Safety of Newer Parenteral Antibiotics

Abstract

Several parenteral antimicrobials have been introduced into clinical practice over the course of the last decade. Some of these agents (e.g., linezolid, daptomycin, and tigecycline) are prototypes of new classes of compounds. In comparative clinical trials, these newer anti-infectives have been shown to be safe and to have low rates of discontinuation by patients. However, long-term use has revealed unique toxicities associated with the use of some of these drugs. The adverse events and potential drug interactions associated with the use of these antibiotics are variable and require familiarity with the safety profile of each drug. It is especially important that clinicians be able to recognize serious adverse events associated with the use of specific drugs, because most of the adverse events can be readily reversed by cessation of therapy.

In Vitro Activities of Daptomycin, Vancomycin, and Penicillin against Clostridium difficile , C. perfringens , Finegoldia magna , and Propionibacterium acnes

“…It has been found to be safe and effective in complicated skin and skin structure infections (2,21) and does not disrupt the anaerobic microflora or promote colonization by vancomycinresistant enterococci or extended-spectrum-␤-lactamase-producing Klebsiella pneumoniae in mice (17). While antibiotic resistance is an increasing worldwide problem, daptomycin has shown low spontaneous resistance rates in vitro (19).…”

Tigecycline: A Single Antibiotic for Polymicrobial Infections

“…In a noncomparative trial, diarrhea occurred in 13% but no tigecycline-treated patient tested positive for Clostridium difficile toxin. 9 In healthy volunteers, there were no clinically relevant changes in laboratory studies with the exception of transient elevations in alanine aminotransferase or aspartate aminotransferase (5 subjects) and alkaline phosphatase levels in 2 test subjects. 10 Blood pressure and electrocardiograms remained normal in all subjects.…”

Frontline antibiotic therapy

“…The only intravenous streptogramin preparation, quinupristin/dalfopristin, has serious toxicity issues in the form of arthralgia/myalgia, gastrointestinal intolerance, thrombophlebitis and hyperbilirubinaemia. 38 Temocillin, a 6-α-methoxy derivative of ticarcillin, was developed and first marketed in the UK in the 1980s. 39 Temocillin is active only against Enterobacteriaceae and Burkholderia cepacia, with no significant activity against Pseudomonas spp, Acinetobacter spp, anaerobes and Gram-positive organisms.…”