h of exposure and declining with further exposure. In the presence of the DNA repair inhibitors cytosine arabinoside (AraC) and hydroxyurea (HU), together with MCLR, DNA strand breaks accumulated after prolonged exposure. These results suggest that DNA strand breaks are intermediates, produced during the cellular repair of MCLR induced DNA damage. Digestion of DNA with purified, oxidative DNA damage specific enyzmes, endonuclease III (Endo III) and formamidopyrimidine-DNA glycosylase (Fpg) markedly increased DNA strand breaks in MCLR treated cells, providing evidence that a substantial portion of the MCLR induced DNA strand breaks originate from excision of oxidative DNA adducts. A hydroxyl radical scavenger (DMSO) significantly reduced MCLR induced DNA damage. From these results we conclude that MCLR induces formation of reactive oxygen species that cause DNA damage, and that MCLR may act as an initiator of liver cancer.     

Tributyltin induces DNA damage as well as oxidative damage in rats

In this study, oxidative and DNA damage were measured synchronously after Sprague-Dawley rats were exposed to different dosages of tributyltin (TBT) for 3 and 7 consecutive days. Oxidative damage was measured by analyzing the production of hepatic reactive oxygen species (ROS), the activity of superoxide dismutase (SOD), and the content of malondialdehyde (MDA). DNA damage was measured by single-cell gel electrophoresis (comet assay). After 3 days of exposure, significant differences in ROS production could only be seen between the control and the highest dosage group (10 mg/kg BW d), although after 7 days of treatment, ROS production increased in a dose-dependent manner. SOD activity increased with dosage after 3 days of exposure and decreased with dosage after 7 days of exposure. TBT also induced significant production of MDA after 7 days of exposure. The changes in ROS, SOD, and MDA found in this study suggest that the antioxidative systems of rats were activated by TBT in the first 3 days of exposure but had become exhausted by 7 days of exposure. In the comet assay, the number of cells with damaged DNA in rats treated with TBT increased with dosage of TBT. The most likely mechanism of the DNA breakage induced by TBT is oxidative damage. It can be concluded that exposure of TBT can promote both oxidative and DNA damage in mammals in vivo.     

DNA damage response and apoptosis induced by hyperthermia in human umbilical cord blood lymphocytes

While hyperthermia (HT) is a promising modality for cancer treatment, the knowledge on mechanisms of its effect on cells is still limited. We have investigated DNA double-strand break (DSB) and apoptosis induced by HT. Umbilical cord blood lymphocytes (UCBL) were subjected to HT at 43 °C. We have treated cells for 1 h (1 h HT), 2 h (2 h HT) and by combined HT and ice treatment (both lasting 1 h). Enumeration of DSB by 53BP1/γH2AX DNA repair focus formation and early apoptosis by γH2AX pan-staining was conducted by automated fluorescent microscopy. Apoptotic stages and viability were assessed by the annexin/propidium iodide (PI) assay using flow cytometry 0, 18, and 42 h post-treatment. HT induced either immediate (2 h HT) or postponed (1 h HT) DNA damage. The levels of 53BP1 and γH2AX foci differed under the same treatment conditions, suggesting that the ratio of co-localized γH2AX/53BP1 foci to all γH2AX and also to all 53BP1 foci could be a valuable marker. The ratio of co-localized foci increased immediately after 2 h HT regardless the way of assessment. For the first time we show, by both annexin/PI and γH2AX pan-staining assay that apoptosis can be induced during or immediately after the 2 h HT treatment. Our results suggest that HT may induce DSB in dependence on treatment duration and post-treatment time due to inhibition of DNA repair pathways and that HT-induced apoptosis might be dependent or associated with DSB formation in human lymphocytes. Assessment of γH2AX pan-staining in lymphocytes affected by HT may represent a valuable marker of HT treatment side effects.     

