[New antibiotics for the therapy of respiratory tract infections]
1Institut für Klinische Pharmakologie und Toxikologie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin. matthias.kruse@charite.de
Abstract:
The need for new antibiotics is ongoing in view of manifold resistance developments. The resistance of Streptococcus pneumoniae against macrolides and penicillins in the USA already amounts to more than 30 %. The approval of new antibiotics, particularly those with a new mode of action, has been decreasing over the past years which is anticipated to result in a lack of resourceful therapy options in the future. Some new substances with good in vitro activity against S. pneumoniae have turned out to raise safety issues as shown for a number of quinolones. Likewise daptomycin, a lipopeptide with a new mechanism of action, did not show satisfying results due to its inactivation by surfactant. Established quinolones are levofloxacin and moxifloxacin, the latter being available as i. v. formulation since 2002. For ketolides, telithromycin (oral) and for azalides azithromycin (since 2005 as i. v. formulation) are available for antimicrobial therapy. Linezolid is the only approved oxazolidinone. Tigecycline, a tetracycline derivate, will be approved in 2006 in Germany. The latest approval regarding carbapenems was ertapenem in 2003, while doripenem, a new antibiotic from this group, is still under clinical development.
Insights
The increasing resistance of Streptococcus pneumoniae to antibiotics necessitates novel treatments. Current antibiotic development faces challenges, risking future therapeutic options.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Context:
- Rising antibiotic resistance in Streptococcus pneumoniae, exceeding 30% in the USA for macrolides and penicillins.
- Decreasing approval rates for new antibiotics, especially those with novel mechanisms of action.
- Safety concerns and efficacy limitations observed with some emerging antibiotic classes.
Purpose:
- To review the current landscape of antibiotic resistance and development.
- To highlight challenges in bringing new antibiotics to market.
- To discuss available and investigational therapies for Streptococcus pneumoniae infections.
Summary:
- Significant Streptococcus pneumoniae resistance to established antibiotics necessitates new therapeutic strategies.
- Development of novel antibiotics is hampered by safety issues and limited clinical success.
- Several antibiotic classes, including quinolones, ketolides, azalides, oxazolidinones, tetracycline derivatives, and carbapenems, are discussed regarding their availability and development status.
Impact:
- Addresses the urgent need for effective treatments against resistant bacterial infections.
- Informs clinicians and researchers about the current state and future prospects of antibiotic therapy.
- Emphasizes the critical gap between antibiotic resistance and the pipeline of new drugs.
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