quinupristin-dalfopristin and evernimicin

The increasing resistance among Gram-positive cocci have been accompanied by their increasing frequency as cause of severe infection. Thus new antimicrobial agents, TAZ/PIPC, synercid and linezolid, are in various stages of development. TAZ/PIPC, a combination drug of a new beta-lactamase inhibitor tazobactam and piperacillin at ratio in 1 to 4 has a broad spectrum of antimicrobial activity. Evidence from randomized clinical trials in adults in Japan has shown that TAZ/PIPC is superior to PIPC as a drug for complicated urinary tract infection. Synercid is a streptogramin antibiotic. The spectrum of activity of synercid is similar to vancomycin. Furthermore, most of E. faecium were susceptible. The efficacy of synercid in clinical trials in patients infected with VREF was 65-70%. Linezolid is a member of the oxazolidinones. The antimicrobial spectrum of linezolid is similar to that of vancomycin. In the US, patients with significant infection caused by resistant Gram-positive organisms(mostly VREF) were treated with linezolid. The efficacy of linezolid was about 75%. The clinical trials for everninomicin had been discontinued because of insufficient clinical data supporting its efficacy and safety.

Topics: Acetamides; Adult; Aminoglycosides; Anti-Bacterial Agents; Anti-Infective Agents; Bacterial Infections; Drug Combinations; Drug Therapy, Combination; Enzyme Inhibitors; Humans; Linezolid; Oxazolidinones; Penicillanic Acid; Penicillins; Piperacillin; Protein Synthesis Inhibitors; Tazobactam; Virginiamycin

Topics: Aminoglycosides; Anti-Bacterial Agents; Anti-Infective Agents; Bacterial Infections; Daptomycin; Drug Resistance, Bacterial; Drug Therapy, Combination; Fluoroquinolones; Humans; Oxazolidinones; Protein Synthesis Inhibitors; Vancomycin; Virginiamycin

The susceptibilities of Mycoplasma hominis, Mycoplasma pneumoniae, and Ureaplasma urealyticum to eight new antimicrobial agents were determined by agar dilution. M. pneumoniae was susceptible to the new glycylcycline GAR-936 at 0.12 microg/ml and evernimicin at 4 microg/ml, but it was resistant to linezolid. It was most susceptible to dirithromycin, quinupristin-dalfopristin, telithromycin, reference macrolides, and josamycin. M. hominis was susceptible to linezolid, evernimicin, and GAR-936. It was resistant to macrolides and the ketolide telithromycin but susceptible to quinupristin-dalfopristin and josamycin. U. urealyticum was susceptible to evernimicin (8 to 16 microg/ml) and resistant to linezolid. It was less susceptible to GAR-936 (4.0 microg/ml) than to tetracycline (0.5 microg/ml). Telithromycin and quinupristin-dalfopristin were the most active agents against ureaplasmas (0.06 microg/ml). The new quinolone gatifloxacin was active against M. pneumoniae and M. hominis at 0.12 to 0.25 microg/ml and active against ureaplasmas at 1.0 microg/ml. The MICs of macrolides were markedly affected by pH, with an 8- to 32-fold increase in the susceptibility of M. pneumoniae as the pH increased from 6.9 to 7.8. A similar increase in susceptibility with increasing pH was also observed with ureaplasmas. Tetracyclines showed a fourfold increase of activity as the pH decreased 1 U, whereas GAR-936 showed a fourfold decrease in activity with a decrease in pH.

Topics: 4-Quinolones; Acetamides; Aminoglycosides; Anti-Bacterial Agents; Aza Compounds; Erythromycin; Fluoroquinolones; Gatifloxacin; Humans; Hydrogen-Ion Concentration; Ketolides; Linezolid; Macrolides; Microbial Sensitivity Tests; Minocycline; Moxifloxacin; Mycoplasma hominis; Mycoplasma pneumoniae; Oxazolidinones; Quinolines; Tetracyclines; Tigecycline; Ureaplasma urealyticum; Virginiamycin