Issue: November 2011
November 01, 2011
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Nine IV compounds in development for resistant gram-negative bacilli

Issue: November 2011
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BOSTON — The pipeline for new therapies to treat drug-resistant gram-negative bacilli is small, but measurable progress is being made, according to Helen Boucher, MD, who presented results on the progress of IDSA's "10 x '20 initiative." She and colleagues identified nine intravenous compounds in development to treat these resistant bacteria.

Since a previous survey was conducted in 2009, only two new antibiotics have been approved, and only one of the hoped for 10 x '20 drugs has been approved, Boucher, who is assistant professor of medicine at Tufts University School of Medicine, said during a press conference today. In addition, the number of large pharmaceutical companies that are actively developing antibiotics continues to decrease.

To quantify the severity of this problem, Boucher and colleagues conducted a review of literature, clinical trial registries and interviews with pharmaceutical leaders to gain information on the pipeline of novel antimicrobial therapies to treat drug-resistant gram-negative bacilli.

They found nine IV compounds in clinical development, including one beta-lactamase inhibitor in a phase 3 trial and six compounds (an aminoglycoside, a beta-lactamase inhibitor, a tRNA synthetase inhibitor, a peptide mimetic and a fluorocycline) in phase 2 studies of acute bacterial skin and skin structure infections, complicated urinary tract infection and/or complicated intra-abdominal infections. Two agents - a siderophore monosulfactam and a beta-lactamase inhibitor - are currently in phase 1 or preclinical development, the researchers reported.

There were no studies of hospital-acquired bacterial pneumonia or ventilator-associated bacterial pneumonia, and only three compounds had a novel mechanism of action, according to the abstract.

Boucher said the decline in the number of large pharmaceutical companies investing in the development of antibiotics - "the loss of the brain trust" - has tremendous consequences that may take years to overcome. — by Stacey L. Fisher

For more information:

  • Boucher H. LB-27. Presented at: IDSA 49th Annual Meeting; Oct. 20-23, 2011; Boston.

Disclosure: Dr. Boucher is on the adjudication committee and receives a consulting fee from Merck; is a Data and Safety Monitoring Board member and receives a consulting fee from Wyeth/Pfizer; is a consultant and receives fees from Durata Therapeutics; and is a consultant and receives a fee from PolyMedix.

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