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DOI: 10.1055/s-0028-1119813
New Antibiotics for Healthcare-Associated Pneumonia
Publication History
Publication Date:
06 February 2009 (online)
ABSTRACT
Current antibiotics available for the treatment of healthcare-associated pneumonia (HCAP) may result in clinical failure due to resistance development, side effect intolerance, or poor pharmacokinetic-pharmacodynamic profiles. New agents active against common HCAP pathogens are needed. The mechanism of action, spectrum of activity, pharmacokinetics, adverse effects, and clinical efficacy of seven new agents in clinical development or recently approved with either methicillin-resistant Staphylococcus aureus (MRSA) or pseudomonal activity are reviewed. They include doripenem, a new antipseudomonal carbapenem; ceftobiprole and ceftaroline, two anti-MRSA cephalosporins; iclaprim, a selective dihydrofolate reductase antagonist; and three glycopeptides, dalbavancin, telavancin, and oritavancin.
KEYWORDS
Healthcare-associated pneumonia - antibiotics - treatment
REFERENCES
- 1 American Thoracic Society and Infectious Diseases Society of America . Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005; 171 388-416
- 2 Jones R N, Huynh H K, Biedenbach D J, Fritsche T R, Sader H S. Doripenem (S-4661), a novel carbapenem: comparative activity against contemporary pathogens including bactericidal action and preliminary in vitro methods evaluations. J Antimicrob Chemother. 2004; 54 144-154
- 3 Jones R N, Huynh H K, Biedenbach D J. Activities of doripenem (S-4661) against drug-resistant clinical pathogens. Antimicrob Agents Chemother. 2004; 48 3136-3140
- 4 Davies T A, Shang W, Bush K, Flamm R K. Affinity of doripenem and comparators to penicillin-binding proteins in Escherichia coli and Pseudomonas aeruginosa . Antimicrob Agents Chemother. 2008; 52 1510-1512
- 5 Mushtaq S, Ge Y, Livermore D M. Comparative activities of doripenem versus isolates, mutants, and transconjugants of Enterobacteriaceae and Acinetobacter spp. with characterized β-lactamases. Antimicrob Agents Chemother. 2004; 48 1313-1319
- 6 Jones R N, Sader H S, Fritsche T R. Comparative activity of doripenem and three other carbapenems tested against gram-negative bacilli with various β-lactamase resistance mechanisms. Diagn Microbiol Infect Dis. 2005; 52 71-74
- 7 Mushtaq S, Ge Y, Livermore D M. Doripenem versus Pseudomonas aeruginosa in vitro: activity against characterized isolates, mutants, and transconjugants and resistance selection potential. Antimicrob Agents Chemother. 2004; 48 3086-3092
- 8 Sakyo S, Tomita H, Tanimoto K, Fujimoto S, Ike Y. Potency of carbapenems for the prevention of carbapenem-resistant mutants of Pseudomonas aeruginosa . J Antibiot (Tokyo). 2006; 59 220-228
- 9 Ikawa K, Morikawa N, Urakawa N, Ikeda K, Ohge H, Sueda T. Peritoneal penetration of doripenem after intravenous administration in abdominal-surgery patients. J Antimicrob Chemother. 2007; 60 1395-1397
- 10 Bhavnani S M, Hammel J P, Cirincione B B, Wikler M A, Ambrose P G. Use of pharmacokinetic-pharmacodynamic target attainment analyses to support phase 2 and 3 dosing strategies for doripenem. Antimicrob Agents Chemother. 2005; 49 3944-3947
- 11 Floren L, Wikler M, Kilfoil T, Ge Y. A phase 1 open-label controlled study to evaluate the safety, tolerability, and pharmacokinetics of doripenem administered intravenously to subjects with renal impairment. Presented at: 44th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) October 30–Nov 2, 2004 Washington, DC; A-17
