A profile of delafloxacin in the treatment of adults with community-acquired bacterial pneumonia

Gómez-Zorrilla, Sílvia; Sendra, Elena; Horcajada, Juan Pablo

doi:10.1080/17512433.2022.2100346

Cited by 3 publications

(4 citation statements)

References 69 publications

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“…DLX is, therefore, a promising antibiotic that exerts a large spectrum of activity (targeting both Gram-positive and Gram-negative bacteria) and interesting PK/PD properties. During clinical trials, patients were exposed to DLX for a short period of time (5 to 14 days), and DLX was generally well-tolerated, as the majority of AEs were gastrointestinal disorders and headaches [ 54 ]. Therefore, AEs related to its current use should be monitored, especially for those known to be associated with FQs (e.g., QT prolongation, hepatic or tendon disorders), particularly in case of prolonged treatments.…”

Section: Discussionmentioning

confidence: 99%

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Updated Review on Clinically-Relevant Properties of Delafloxacin

Turban¹,

Guérin

Dinh

et al. 2023

Antibiotics

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The extensive use of fluoroquinolones has been consequently accompanied by the emergence of bacterial resistance, which triggers the necessity to discover new compounds. Delafloxacin is a brand-new anionic non-zwitterionic fluoroquinolone with some structural particularities that give it attractive proprieties: high activity under acidic conditions, greater in vitro activity against Gram-positive bacteria—even those showing resistance to currently-used fluoroquinolones—and nearly equivalent affinity for both type-II topoisomerases (i.e., DNA gyrase and topoisomerase IV). During phases II and III clinical trials, delafloxacin showed non-inferiority compared to standard-of-care therapy in the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia, which resulted in its approval in 2017 by the Food and Drug Administration for indications. Thanks to its overall good tolerance, its broad-spectrum in vitro activity, and its ease of use, it could represent a promising molecule for the treatment of bacterial infections.

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Section: Discussionmentioning

confidence: 99%

“…In vitro activity of delafloxacin and comparators against clinical isolates of Gram-positive bacteria[10,11,45,[47][48][49][51][52][53][54].…”

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confidence: 99%

Updated Review on Clinically-Relevant Properties of Delafloxacin

Turban¹,

Guérin

Dinh

et al. 2023

Antibiotics

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“…47 Delafloxacin a novel fluoroquinolone has proven efficacy in patients with CAP compared with moxifloxacin. 48 Delafloxacin covered MRSA and some gram-negative DTR bacilli 49 Other new antibiotics available include β-lactamase inhibitors or β-lactam with coverage of ESBL-producing gram-negative bacilli, P. aeruginosa or non-fermenting gram-negative bacilli; however, it is less likely that broadspectrum antibiotics can be used as empirical treatments and should be reserved for those patients at risk of DTR as we suggested above. According to the prevalence of DTR, each hospital should decide on its empirical treatment, covering the most common pathogens and according to the efficacy/ effectiveness and safety profile of the available antibiotics.…”

Section: Clinical Managementmentioning

confidence: 99%

“…47 Delafloxacin a novel fluoroquinolone has proven efficacy in patients with CAP compared with moxifloxacin. 48 Delafloxacin covered MRSA and some gram-negative DTR bacilli 49…”

Section: Clinical Managementmentioning

confidence: 99%

Risk of Multidrug-Resistant Pathogens in Severe Community-Acquired Pneumonia

Campaña-Duel,

Camprubí-Rimblas,

Areny-Balagueró

et al. 2024

Semin Respir Crit Care Med

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Severe community-acquired pneumonia (SCAP) is difficult to treat when caused by difficult-to-treat (DTR) pathogens because of limited treatment options and poorer clinical outcomes. Over time, several predictive scoring systems based on risk factors for infection with multidrug resistant pathogens have been developed. We reviewed the available tools for identifying DTR pathogens as the cause of SCAP, both predictive scoring systems and rapid diagnostic methods, to develop management strategies aimed at early identification of DTR pathogens, reducing broad-spectrum antibiotic use and improving clinical outcomes. The scoring systems reviewed show considerable heterogeneity among them at the level of the region studied, the definition of risk factors, as well as which DTR pathogens are the target pathogens. The models described have shown limited effectiveness in reducing inappropriate antibiotic treatment or improving patient outcomes by themselves. However, predictive models could serve as a first step in identifying DTR pathogen infections as part of a larger detection algorithm. Rapid diagnostic tools, such as multiplex polymerase chain reaction, would be useful for the rapid identification of pneumonia-causing pathogens and their resistance mechanisms. In resource-limited settings, rapid tests should be limited to patients at high risk of developing SCAP due to DTR pathogens. We propose an integrative algorithm based on the different scores, taking into account local epidemiological data, where ideally each center should have an antimicrobial stewardship program.

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In vitro activity of delafloxacin against clinical levofloxacin-resistant Helicobacter pylori isolates

Luzarraga,

Cremniter,

Plouzeau

et al. 2024

Journal of Antimicrobial Chemotherapy

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Background Increasing antibiotic resistance in Helicobacter pylori necessitates research on new active molecules. In 2017, delafloxacin, a new fluoroquinolone with chemical properties of activity under acidic conditions, was approved for treatment of community-acquired bacterial pneumonia and acute bacterial skin and soft-tissue infections. Mutations in gyrA are responsible for fluoroquinolone resistance, but certain clinical isolates of H. pylori appear to display a dual phenotype: resistance to levofloxacin associated with very low delafloxacin MICs. Objectives To estimate epidemiological cut-off (ECOFF) values and to identify mutations in the gyrA gene, specific to FQ resistance, without increasing the MICs of delafloxacin. Methods Clinical strains (n = 231) were collected in the bacteriology laboratory of Poitiers University Hospital over a 2 year period to determine the ECOFF of delafloxacin. Retrospectively, 101 clinical strains with an levofloxacin-resistant phenotype (MIC > 1 mg/L) were selected from 2018 to 2022 for delafloxacin MIC determination and QRDR (gyrA) sequencing. Results The estimated ECOFF of delafloxacin was ≤0.125 mg/L. No H. pylori isolate showed a levofloxacin-sensitive phenotype with a delafloxacin MIC of >0.125 mg/L. Among the levofloxacin-resistant H. pylori isolates, 53.5% had delafloxacin MICs of ≤0.125 mg/L. The N87I mutation was associated with dual levofloxacin/delafloxacin resistance (P < 0.001) in contrast to the N87K and D91N mutations (P > 0.05). Mutations D91G and D91Y were not associated with a delafloxacin resistance phenotype (P > 0.05). Conclusions Delafloxacin seems to be a therapeutic alternative for levofloxacin-resistant strains with greater in vitro activity. However, further clinical/biological investigations are required to determine its efficacy in H. pylori eradication.

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A profile of delafloxacin in the treatment of adults with community-acquired bacterial pneumonia

Cited by 3 publications

References 69 publications

Updated Review on Clinically-Relevant Properties of Delafloxacin

Updated Review on Clinically-Relevant Properties of Delafloxacin

Risk of Multidrug-Resistant Pathogens in Severe Community-Acquired Pneumonia

In vitro activity of delafloxacin against clinical levofloxacin-resistant Helicobacter pylori isolates

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