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依拉环素用于治疗腹腔内感染。

Eravacycline for the treatment of intra-abdominal infections.

作者信息

Bassetti Matteo, Righi Elda

机构信息

Santa Maria Misericordia Hospital, Infectious Diseases Division , Piazzale Santa Maria della Misericordia 15, 33100 Udine , Italy +39 0432 559355 ; +39 0432 559360 ;

出版信息

Expert Opin Investig Drugs. 2014 Nov;23(11):1575-84. doi: 10.1517/13543784.2014.965253. Epub 2014 Sep 24.

Abstract

INTRODUCTION

There has been a dramatic increase in the incidence of multidrug-resistant pathogens over the past few years, which highlights the need for new anti-infective therapeutics. Eravacycline is a novel, broad-spectrum synthetic tetracycline indicated for the treatment of severe infections caused by Gram-positive and Gram-negative bacteria.

AREAS COVERED

In this review, the authors report eravacycline's pharmacokinetic characteristics and its microbiological spectrum of activity. Furthermore, the authors also highlight the safety and efficacy data from the recent studies on urinary and intra-abdominal infections.

EXPERT OPINION

The profile of eravacycline offers several advantages. Indeed, eravacycline has a broad-spectrum activity toward pathogens involved in complicated urinary tract (cUTIs) and intra-abdominal infections (cIAIs), including extended-spectrum beta-lactamase and carbapenem-resistant Enterobacteriaceae, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. The availability of an oral formulation supports eravacycline's possible use in sequential therapy. High urinary concentrations favor its use in cUTIs and may reduce the overuse of other antimicrobials that may select resistance, such as carbapenems. Eravacycline efficacy and tolerability have been investigated in a Phase II clinical trial in cIAIs comparing two dosages of eravacycline with ertapenem, showing comparable efficacy among the three arms and a low rate of adverse effects. The results of new Phase III studies are awaited to confirm eravacycline's future applications in severe nosocomial infections.

摘要

引言

在过去几年中,多重耐药病原体的发病率急剧上升,这凸显了对新型抗感染治疗药物的需求。依拉环素是一种新型广谱合成四环素,用于治疗由革兰氏阳性菌和革兰氏阴性菌引起的严重感染。

涵盖领域

在本综述中,作者报告了依拉环素的药代动力学特征及其微生物活性谱。此外,作者还强调了近期关于泌尿系统和腹腔内感染研究的安全性和有效性数据。

专家观点

依拉环素具有多个优势。事实上,依拉环素对涉及复杂性尿路感染(cUTIs)和腹腔内感染(cIAIs)的病原体具有广谱活性,包括产超广谱β-内酰胺酶和耐碳青霉烯类肠杆菌科细菌、耐甲氧西林金黄色葡萄球菌和耐万古霉素肠球菌。口服制剂的可用性支持依拉环素在序贯治疗中的可能应用。高尿药浓度有利于其在cUTIs中的应用,并可能减少其他可能选择耐药性的抗菌药物(如碳青霉烯类)的过度使用。在一项针对cIAIs的II期临床试验中,对两种剂量的依拉环素与厄他培南进行了比较,研究了依拉环素的疗效和耐受性,结果显示三组疗效相当,不良反应发生率较低。期待新的III期研究结果来证实依拉环素在严重医院感染中的未来应用。

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