- 12 Horiuchi M, Kimura M, Tokumura M, Hasebe N, Arai T, Abe K. Absence of convulsive liability of doripenem, a new carbapenem antibiotic, in comparison with β-lactam antibiotics. Toxicology. 2006; 222 114-124
-
13 Naber K, Redman R, Kotey P, Llorens L, Kaniga K. Intravenous therapy with doripenem versus levofloxacin with an option for oral step-down therapy in the treatment of complicated urinary tract infections and pyelonephritis. In: 17th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) March 31–April 3, 2007 Munich, Germany; Abstract P 833
- 14 Lucasti C, Jasovich A, Umeh O, Jiang J, Kaniga K, Friedland I. Efficacy and tolerability of IV doripenem versus meropenem in adults with complicated intra-abdominal infection: a phase III prospective, multicenter, randomized, double-blind, noninferiority study. Clin Ther. 2008; 30 868-883
- 15 Malafaia O, Umeh O, Jiang J. Doripenem versus meropenem for the treatment of complicated intra-abdominal infections. Presented at: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2007 San Francisco, CA; L-1564b
- 16 Rea-Neto A, Niederman M, Lee M, Kaniga K, Prokocimer P, Friedland I. Efficacy and safety of intravenous doripenem vs piperacillin/tazobactam in nosocomial pneumonia. Presented at: 47th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 17–20, 2007 Chicago, IL;
- 17 Chastre J, Wunderink R, Prokocimer P, Lee M, Kaniga K, Friedland I. Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: A multicenter, randomized study. Crit Care Med. 2008; 36 1089-1096
- 18 Bogdanovich T, Ednie L M, Shapiro S, Appelbaum P C. Antistaphylococcal activity of ceftobiprole, a new broad-spectrum cephalosporin. Antimicrob Agents Chemother. 2005; 49 4210-4219
- 19 Fritsche T R, Sader H S, Jones R N. Antimicrobial activity of ceftobiprole, a novel anti-methicillin-resistant Staphylococcus aureus cephalosporin, tested against contemporary pathogens: results from the SENTRY antimicrobial surveillance pro (2005–2006). Diagn Microbiol Infect Dis. 2008; 61 86-95
- 20 Lin G, Appelbaum P C. Activity of ceftobiprole compared with those of other agents against Staphylococcus aureus strains with different resistotypes by time-kill analysis. Diagn Microbiol Infect Dis. 2008; 60 233-235
- 21 Davies T A, Page M GP, Shang W, Andrew T, Kania M, Bush K. Binding of ceftobiprole and comparators to the penicillin-binding proteins of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pneumoniae . Antimicrob Agents Chemother. 2007; 51 2621-2624
- 22 Banerjee R, Gretes M, Basuino L, Strynadka N, Chambers H F. In vitro selection and characterization of ceftobiprole-resistant methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2008; 52 2089-2096
- 23 Queenan A M, Shang W, Kania M, Page M GP, Bush K. Interactions of ceftobiprole with β-lactamases from molecular classes A to D. Antimicrob Agents Chemother. 2007; 51 3089-3095
- 24 Zbinden R, Punter V, von Graevenitz A. In vitro activities of BAL9141, a novel broad-spectrum pyrrolidinone cephalosporin, against gram-negative nonfermenters. Antimicrob Agents Chemother. 2002; 46 871-874
- 25 Lodise T P, Patel N, Renaud-Mutart A, Gorodecky E, Fritsche T R, Jones R N. Pharmacokinetic and pharmacodynamic profile of ceftobiprole. Diagn Microbiol Infect Dis. 2008; 61 96-102
- 26 Balis D, Strauss R, Murthy B, Tiian H, Noel G. QT/QTc assessment of ceftobiprole in a single-dose study. Presented at: 17th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) March 31–April 3, 2007 Munich, Germany; Abstract P 783
