Efficacy and safety of eravacycline: A meta-analysis

Eljaaly, Khalid; Ortwine, Jessica; Shaikhomer, Mohammed; Almangour, Thamer A.; Bassetti, Matteo

doi:10.1016/j.jgar.2021.02.009

Cited by 20 publications

(11 citation statements)

References 18 publications

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“…Fluoroquinolones have additional activity against mycobacteria, and some are also active against anaerobes ( Appelbaum and Hunter, 2000 , Eljaaly et al, 2017 ). Fluoroquinolones and tetracyclines share some similar side effects such as gastrointestinal and photosensitivity reactions, but each class has its unique side effects such as QTc prolongation and tendon rupture with fluoroquinolones or esophagitis with tetracyclines ( Appelbaum and Hunter, 2000 , Eljaaly et al, 2017 , Eljaaly et al, 2019 , Eljaaly et al, 2020 , Eljaaly et al, 2021 ). Both fluoroquinolones and tetracyclines are available orally and some as intravenous formulations.…”

Section: Introductionmentioning

confidence: 99%

Multivalent cations interactions with fluoroquinolones or tetracyclines: A cross-sectional study

Eljaaly

Helal

Almandeel

et al. 2021

Saudi Journal of Biological Sciences

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Introduction Oral fluoroquinolones and tetracyclines are known to interact with divalent or trivalent cation-containing compounds (DTCCs) via chelation. The objective of this study is to describe the prevalence of these drug-drug interactions (DDIs) in an inpatient setting. Methods A cross-sectional study of prospectively collected data were conducted at an academic tertiary care hospital. We included hospitalized adults who were receiving oral fluoroquinolones or tetracyclines with DTCCs in 2019. Our hospital uses electronic health records for medication ordering and handwritten medication administration records (MARs). The primary study outcome was the percentage of simultaneous administration of fluoroquinolones or tetracyclines with DTCCs, and the secondary outcome was the percentage of inappropriate separation time. Results Among patients who received oral fluoroquinolones or tetracyclines, 47 patients (26.6%) were co-administered DTCCs and included in this study. Ciprofloxacin (n = 29; 61.7%) was the most commonly interacting antibiotic, followed by moxifloxacin (n = 12; 25.5%) and doxycycline (n = 6; 12.8%). The interacting DTCCs included iron-containing products and calcium-containing products, and half of the patients (n = 24; 51%) received DTCCs once daily. Most patients (n = 35; 74.5%) were found to receive oral fluoroquinolones or tetracyclines at the same time as DTCCs, while one (2.1%) received inappropriately separated DTCCs. Conclusions Despite being a very known contraindicated DDI, the prevalence of simultaneous co-administration of oral fluoroquinolones or tetracyclines with polyvalent cations was extremely high in a hospital with handwritten MARs. Antimicrobial stewardship programs should target this DDI, and future studies should evaluate the impact of different practical solutions to this problem in different clinical settings.

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Section: Introductionmentioning

confidence: 99%

Multivalent cations interactions with fluoroquinolones or tetracyclines: A cross-sectional study

Eljaaly

Helal

Almandeel

et al. 2021

Saudi Journal of Biological Sciences

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“… 28 Some countries have approved the former in the treatment of complicated intra-abdominal infections. 29 In our experiments, the MIC range of eravacycline against N. gonorrhoeae isolates was 0.06–0.5 mg/L. Approximately 88.3% of N. gonorrhoeae isolates had an eravacycline MIC below the susceptible breakpoint provided by the CLSI guidelines for Staphylococcus aureus (≤0.25 mg/L) and 100% had an eravacycline MIC below the susceptible breakpoint for Escherichia coli (≤0.5mg/L).…”

Section: Discussionmentioning

confidence: 51%

Evaluation of Neisseria gonorrhoeae Isolates Susceptibility to Tetracycline Antibiotics from 9 Provinces in China Since 2020

