OBJECTIVES: Complicated Skin and Skin Structure Infections (cSSSIs) are among the most common treated infections in the hospitals. Ceftobiprole has demonstrated efficacy in treating cSSSIs in two non-inferiority trials, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). It is currently under review by the FDA for the treatment of cSSSIs. This study investigated the economic implications of treating cSSSIs with ceftobiprole, compared to vancomycin or ceftazidime. METHODS: A discrete event simulation of acute anti-infective treatment in patients with cSSSI was developed. Three copies of patients were created. Each copy was assigned one of the treatments (ceftobiprole, vancomycin or ceftazidime). Patients’ clinical course was simulated using data from clinical trials of ceftobiprole (patient and infection characteristics, cure rates, treatment duration, length of hospital stay, adverse event rates, treatment discontinuation, use of subsequent treatments). Pathogen coverage status was determined based on the extent to which the treatment can cover the pathogens causing the infection (MRSA only, Gram-positive non-MRSA, Gram-negative, and other possible combinations). Costs in 2007 USD were taken from published sources. Various events (relapse, treatment adjustment, and death) and the associated direct medical costs were estimated for a treatment episode (49 days). Results are based on 100 simulations of 1,000 patients each. RESULTS: The mean cost per patient was estimated to be $19,247 treated with ceftobiprole vs. $19,884 for vancomycin and $19,721 for ceftazidime.  The frequencies of cure, relapse, and death were similar across the groups. Less than 1% of patients started on ceftobiprole required treatment escalation compared to 23% for vancomycin and ceftazidime, indicating that ceftobiprole provided broader coverage against the causing pathogens of cSSSIs, thus patients received adequate coverage more promptly.     CONCLUSIONS: Using ceftobiprole for treatment of cSSSIs is expected to provide similar cure rates without increasing costs compared to vancomycin and ceftazidime in the US.