- 27 Noel G J, Strauss R S, Amsler K, Heep M, Pypstra R, Solomkin J S. Results of a double-blind, randomized trial of ceftobiprole treatment of complicated skin and skin structure infections caused by gram-positive bacteria. Antimicrob Agents Chemother. 2008; 52 37-44
- 28 Noel G J, Bush K, Bagchi P, Ianus J, Strauss R S. A randomized, double-blind trial comparing ceftobiprole medocaril with vancomycin plus ceftazidime for the treatment of patients with complicated skin and skin-structure infections. Clin Infect Dis. 2008; 46 647-655
- 29 Nicholson S C, Strauss R A, Michiels B, Noel G J. Efficacy of ceftobiprole (BPR) compared to ceftriaxone +/− linezolid for the treatment of hospitalized community-acquired pneumonia. Presented at: American Thoracic Society International Conference May 16–21, 2008 Toronto, Canada; C 16 Available at: http://www.abstracts2view.com/ats08/
- 30 Basilea. Basilea announces positive top-line data from phase III study of ceftobiprole in hospital-acquired pneumonia. Available at: http://www.basilea.com/template_loader.php?tplpage_id=34&mode=details&id=144 Accessed 17 July 2008
- 31 Sader H S, Fritsche T R, Kaniga K, Ge Y, Jones R N. Antimicrobial activity and spectrum of PPI-0903M (T-91825), a novel cephalosporin, tested against a worldwide collection of clinical strains. Antimicrob Agents Chemother. 2005; 49 3501-3512
- 32 Mushtaq S, Warner M, Ge Y, Kaniga K, Livermore D M. In vitro activity of ceftaroline (PPI-0903M, T-91825) against bacteria with defined resistance mechanisms and phenotypes. J Antimicrob Chemother. 2007; 60 300-311
- 33 Jacqueline C, Caillon J, Le Mabecque V et al.. In vivo efficacy of ceftaroline (PPI-0903), a new broad-spectrum cephalosporin, compared with linezolid and vancomycin against methicillin-resistant and vancomycin-intermediate Staphylococcus aureus in a rabbit endocarditis model. Antimicrob Agents Chemother. 2007; 51 3397-3400
- 34 Ge Y, Hubbel A. In vitro evaluation of plasma protein binding and metabolic stability of ceftaroline (PPI-0903). In: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2006 San Francisco, CA; A-1935
- 35 Jacqueline C, Caillon J, Miegeville A et al.. Penetration of ceftaroline (PPI-0903), a new cephalosporin, into lung tissues: measurement of plasma and lung tissue concentrations after a short IV infusion in the rabbit. In: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2006 San Francisco, CA; A-1938
- 36 Ge Y, Floren L, Redman R, Liao S, Wilker M. The pharmacokinetics and safety of ceftaroline (PPI-0903) in healthy subjects receiving multiple-dose intravenous infusions. In: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2006 San Francisco, CA; A-1937
- 37 Ge Y, Thye D, Liao S, Talbot G. Pharmacokinetics of ceftaroline (PPI-0903) in subjects with mild or moderate renal impairment. In: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2006 San Francisco, CA; A-1939
- 38 Andes D, Craig W A. Pharmacodynamics of a new cephalosporin, PPI-0903 (TAK-599), active against methicillin-resistant Staphylococcus aureus in murine thigh and lung infection models: identification of an in vivo pharmacokinetic-pharmacodynamic target. Antimicrob Agents Chemother. 2006; 50 1376-1383
- 39 Talbot G H, Thye D, Das A, Ge Y. Phase 2 study of ceftaroline versus standard therapy in treatment of complicated skin and skin structure infections. Antimicrob Agents Chemother. 2007; 51 3612-3616