Valproic acid monotherapy induces DNA oxidative damage

Valproic acid (VPA) and 8-hydroxy-2-deoxyguanosine (8-OHdG) are implicated with the free radicals production. We aimed to evaluate total oxidant status (TOS) and 8-OHdG in children on VPA monotherapy. Fifty patients with seizures, mean age 8.5+/-3.6 years, were divided into group A (N=26) and group B (N=24) with VPA serum levels 81.0+/-8.0 and 114+/-9.7 microg/mL, respectively. Thirty healthy children were the controls. Liver function tests and lipids were determined with routine methods, TOS and 8-OHdG with commercial kits, after 60 days on VPA therapy. Liver function parameters, lipids, TOS (647+/-43 micromol/L) and 8-OHdG (0.49+/-0.08 ng/mL) were significantly higher in group B than those in group A (580+/-40 micromol/L, 0.37+/-0.04 ng/mL, p<0.001) and controls (124+/-30 micromol/L, 0.11+/-0.04 ng/mL, p<0.001, respectively). Significant correlation coefficients were found between 8-OHdG versus TOS (r=0.67, p<0.001) and 8-OHdG versus VPA (r=0.60, p<0.001) levels. It is suggested that VPA impairs the liver function resulting in free radicals production. The latter seems to produce DNA oxidative damage in liver cells, not excluding neuronal cells, as evidenced by the measured remarkably increased 8-OHdG serum levels. 8-OHdG evaluation may be a useful biomarker to follow up the increased risk of degeneration process in VPA patients.     

Modulation of ethoxyquin genotoxicity by free radical scavengers and DNA damage repair in human lymphocytes

N-tert-butyl-α-phenylnitrone (PBN) and its new derivative N-(Pyridine-4-ylmethylidene)-2-carboxy-tert-butylamine N-oxide (PBNC) were synthesized and used to modulate ethoxyquin (1,2-dihydro-6-ethoxy-2,2,4-trimethylquinoline, EQ) genotoxicity. Ethoxyquin, an antioxidant used mainly as a preservative in animal feeds, was shown to cause DNA breaks in human lymphocytes. The aim of the study was to evaluate the involvement of free radicals in the genotoxicity of EQ and its modulation by cellular repair systems. Human lymphocytes treated with EQ (10–50 μM) and nitrone free radical scavengers (100 μM) were tested with the comet assay. It was shown that both PBN and PBNC reduced the level of EQ-induced DNA damage, but PBN was slightly more effective. The modulation of the level of DNA damage was also observed as a result of DNA repair by cellular repair systems. Moreover, induction of oxidized bases by ethoxyquin was showed; lymphocytes exposed to ethoxyquin and treated with endonuclease III (Endo III) and formamidopyrimidine-DNA glycosylase (FpG), enzymes recognizing oxidized bases, displayed greater extent of DNA damage than those not treated with the enzymes.     

Ceftobiprole: a new broad spectrum cephalosporin

Ceftobiprole, formerly designated BAL9141/Ro 63-9141, is a pyrrolidinone-3-ylidene-methyl cephalosporin with demonstrated in vitro activity against MRSA, Enterococcus faecalis, Enterobacteriaceae and Pseudomonas aeruginosa. Ceftobiprole has a low potential for inducing chromosomal AmpC β-lactamases but it is hydrolyzed by most extended spectrum β-lactamases and metallo-β-lactamases. Glomerular filtration is predominantly responsible for removal of the free drug from the systemic circulation. The efficacy of ceftobiprole in the treatment of complicated skin and ski-structure infections has been recently demonstrated in two Phase III randomized clinical trials involving 1600 patients. Two other Phase III clinical trials to assess ceftobiprole's efficacy in community-acquired pneumonia and nosocomial pneumonia have also concluded. While the drug met the noninferiority criteria for community-acquired pneumonia and nosocomial pneumonia involving non-ventilator associated pneumonia, ceftobiprole was less effective than the comparator in ventilator associated pneumonia subjects. Ceftobiprole was well tolerated with a safety profile consistent with the cephalosporin class of antibiotic. The most frequent drug-related adverse event was dysgeusia. Ceftobiprole is intended for use in the hospital for the treatment of infections that frequently involve β-lactam-resistant Gram-negative and Gram-positive organisms.