Abstract
Eravacycline is a novel, fully synthetic fluorocycline antibiotic developed for the treatment of serious infections, including those caused by multidrug-resistant (MDR) pathogens. Here, we evaluated the in vitro activities of eravacycline and comparator antimicrobial agents against a global collection of frequently encountered clinical isolates of Gram-negative bacilli. The CLSI broth microdilution method was used to determine MIC data for isolates of Enterobacterales (n = 13,983), Acinetobacter baumannii (n = 2,097), Pseudomonas aeruginosa (n = 1,647), and Stenotrophomonas maltophilia (n = 1,210) isolated primarily from respiratory, intra-abdominal, and urinary specimens by clinical laboratories in 36 countries from 2013 to 2017. Susceptibilities were interpreted using both CLSI and EUCAST breakpoints. Multidrug-resistant (MDR) isolates were defined by resistance to agents from ≥3 different antimicrobial classes. The MIC90s ranged from 0.25 to 1 μg/ml for Enterobacteriaceae and were 1 μg/ml for A. baumannii and 2 μg/ml for S. maltophilia, Proteus mirabilis, and Serratia marcescens Eravacycline's potency was up to 4-fold greater than that of tigecycline against genera/species of Enterobacterales, A. baumannii, and S. maltophilia The MIC90s for five of six individual genera/species of Enterobacterales and A. baumannii were within 2-fold of the MIC90s for their respective subsets of MDR isolates, while the MDR subpopulation of Klebsiella spp. demonstrated 4-fold higher MIC90s. Eravacycline demonstrated potent in vitro activity against the majority of clinical isolates of Gram-negative bacilli, including MDR isolates, collected over a 5-year period. This study further underscores the potential benefit of eravacycline in the treatment of infections caused by MDR Gram-negative pathogens.
Highlights
Eravacycline is a novel, fully synthetic fluorocycline antibiotic developed for the treatment of serious infections, including those caused by multidrug-resistant (MDR) pathogens
Eravacycline is a novel, fully synthetic fluorocycline antibiotic developed for the treatment of serious infections, including those caused by MDR pathogens (5, 7; https://clinicaltrials.gov/ct2/show/NCT01844856)
Enterobacteriaceae accounted for the majority of these isolates (n ϭ 10,531)
Summary
Eravacycline is a novel, fully synthetic fluorocycline antibiotic developed for the treatment of serious infections, including those caused by multidrug-resistant (MDR) pathogens. Important antimicrobial-resistant Gram-negative pathogens include extended-spectrum--lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae; carbapenemase-producing, fluoroquinolone-resistant, and multidrugresistant (MDR) Enterobacterales; as well as carbapenem-resistant and MDR Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia [1,2,3,4,5]. Eravacycline demonstrates potent broad-spectrum activity against Gram-negative bacilli (except for P. aeruginosa and Burkholderia spp.) and Gram-positive cocci, including anaerobes, as well as atypical bacterial pathogens and Neisseria gonorrhoeae [5, 11,12,13,14,15,16], and does not exhibit a loss of antibacterial activity against isolates expressing tetracycline ribosomal protection genes or most tetracycline efflux resistance genes [10, 11, 14]
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