Zhou¹,

Xu²,

Zhu³

et al. 2022

IDR

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Purpose The increasing drug resistance of Neisseria gonorrhoeae has become a serious public health concern. This study investigated N. gonorrhoeae isolates susceptibility to tetracycline antibiotics and the correlation between minimum inhibitory concentrations (MICs) of different antibiotics. The presence of resistance determinants in N. gonorrhoeae strains displaying different levels of tigecycline resistance was also compared. Methods The minimum inhibitory concentrations (MICs) of tetracycline, minocycline, tigecycline, eravacycline, omadacycline on 412 N. gonorrhoeae isolates were measured by the agar dilution method. The MICs of ceftriaxone and azithromycin were also measured to determine the correlations between antibiotics by the value of the correlation coefficient R . The presence of resistance determinants was identified through polymerase chain reaction (PCR) and sequencing. Results The MIC 90 was 64mg/L for tetracycline, 64mg/L for minocycline, 0.5mg/L for tigecycline, 0.5mg/L for eravacycline, 4mg/L for omadacycline, 0.25 mg/L for ceftriaxone, and 1mg/L for azithromycin. The MIC 90 and mode of tigecycline and eravacycline were much lower than those of tetracycline and minocycline. A poor correlation between omadacycline, eravacycline and tetracycline susceptibility was observed. Minocycline has a strong correlation with tetracycline. PorB1 typing, TetM -encoding plasmid, and mtrR promoter adenine deletion were significantly correlated with tigecycline MIC > 0.25mg/L. Conclusion This study suggested that tigecycline and eravacycline had better in vitro activity and might be alternative antibiotics against resistant N. gonorrhoeae infections. Nevertheless, further in vitro experiments and clinical studies are needed for verification.

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“…Novel tetracyclines include omadacycline (aminomethylcycline subclass) and eravacycline (fluorocycline subclass), both of which are active against bacteria that have efflux pumps or ribosomal protection proteins, mechanisms that typically confer resistance to older tetracyclines [126,128]. Omadacycline has good oral bioavailability and a relatively long half-life (around 16 h), which permits convenient once daily dosing.…”

Section: Overcoming Resistance Through Novel Antibioticsmentioning

confidence: 99%

“…Eravacycline is approved for complicated intra-abdominal infections. A meta-analysis of 3 randomized control trials evaluating eravacycline in complicated intra-abdominal infections found that it has similar profiles of clinical efficacy and mortality with carbapenems [128,129].…”

Section: Overcoming Resistance Through Novel Antibioticsmentioning

confidence: 99%

Mechanisms of Antibiotic Resistance in Important Gram-Positive and Gram-Negative Pathogens and Novel Antibiotic Solutions

et al. 2021

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Multidrug-resistant bacteria have on overwhelming impact on human health, as they cause over 670,000 infections and 33,000 deaths annually in the European Union alone. Of these, the vast majority of infections and deaths are caused by only a handful of species—multi-drug resistant Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., Acinetobacter spp. and Klebsiella pneumoniae. These pathogens employ a multitude of antibiotic resistance mechanisms, such as the production of antibiotic deactivating enzymes, changes in antibiotic targets, or a reduction of intracellular antibiotic concentration, which render them insusceptible to multiple antibiotics. The purpose of this review is to summarize in a clinical manner the resistance mechanisms of each of these 6 pathogens, as well as the mechanisms of recently developed antibiotics designed to overcome them. Through a basic understanding of the mechanisms of antibiotic resistance, the clinician can better comprehend and predict resistance patterns even to antibiotics not reported on the antibiogram and can subsequently select the most appropriate antibiotic for the pathogen in question.

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Efficacy and safety of eravacycline: A meta-analysis

Cited by 20 publications

References 18 publications

Multivalent cations interactions with fluoroquinolones or tetracyclines: A cross-sectional study

Multivalent cations interactions with fluoroquinolones or tetracyclines: A cross-sectional study

Evaluation of Neisseria gonorrhoeae Isolates Susceptibility to Tetracycline Antibiotics from 9 Provinces in China Since 2020

Mechanisms of Antibiotic Resistance in Important Gram-Positive and Gram-Negative Pathogens and Novel Antibiotic Solutions

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