- 40 Schneider P, Hawser S, Islam K. Iclaprim, a novel diaminopyrimidine with potent activity on trimethoprim sensitive and resistant bacteria. Bioorg Med Chem Lett. 2003; 13 4217-4221
- 41 Hawser S, Lociuro S, Islam K. Dihydrofolate reductase inhibitors as antibacterial agents. Biochem Pharmacol. 2006; 71 941-948
- 42 Bajaksouzian S, Windau A, Appelbaum P C, Jacobs M R. AR-100, a novel diaminopyrimidine compound: activity against staphylococci and enterococci. In: 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2002 San Diego, CA; F-2024
- 43 Bozdogan B, Esel D, Whitener C, Browne F A, Appelbaum P C. Antibacterial susceptibility of a vancomycin-resistant Staphylococcus aureus strain isolated at the Hershey Medical Center. J Antimicrob Chemother. 2003; 52 864-868
- 44 Then R L, Hartman P G, Locher H H. AR-100, a novel diaminopyrimidine compound: in vitro activity against pneumococci. In: 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2002 San Diego, CA; F-2021
- 45 Kohlhoff S A, Roblin P M, Reznik T, Hawser S, Islam K, Hammerschlag M R. In vitro activity of a novel diaminopyrimidine compound, iclaprim, against Chlamydia trachomatis and C. pneumoniae . Antimicrob Agents Chemother. 2004; 48 1885-1886
- 46 Morrissey I, Hawser S. Activity of iclaprim against Legionella pneumophila . J Antimicrob Chemother. 2007; 60 905-906
- 47 Milatovic D, Verhoef J, Fluit A C. In vitro activity of iclaprim (AR-100) against gram-positive and gram-negative bacteria. In: 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 14–17, 2003 Chicago, IL; Abstract E-2006
- 48 Laue H, Weiss L, Bernardi A, Hawser S, Lociuro S, Islam K. In vitro activity of the novel diaminopyrimidine, iclaprim, in combination with folate inhibitors and other antimicrobials with different mechanisms of action. J Antimicrob Chemother. 2007; 60 1391-1394
- 49 Hawser S, Haldimann A, Parisi S, Gillessen D, Islam K. AR-100, a novel diaminopyrimidine compound: resistance studies in trimethoprim-sensitive and -resistant Staphylococcus aureus . In: 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2002 San Diego, CA; F-2028
- 50 Andrews J, Honeybourne D, Ashby J et al.. Concentrations in plasma, epithelial lining fluid, alveolar macrophages and bronchial mucosa after a single intravenous dose of 1.6 mg/kg of iclaprim (AR-100) in healthy men. J Antimicrob Chemother. 2007; 60 677-680
- 51 Arpida. Arpida presents additional clinical evidence of good bioavailability of oral iclaprim. Available at: http://www.arpida.ch/index.php?MenuID=0&UserID=1&ContentID=99 Accessed 17 July 2008
- 52 Arpida. Arpida announces positive results in first phase III trial of iclaprim in complicated skin and skin structure infections. Available at: http://www.arpida.ch/index.php?MenuID=0&UserID=1&ContentID=116 Accessed 17 July 2008
- 53 Arpida. Arpida provides comprehensive overview of pivotal phase III trial data. Available at: http://www.arpida.ch/index.php?MenuID=0&UserID=1&ContentID=164 Accessed 17 July 2008
- 54 Malabarba A, Goldstein B P. Origin, structure, and activity in vitro and in vivo of dalbavancin. J Antimicrob Chemother. 2005; 55(Suppl 2) ii15-ii20
- 55 Jones R N, Stilwell M G, Sader H S, Fritsche T R, Goldstein B P. Spectrum and potency of dalbavancin tested against 3322 gram-positive cocci isolated in the United States surveillance program (2004). Diagn Microbiol Infect Dis. 2006; 54 149-153
- 56 Streit J M, Sader H S, Fritsche T R, Jones R N. Dalbavancin activity against selected populations of antimicrobial-resistant gram-positive pathogens. Diagn Microbiol Infect Dis. 2005; 53 307-310
