To Kill A Mocking Bug – of the CRKP or CRAB Variety

Meropenem stands out as an antibiotic to be used first in ESBL and MDR infections, given its efficacy profile and safety record (see earlier blog). It also would seem to be appropriate to use relatively high doses or prolonged infusion Continue reading To Kill A Mocking Bug – of the CRKP or CRAB Variety

Antibiotic Inhalers Galore (Part 1):  More Combinations and Permutations than a Rubik’s Cube

There is much interest in inhaled antibiotics these days.  Prima facie, the logic for this approach is compelling: Getting the antibiotic (and a lot of it) directly to the site of infection, while avoiding systemic toxicity, sounds like optimized efficacy Continue reading Antibiotic Inhalers Galore (Part 1):  More Combinations and Permutations than a Rubik’s Cube

Progress Report: New Antibacterials In the Fight against MDR Bacteria

Since the beginning of this millennium we have seen antibiotic R&D dwindle year after year. There are many reasons for this; while economics are often cited for this decline, the FDA and the ‘Guideline Wars’, i.e., those never ending discussions Continue reading Progress Report: New Antibacterials In the Fight against MDR Bacteria

The Brave New World of Infectious Diseases

Coming back from ECCMID, one gets the impression that we are moving towards an era in which we can diagnose everything but treat nothing. A late breaker session on colistin resistance provided much detail data on the situation in the EU. As Continue reading The Brave New World of Infectious Diseases

IV Fosfomycin To The Rescue – And To a Place Near You

A recent letter to the Editor by Simkins et al. is worth reviewing [1]. The authors describe the complicated course of a patient who suffered graft rejection after liver transplantation, received broad-spectrum antibiotics during prolonged hospitalization and eventually had a Continue reading IV Fosfomycin To The Rescue – And To a Place Near You

Aztreonam PLUS Avibactam – A New Bright Star in the Night Sky

Looking at the molecular structure of ceftazidime (CTAZ) and aztreonam (ATM), the differences are clear, and so are the similarities: ATM does not have the cephem ring structure of CTAZ, only the 4-member beta-lactam ring.  However, the side chains are Continue reading Aztreonam PLUS Avibactam – A New Bright Star in the Night Sky

Polyphor POL7080 And The Journey to The Land of Pyocyanea  (Part 1)

When Roche inlicensed Polyphor’s anti-pseudomonas drug POL7080 in November 2013, it marked a turning point.  It seemed that Big Pharma that had all but abandoned the field in the last decade and was getting engaged in anti-infectives again.  When a Continue reading Polyphor POL7080 And The Journey to The Land of Pyocyanea  (Part 1)

ALLPHASE PHARMA – THE FIRST 100 BLOG POSTS

After the first 100 blogs, it is appropriate to reflect on reader preferences.  When I arbitrarily select a topic, it is not always clear whether what interests me also interests you. Since its start 1½ years ago, this blog has grown Continue reading ALLPHASE PHARMA – THE FIRST 100 BLOG POSTS

Nitrofurantoin – An Old Drug Resurrected Needs Prospective Scrutiny

When older drugs get reintroduced into clinical practice because pathogens have developed resistance to newer agents, it comes at the price of uncertainty. Often, older drugs were approved based on rather limited data, often considered incomplete by today’s standards.  Take colistin Continue reading Nitrofurantoin – An Old Drug Resurrected Needs Prospective Scrutiny

A Renaissance for Old Drugs: Fosfomycin and Colistin

Fosfomycin Who would have thought that a drug that has been around since 1969 [2] could become eligible for QIDP status in 2015? Well, Zavante Therapeutics recently garnered the coveted QIDP designation for fosfomycin IV. This formulation has been available Continue reading A Renaissance for Old Drugs: Fosfomycin and Colistin

Artie’s Law: Avoid Bad Advice and Don’t Follow ‘Mission Impossible’ Advice

In this day and age, few truly broad spectrum antibiotics are in development, although this does not hold true for narrow-spectrums.  Just think of all the MRSA drugs (quinolones, FabI inhibitors), the pseudomonas drugs (NCEs and monoclonals) or some narrow Continue reading Artie’s Law: Avoid Bad Advice and Don’t Follow ‘Mission Impossible’ Advice

Perusing the Literature

Inhibitor of the NDM Enzyme Aspergillomarasmine (AMA) was identified as an inhibitor of the New Delhi metallo-betalactamase (NDM) enzyme. This substance, when combined with meropenem, restored antibiotic activity against an NDM lab strain.   AMA is a substance which was already tested in the Continue reading Perusing the Literature

What is the “Niche” for Ceftolozane / Tazobactam?

There are currently a total of 6 beta-lactam + beta-lactamase inhibitor combinations in clinical trials. It will be a steep learning curve for the pharma reps (and physicians) to understand the resistance classifications, the confusing ESBL definitions, the CRE nomenclature, Continue reading What is the “Niche” for Ceftolozane / Tazobactam?

Fighting P. aeruginosa (Part I)

It has never been easy to cure Pseudomonas aeruginosa infections.  Few antibiotics nowadays have reliable activity against this problem pathogen that seems to have more built-in resistance features than most other Gram-negatives.  In the past, cephalosporins, aztreonam, penems, ciprofloxacin, and Continue reading Fighting P. aeruginosa (Part I)