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Iclaprim comparable with vancomycin in nosocomial pneumonia

24 Aug 2017

Iclaprim is as good as vancomycin in the treatment of nosocomial pneumonia, with similar cure rates and safety profile, according to the results of a phase II study.

The study included 70 patients with nosocomial pneumonia suspected or confirmed to be caused by gram-positive pathogens who were randomly assigned to three treatment arms: iclaprim 0.8 mg/kg IV q12h (iclaprim q12h; n=23), iclaprim 1.2 mg/kg IV q8h (iclaprim q8h; n=24), or vancomycin 1 g IV q12h (n=23). Treatment lasted between 7 and 14 days.

There was no significant difference in the baseline and demographic characteristics of patients across the treatment groups.

Likewise, the primary endpoint of clinical cure rate in the intention-to-treat population at test of cure (7 days post-treatment) visit was comparable: 73.9 percent in the iclaprim q12h arm, 62.5 percent in the iclaprim q8h arm and 52.2 percent in the vancomycin arm (iclaprim q12h vs vancomycin, p=0.13; iclaprim q8h vs vancomycin, p=0.47).

The respective death rates within 28 days of treatment initiation were 8.7, 12.5 and 21.7 percent for the iclaprim q12h, q8h and vancomycin arms. No statistically significant differences were noted.

All study drugs were generally well tolerated, with both iclaprim dosing regimens showing a safety profile similar to that of vancomycin.

The current data indicate that iclaprim potentially represents an important new therapeutic option for the treatment of nosocomial pneumonia, and a pivotal clinical trial is warranted to evaluate the drug’s safety and efficacy in this indication, researchers said.

Iclaprim is a novel diaminopyrimidine that inhibits bacterial dihydrofolate reductase. The drug has demonstrated potent in vitro activity against gram-positive pathogens associated with acute bacterial skin and skin structure infections and nosocomial pneumonia, including methicillin-resistant S aureus, vancomycin-intermediate S aureus, vancomycin-resistant Enterococcus species, and Streptococcus species. [Antimicrob Agents Chemother 2009;53:2171–2175; Bioorg Med Chem Lett 2003;13:4217–4221]

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Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, Yesterday
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.