- 57 Leighton A, Bendix-Gottlieb A, Dorr M B et al.. Tolerability, pharmacokinetics, and serum bactericidal activity of intravenous dalbavancin in healthy volunteers. Antimicrob Agents Chemother. 2004; 48 940-945
- 58 Dowell J, Seltzer E, Stogniew M, Dorr M B, Fayocavitz S, Krause D. Dalbavancin dosage adjustments not required for patients with mild renal impairment. Clin Microbiol Infect. 2003; 9(Suppl 1) 291 P 1224
- 59 Dowell J, Seltzer E, Krause R, Henkel T. The safety and pharmacokinetics of dalbavancin in subjects with renal impairment or end-stage renal disease. Clin Microbiol Infect. 2005; 11(Suppl 2) 272 P 896
- 60 Bowker K E, Noel A R, MacGowan A P. Pharmacodynamics of dalbavancin studied in an in vitro pharmacokinetic system. J Antimicrob Chemother. 2006; 58 802-805
- 61 Nord C E, Rasmanis G, Wahlund E. Effect of dalbavancin on the normal intestinal microflora. J Antimicrob Chemother. 2006; 58 627-631
- 62 Jauregui L E, Babazadeh S, Seltzer E et al.. Randomized, double-blind comparison of once-weekly dalbavancin versus twice-daily linezolid therapy for the treatment of complicated skin and skin structure infections. Clin Infect Dis. 2005; 41 1407-1415
- 63 Raad I, Darouiche R, Vazquez J et al.. Efficacy and safety of weekly dalbavancin therapy for catheter-related bloodstream infection caused by gram-positive pathogens. Clin Infect Dis. 2005; 40 374-380
- 64 Cavaleri M, Riva S, Valagussa A et al.. Pharmacokinetics and excretion of dalbavancin in the rat. J Antimicrob Chemother. 2005; 55(Suppl 2) ii31-ii35
- 65 Higgins D L, Chang R, Debabov D V et al.. Telavancin, a multifunctional lipoglycopeptide, disrupts both cell wall synthesis and cell membrane integrity in methicillin-resistant Staphylococcus aureus . Antimicrob Agents Chemother. 2005; 49 1127-1134
- 66 King A, Phillips I, Kaniga K. Comparative in vitro activity of telavancin (TD-6424), a rapidly bactericidal, concentration-dependent anti-infective with multiple mechanisms of action against gram-positive bacteria. J Antimicrob Chemother. 2004; 53 797-803
- 67 Leuthner K D, Cheung C M, Rybak M J. Comparative activity of the new lipoglycopeptide telavancin in the presence and absence of serum against 50 glycopeptide non-susceptible staphylococci and three vancomycin-resistant non-susceptible staphylococci and three vancomycin-resistant Staphylococcus aureus . J Antimicrob Chemother. 2006; 58 338-343
- 68 Krause K, Debabov D, Pace J, Kaniga K. Low frequency of spontaneous resistance to td-6424 and delayed resistance selection in vitro among staphylococci and enterococci. In: 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 14–17, 2003 Chicago, IL; C1–1810
- 69 Shaw J P, Seroogy J, Kaniga K, Higgins D L, Kitt M, Barrier S. Pharmacokinetics, serum inhibitor and bactericidal activity, and safety of telavancin in healthy subjects. Antimicrob Agents Chemother. 2005; 49 195-201
- 70 Gotfried M H, Shaw J P, Benton B M et al.. Intrapulmonary distribution of intravenous telavancin in healthy subjects and effect of pulmonary surfactant on in vitro activities of telavancin and other antibiotics. Antimicrob Agents Chemother. 2008; 52 92-97
- 71 Odenholt I, Lowdin E, Cars O. Pharmacodynamic effects of telavancin against methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains in the presence of human albumin or serum and in an in vitro kinetic model. Antimicrob Agents Chemother. 2007; 51 3311-3316
