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Plazomicin in multidrug-resistant complicated urinary tract infections: a scoping review
Subhash Todi1, Rajeev Soman2, Yatin Mehta3
1Critical Care and Emergency Medicine, Academics & Health Research at AMRI Hospitals, Kolkata, West Bengal, India.
Background:
Complicated urinary tract infections (cUTIs) cause significant morbidity and mortality. Multidrug-resistant (MDR) organisms complicate cUTI management, highlighting the need for effective antimicrobials.
Objective:
This scoping review was conducted to assess the role of plazomicin in managing cUTIs.
Eligibility Criteria:
This review included observational studies, clinical trials, qualitative studies, and in vitro studies published between 01 January 2018 and 15 July 2025.
Source Of Evidence:
Searches were conducted on PubMed, MEDLINE, EMBASE, and Google Scholar.
Method:
The screening process involved reviewing titles and abstracts, followed by full-text evaluation.
Results:
Thirty studies were included in this review. Compared with meropenem, plazomicin demonstrated superior microbiological eradication at the test of cure (TOC; 89.5%), composite cure rate at the TOC (81.7%), and comparable clinical cure rates both at the TOC (89%) and end of intravenous therapy (96.3%). Adverse events, observed in 19.5% of patients, primarily included diarrhea, nausea, and renal dysfunction, indicating a favorable safety profile. In vitro data showed susceptibility rates for plazomicin ranging from 87% to 99.8% against Enterobacteriaceae, with superior activity over gentamicin, amikacin, and tobramycin. Plazomicin demonstrated synergistic effects with colistin, meropenem, and fosfomycin against extensively drug-resistant isolates and carbapenem-resistant Enterobacteriaceae.
Conclusion:
This review underscores plazomicin as a promising treatment for MDR cUTIs. However, limited data from low- and middle-income countries like India highlight the need for real-world studies on its efficacy, safety, and cost-effectiveness in such countries.
Insights
Plazomicin shows promise for treating complicated urinary tract infections (cUTIs) caused by multidrug-resistant organisms. Real-world studies are needed in diverse settings to confirm its efficacy and safety.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Medicine
Background:
- Complicated urinary tract infections (cUTIs) are a significant cause of illness and death.
- Multidrug-resistant (MDR) organisms present challenges in managing cUTIs, necessitating novel antimicrobial agents.
Purpose of the Study:
- To evaluate the role of plazomicin in the management of cUTIs.
- To synthesize current evidence on plazomicin's efficacy and safety for cUTI treatment.
Main Methods:
- A scoping review of studies published between January 2018 and July 2025.
- Searches conducted across major databases including PubMed, MEDLINE, EMBASE, and Google Scholar.
- Inclusion of observational studies, clinical trials, qualitative studies, and in vitro investigations.
Main Results:
- Plazomicin demonstrated superior microbiological eradication (89.5%) and composite cure rates (81.7%) compared to meropenem at the test of cure.
- Comparable clinical cure rates were observed for plazomicin (89% at TOC, 96.3% at end of IV therapy).
- In vitro studies indicated high susceptibility rates for plazomicin against Enterobacteriaceae, with synergistic effects noted with other antibiotics against resistant strains.
Conclusions:
- Plazomicin is a potential therapeutic option for MDR cUTIs.
- Further real-world studies are required, particularly in low- and middle-income countries, to assess plazomicin's efficacy, safety, and cost-effectiveness.
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