New approaches to antibiotic therapy in Gram-positive infections

73 Pages·2014·4.27 MB·English

by  Françoise Van Bambeke

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Paul M. Tulkens, MD, PhD
Cellular and Molecular Pharmacology
& Center of Clinical Pharmacy
Louvain Drug Research Institute
Université catholique de Louvain
http://www.facm.ucl.ac.be
Session: Perspectives on the evolution and dissemination of
Gram-positive organisms: a global challenge
With approval of the Common Belgian Medical Ethical platform - visa no. 14/V1/5871/060591.
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Disclosures
Financial support from
• the Belgian Fonds de la Recherche Scientifique for basic research
on pharmacology antibiotics and related topics
• Université catholique de Louvain for past personal support
• Commercial Relationships:
– AstraZeneca, GSK, Sanofi-Aventis, Bayer HealthCare, Cempra
Pharmaceuticals, The Medicines Company, Northern Antibiotics, RibX,
Cubist, Galapagos, …
• Other relationships in relation to this talk
– Belgian Antibiotic Policy Coordination Committee
– European Medicines Agency (as expert for the agency and for Industry)
Slides: http://www.facm.ucl.ac.be  Lectures
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The Antibiotic Saga…
Davies & Davies, Microbiol. Mol. Biol. Rev. (2010) 74:417-33
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… as a result…
daptomycin
tigecycline
telavancin
ceftaroline
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… But actually there are escapes for some
of the “No ESKAPE” !
E. faecium
E. aerogenes
S. aureus
P. aeruginosa
K. pneumoniae A. baumannii
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Anti Gram-positive agents in the near pipeline
* new target (not yet exploited) – dual site of action for oritavancin
** old target but not exploited in human systemic medicine
a unanimous vote in favor at the last FDA Public Hearing (March 2013)
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Main drugs approved for MRSA before 2008
• Vancomycin
/ teicoplanin
(the old guys)
• Linezolid
(approved in 2000)
• Tigecycline
(approved in 2005)
• Daptomycin
(approved in 2003)
• Cotrimoxazole, clindamycin, doxycycline/minocycline (CA-MRSA)
(also old guys)
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VANCOMYCIN (in the good old time)
peak level: 30-40 mg/L
2 h after the end of infusion

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VANCOMYCIN for IDSA

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VANCOMYCIN with IDSA guidelines: what are the risks …
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