- 72 Barriere S, Genter F, Spencer E, Kitt M, Hoelscher D, Morganroth J. Effects of a new antibacterial, telavancin, on cardiac repolarization (QTc interval duration) in healthy subjects. J Clin Pharmacol. 2004; 44 689-695
- 73 Stryjewski M E, Graham D R, Wilson S E et al.. Telavancin versus vancomycin for the treatment of complicated skin and skin-structure infections caused by gram-positive organisms. Clin Infect Dis. 2008; 46 1683-1693
- 74 Rubinstein E, Corey G R, Stryjewski M E et al.. Telavancin for hospital-acquired pneumonia, including ventilator-associated pneumonia: the ATTAIN studies. In: 18th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) April 19–22, 2008 Barcelona, Spain; Abstract O 75
- 75 Mckay G A, Fadhil I, Beaulieu S et al.. Oritavancin disrupts transmembrane potential and membrane integrity concomitantly with cell killing in Staphylococcus aureus and vancomycin-resistant enterococci. In: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 27–30, 2006 San Francisco, CA; Abstract C1–682
- 76 Zeckel M L, Preston D A, Allen B S. In vitro activities of LY333328 and comparative agents against nosocomial gram-positive pathogens collected in a 1997 global surveillance study. Antimicrob Agents Chemother. 2000; 44 1370-1374
- 77 Hershberger E, Aeschlimann J R, Moldovan T, Rybak M J. Evaluation of bactericidal activities of LY333328, vancomycin, teicoplanin, ampicillin-sulbactam, trovafloxacin, and RP59500 alone or in combination with rifampin or gentamicin against different strains of vancomycin-intermediate Staphylococcus aureus by time-kill curve methods. Antimicrob Agents Chemother. 1999; 43 717-721
- 78 Sahm D F, Blosser R S, Loutit J S, Porter S B. Selection studies for oritavancin-resistant Staphylococcus aureus and enterococci. In: 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) September 14–17, 2003 Chicago, IL; C1–1808
- 79 Bhavnani S M, Owen J S, Loutit J S, Porter S B, Ambrose P G. Pharmacokinetics, safety, and tolerability of ascending single intravenous doses of oritavancin administered to healthy human subjects. Diagn Microbiol Infect Dis. 2004; 50 95-102
- 80 Rodvold K A, Gotfried M H, Loutit J S, Porter S B. Plasma and intrapulmonary concentrations of oritavancin and vancomycin in normal healthy adults. Clin Microbiol Infect. 2004; 10(Suppl 3) 44 O 254
- 81 Bhavnani S M, Passarell J A, Owen J S, Loutit J S, Porter S B, Ambrose P G. Pharmacokinetic-pharmacodynamic relationships describing the efficacy of oritavancin in patients with Staphylococcus aureus bacteremia. Antimicrob Agents Chemother. 2006; 50 994-1000
- 82 Van Bambeke F, Saffran J, Mingeot-Leclercq M P, Tulkens P M. Mixed-lipid storage disorder induced in macrophages and fibroblasts by oritavancin (LY333328), a new glycopeptides antibiotic with exceptional cellular accumulation. Antimicrob Agents Chemother. 2005; 49 1695-1700
- 83 Wasilewski M M, Disch D P, Mcgill J M, Harris H W, O'Riordan W, Zeckel M L. Equivalence of shorter course therapy with oritavancin vs. vancomycin/cephalexin in complicated skin/skin structure infections. In: 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) December 16–19, 2001 Chicago, IL; Abstract UL-18
- 84 Loutit J S, O'Riordan W, San Juan J et al.. Phase 2 trial comparing four regimens of oritavancin vs. comparator in the treatment of patients with S. aureus bacteremia. Clin Microbiol Infect. 2004; 10(Suppl 3) 122 , P 541
Scott T MicekPharm.D.
Department of Pharmacy, Barnes-Jewish Hospital
Mailstop 90-52-411, 216 S. Kingshighway Blvd., St. Louis, MO 63110
Email: stm8241@bjc.org