New treatment options for lower respiratory tract infections

Abstract

Community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are among the most frequent lower respiratory tract infections (LRTIs). They represent an increased morbidity and mortality rate in adults. Areas covered: This review describes recent advances regarding solithromycin, zabofloxacin and delafoxacin antibacterial agents that have been recently developed for treatment of CAP and in AECOPD. All of them have been introduced into phase III clinical trials. We will be summarising chemical structures, pharmacokinetics, antibacterial efficacy and toxicity of these agents. The manuscript has been prepared based on available scientific publications. Expert opinion: Novel agents of known antimicrobial classes have been developed that demonstrate treatment options in CAP and in AECOPD. Antimicrobials discussed in this review showed bactericide effect against major respiratory tract pathogens. Each has multiple targets in bacteria, thus enabling them for more potency, even against strains exhibiting resistance to commonly used antibiotics. Solithromycin, delafloxacin and zabofloxcian demonstrate broad-spectrum antibacterial activity together with other beneficial features like intracellular accumulation, anti-inflammatory effect and inhibition of biofilm production. These agents showed moderately severe or mild adverse events and demonstrated favourable tissue penetration. These features can make solithromycin, zabofloxacin and delafloxacin treatment options in LRTIs.

Pathogens Isolated in Respiratory Tract Samples of Recently Hospitalized Patients: Implications for Primary Care Physicians

“…A community-acquired lower respiratory tract infection (CA-LRTI) is one of the most common infections attended by primary care physicians and results in considerable use of antibiotics [1,2]. As microbiological analysis of sputum cultures is rarely performed in community settings, little is known about the etiology of CA-LRTI, and bacterial susceptibilities of causative pathogens are unknown in most areas.…”

Antimicrobial activity of ceftaroline and comparator agents tested against organisms isolated from patients with community-acquired bacterial pneumonia in Europe, Asia, and Latin America

“…Community-acquired pneumonia may be caused by bacteria resistant to some or many available therapies, and inappropriate initial empiric therapy contributes to increased morbidity and mortality (Prina et al, 2015;Wunderink and Waterer, 2014). Despite the increasing concern over emerging antimicrobial resistance, relatively few new antibacterial agents have been licensed for the treatment of community-acquired bacterial pneumonia (CABP) in the USA and/or Europe (Kocsis and Szabo, 2017).…”

Prevalence of respiratory bacterial infections in people with lower respiratory tract infections in Africa: the BARIAFRICA systematic review and meta-analysis protocol

“… 1 Depending on their location, diseases can be divided into upper and lower respiratory tract infections (LRTIs). 2 LRTIs including bronchitis, bronchiolitis and pneumonia 3 are heavy burden diseases, and also cause significant economic losses in low-income/middle-income countries and especially those in Sub-Saharan Africa. 4 5 In Sub-Saharan Africa, LRTIs rank third after HIV/AIDS and malaria in terms of causes of mortality.…”