All Smiles at the Press Conference: Plazo+Levo Delivers

This December, Achaogen released much data on 2 plazomicin trials[1]: the pivotal EPIC study comparing plazomicin / levofloxacin with meropenem / levofloxacin in cUTI is the one we want to look at today because it is interpretable, while the other trial Continue reading All Smiles at the Press Conference: Plazo+Levo Delivers

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

Polyphor POL7080 And The Journey to The Land of Pyocyanea (Part 3)

VABP is clearly the main indication to be pursued by a drug like POL7080.  Here is the question: How to conduct a study demonstrating efficacy for a drug which only has a single-organism spectrum?  Which is actually no spectrum at all.  Existing Continue reading Polyphor POL7080 And The Journey to The Land of Pyocyanea (Part 3)

Avycaz Approval and Labeling Restrictions

On Feb 25, 2015 the combination of ceftazidime/avibactam (Avycaz) was approved by FDA for cUTI and cIAI infections in patients ‘who have limited or no alternative treatment options’.  As a QIDP drug, Avycaz received priority review.  Its label states that it is Continue reading Avycaz Approval and Labeling Restrictions

At Last, The Fairy Tale Becomes Clear…

If you ever wondered how Snow White could have been poisoned by eating an apple, you probably did not realize how much this tale of folklore was based on cruel reality.  Science has finally caught up with the Brothers Grimm Continue reading At Last, The Fairy Tale Becomes Clear…

Meropenem Dosing for VAP: High + Prolonged Beats Conventional Dosing

Sometimes an article pops up addressing a question we have been mulling over for quite some time.  It so happened with a recent publication which shed new light on penem dosing for ICU patients[1]. Conducted at a single Belgian centre Continue reading Meropenem Dosing for VAP: High + Prolonged Beats Conventional Dosing

CRE Surveillance Data from France

Despite all the concern about the emergence of CRE pathogens worldwide, it is quite difficult to obtain hard quantitative, prospectively collected incidence figures. A recent article by Robert [1] and colleagues provides useful data from France.  Using a practical definition of carbapenem-non-susceptibility Continue reading CRE Surveillance Data from France

What’s in a Name?  Would ‘Carbavance’ Still Smell as Sweet?

Since the publication of a series of posters at ICAAC 2014, we finally know what’s hidden behind the ‘Carbavance’ name.  ‘Carbavance’ stands for the combination of meropenem with the B-lactamase inhibitor RPX7009 which The Medicines Company (TMC) inlicensed from Rempex Continue reading What’s in a Name?  Would ‘Carbavance’ Still Smell as Sweet?

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 II)

At a still earlier stage of development, we found some exciting anti-pseudomonal compounds. First, there is BAL-30072, a sulfactam-derivative.  It has an interesting dual MoA as it works not only as a traditional B-lactam but also as an Fe-chelator blocking bacteria from Continue reading Fighting P. aeruginosa (Part II)