Table 3.
Intravenous Antimicrobials Active Against Gram-Negative Bacilli in Advanced (Phase 2 or 3) Clinical Developmenta
| Product | Class (Mechanism of Action) | Novel Mechanism of Action? | Status | Activity Targets |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Enterobacteriaceae |
Psuedomonas aeruginosa |
Acinetobacter spp |
||||||||||
| ESBL | sCBP | mCBP | WT | MDR | mCBP | WT | MDR | |||||
| 1 | Ceftolozane/taxobactam (CXA-201; CXA-101/tazobactam) | Antipseudomonal cephalosporin/BLI combination (cell wall synthesis inhibitor) | No | Phase 3 (cUTI, cIAI) | Yes | No | No | Yes | IE | No | No | No |
| 2 | Ceftazidime-avibactam (ceftazidime/NXL104) | Antipseudomonal cephalosporin/BLI combination (cell wall synthesis inhibitor) | No | Phase 3 (cIAI) | Yes | Yes | No | Yes | IE | No | No | No |
| 3 | Ceftaroline-avibactam (CPT-avibactam; ceftaroline/NXL104) | Anti-MRSA cephalosporin/ BLI combination (cell wall synthesis inhibitor) | No | Phase 2 (cUTI, cIAI) | Yes | Yes | No | No | No | No | No | No |
| 4 | Imipenem/MK-7655 | Carbapenem/BLI combination (cell wall synthesis inhibitor) | No | Phase 2 (cUTI, cIAI) | Yes | Yes | No | Yes | IE | No | IE | No |
| 5 | Plazomicin (ACHN-490) | Aminoglycoside (protein synthesis inhibitor) | No | Phase 2 (cUTI) | Yesb | Yesb | IE | No | No | No | No | No |
| 6 | Eravacycline (TP-434) | Fluorocycline (protein synthesis inhibitor targeting the ribosome) | No | Phase 2 (cIAI) | Yesb | Yes | IE | No | No | No | IE | IE |
| 7 | Brilacidin (PMX-30063) | Peptide defense protein mimetic (cell membrane disruption) | Yes? | Phase 2 (ABSSSI) | Yes | IE | IE | IE | IE | IE | No | No |
Activity based on available information.
Abbreviations: ABSSSI, acute bacterial skin and skin structure infection; BLI, β-lactamase inhibitor; cIAI, complicated intra-abdominal infection; cUTI, complicated urinary tract infection; ESBL, extended-spectrum β-lactamase producers; IE, insufficient evidence available; mCPB, metallo-carbapenamase producers (eg, NDM, VIM, IMP); MDR, multidrug-resistant pattern including co-resistances to aminoglycosides (amikacin, gentamicin, tobramycin), fluoroquinolones, tetracyclines, and broad-spectrum β-lactams by various mechanisms carried on common genetic elements; MRSA, methicillin-resistant Staphylococcus aureus; sCBP, serine carbapenemase producers such as KPC; WT, wild-type pattern for species.
a Intravenous antimicrobials not listed in IDSA's 2009 drug status report [2].
b Incomplete coverage of some species (Proteus mirabilis and indole-positive Proteus species).