The rise of antimicrobial resistance and the limited number of new antimicrobial agents make the prudent use of these agents more important than ever. That is why we developed the EXPANS method (Exploratory Positioning of Antimicrobials in New Settings) to systematically broaden the indications of existing agents. As an example, we applied this method to ceftaroline, a cephalosporin.
This method consists of three parts:
• A literature review to identify reported experiences.
• An observational study to identify clinical on-label and off-label experiences in a specific context.
• An expert meeting to discuss possible indications and identify barriers to use.
This case study shows that ceftaroline can be a valuable option for an antimicrobial agent for certain indications. The EXPANS method offers a structured way to explore the untapped potential of antimicrobial agents and thus contribute to prudent use in times of increasing resistance.
These insights come from research that is part of Hester Stoorvogel's completed PhD programme (Internal Medicine and IQ Health) with Marlies Hulscher as supervisor.
Stoorvogel HH, Hulscher MEJL, Kolwijck E, Huis In 't Veld RAG, Zeren A, Schouten JA, Ten Oever J, Wertheim HFL. A mixed methods approach (EXPANS) to assess current and future uses of antimicrobials: a case study of ceftaroline. Eur J Clin Microbiol Infect Dis. 2025 Nov 13. doi: 10.1007/s10096-025-05339-7.