Plazomicin – A New Kid on the Block

Dear All,

We all use Antimicrobials in Abundance and favour the most recent Antimicrobial than the time tested older ones. Today most of the antimicrobials that we use have become resistant to most Bacteriae that we encounter, making treatment of UTIs more complex than ever. This has resulted in many studies being undertaken on the benefits of Vaccines for UTIs and use of Bacteriophages for UTIs. The German Guidelines (2019) on ‘Uncomplicated UTI’ have included some herbal drugs becoming popular (will try to provide informations on these at a later date).

Today we have begun to encounter resistance to Carbapenam and Meropenem and it appears it is mostly due to misuse.  

It is true that we develop Newer Antimicrobials with a fond hope that we can have efficient weapons to counter all forms and varieties of UTI. But this has only remained as a dream so far. The organisms continue to outwit us and we are left with ‘chasing the shadow’.

I am providing information concerning a new Kid on the block for treatment of Complicated UTI. Plazomicin is a Next Generation Aminoglycoside. The study on this molecule commenced in 2012 but this has been approved by US FDA on a fast track basis in 2018. The study centres included India as well among other nations.

Plazomicin is approved by the FDA for the treatment of adults with cUTIs including pyelonephritis.

Plazomicin displays a broad spectrum of activity against aerobic gram-negative bacteria including extended-spectrum b-lactamase–producing Enterobacteriaceae, Carbapenam-resistant Enterobacteriaceae. Plazomicin inhibited 94.8% of gentamycin-resistant, 94.9% of Tobramycin-resistant, and 41.1% of Amikacin resistant Enterobacteriaceae isolates. Plazomicin has variable activity against P. Aeruginosa and is inactive against A. Baumannii and S. Maltophilia.

Plazomicin is administered IV at dosage of 15mg/kg every 24 hrs for 4 to 7 days. FDA has mentioned that it should be used only when other regimes fail and not as a first line drug (this will be violated soon in our desperation to control Infection).

The usual complications are those seen with other Aminoglycosides. It should not be administered in those with moderate to severe renal functional deterioration.

I am providing the Link for an article on Plazomicin by Kristy M Shaeer* et al (2019) which has all the details, many of which are beyond our scope to understand.

https://accpjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/phar.2203

The main mention is that since it is administered only for a short duration, it may not produce resistance but knowing the indiscriminate use of antimicrobials, it could only be a fond hope.

With warm regards,

Venu

 

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