1. Ann Med. 2014 Nov;46(7):512-29. doi: 10.3109/07853890.2014.935470.
Epub 2014 Jul 24.
Renaissance of antibiotics against difficult infections: Focus on
oritavancin and new ketolides and quinolones.
Van Bambeke F.
Author information:
Pharmacologie
cellulaire et moléculaire, Louvain Drug Research Institute, Université
catholique de Louvain, Brussels, Belgium.
Abstract Lipoglycopeptide, ketolide, and quinolone antibiotics are
currently in clinical development, with specific advantages over available
molecules within their respective classes. The lipoglycopeptide oritavancin is
bactericidal against MRSA, vancomycin-resistant enterococci, and multiresistant
Streptococcus pneumoniae, and proved effective and safe for the treatment of
acute bacterial skin and skin structure infection (ABSSSI) upon administration
of a single 1200 mg dose (two completed phase III trials). The ketolide
solithromycin (two phase III studies recruiting for community-acquired
pneumonia) shows a profile of activity similar to that of telithromycin, but in
vitro data suggest a lower risk of hepatotoxicity, visual disturbance, and
aggravation of myasthenia gravis due to reduced affinity for nicotinic
receptors. Among quinolones, finafloxacin and delafloxacin share the unique property
of an improved activity in acidic environments (found in many infection sites).
Finafloxacin (phase II completed; activity profile similar to that of
ciprofloxacin) is evaluated for complicated urinary tract and Helicobacter
pylori infections. The other quinolones (directed towards Gram-positive
pathogens) show improved activity on MRSA and multiresistant S. pneumoniae
compared to current molecules. They are in clinical evaluation for ABSSSI
(avarofloxacin (phase II completed), nemonoxacin and delafloxacin (ongoing
phase III)), respiratory tract infections (zabofloxacin and nemonoxacin
(ongoing phase III)), or gonorrhea (delafloxacin).
PMID:
25058176 [PubMed - in process]