146 - New Drugs for Bad Bugs: Six Newer Antibiotics for Multidrug Resistant Pathogens

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 12 April 2022

⏱️ 40 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we discuss six newer antibiotics that target multidrug resistant gram negative bacteria with Dr. Christie Bertram, PharmD, BCIDP. We review common resistance mechanisms, particularly to carbapenems, and highlight the current role in therapy for the following antibiotics: ceftolozane/tazobactam (Zerbaxa®), ceftazidime/avibactam (Avycaz®), meropenem/vaborbactam (Vabomere®), imipenem/cilastatin/relebactam (Recarbrio®), cefiderocol (Fetroja®), and eravacycline (Xerava®).

Key Concepts

Ceftolozane/tazobactam (Zerbaxa®) is primarily used for multidrug resistant Pseudomonas; it does not cover carbapenemase-producing organisms and (despite the tazobactam) needs metronidazole for intra-abdominal anaerobic coverage.
Ceftazidime/avibactam (Avycaz®) is primarily used to cover CRE (Carbapenem-resistant Enterobacterales) but also has activity for many other gram negatives except Acinetobacter.
Meropenem/vaborbactam (Vabomere®) has similar coverage to Avycaz® but may provide coverage for certain KPCs (Klebsiella pneumoniae carbapenemase). Vaborbactam does not restore activity for meropenem-resistant Pseudomonas.
Imipenem/cilastatin/relebactam (Recarbrio®) has similar coverage to Avycaz® and Vabomere®; true niche in therapy is not yet well defined.
Cefiderocol (Fetroja®) uses a unique mechanism to enter gram negative bacteria and has a broad spectrum of activity against carbapenemase-producing bacteria and many other multidrug resistant gram negatives. It has no gram positive activity.
Eravacycline (Xerava®) is a tigecycline-like tetracycline with a broad spectrum of activity against carbapenemase-producing gram negative, gram positive, an anaerobic bacteria EXCEPT it lacks coverage for Pseudomonas.

References

Yusuf E, Bax HI, Verkaik NJ, van Westreenen M. An Update on Eight "New" Antibiotics against Multidrug-Resistant Gram-Negative Bacteria. J Clin Med. 2021;10(5):1068. Published 2021 Mar 4. doi:10.3390/jcm10051068
CDC Antibiotic Resistance Threats in the United States, 2019 report. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show. Welcome to Helix Talk episode 146. I'm your co-host Dr. Kane.
0:35.6	I'm Dr. Patel. And today with us, coming back is Dr. Christy Bertram to discuss our new and exciting topic.
0:44.3	Thank you for having me. I'm really excited to be here and talk about one of my favorite topics, gram negative resistance and the newer antibiotics we can use to treat these infections.
0:52.7	Wonderful. So the title of today's episode is New Dr.
0:56.1	For Bad Bugs, Six Newer Antibiotics for Multidug-Rosistant Pathogens.
1:00.9	Dr. Bertram, we've obviously asked you to come on today because you are an expert in infectious
1:05.3	diseases and welcome back to the podcast.
1:07.8	You know, today we're talking about six newer drugs that any inpatient
1:12.3	clinician is likely to see in the next several years, if not sooner, to treat some of these
1:17.8	newer multi-drug resistant gram-negative pathogens. I think we owe it to our audience to kind
1:24.0	of give a background on what are these multi-drug resistance. We call it the
1:28.4	MDR bugs. Back in 2013, CDC had published its very first antibiotic resistant threat report
1:36.7	that highlighted the urgency and the issue of antibiotic resistant with the bacteria. At that time,
1:43.9	the report had said about 2.8 million antibiotic resistant with the bacteria. And at that time, the report had said about 2.8 million
1:46.5	antibiotic resistant infections happen in the U.S. And a lot of people die. 35,000 people per year
1:53.6	die from these type of infection. That's mind-boggling in the world of science that we live in
1:58.8	today. It really is.
2:04.3	And in 2019, the CDC updated this threat report.
	...

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