This information is for educational purpose only. It is not for clinical use.

Class: Cyclic lipopeptide.
Semisynthetic derivative of daptomycin.
Molecular weight: 1680.7 g/mol.
It is minimally absorbed from the bowel.

Mechanism of action:
Depolarisation of the bacterial cell membrane – bactericidal. It does not form pores in the cell membrane.
Inhibition of macromolecular synthesis (in DNA, RNA, proteins, and cell wall).

Gram-positive organism (similar to daptomycin) including MRSA and VRE. It has shown some activity against daptomycin non-susceptible strains in initial evaluations.
It has activity against both growing and non-growing Clostridium difficile (concentration-dependent killing).

Clinical trial:
A randomized, double-blind, Phase 3 trial by Daley et al found Surotomycin non-inferior to vancomycin for treatment of C difficile associated diarrhoea.
In another randomized, double-blind, active-controlled, multicenter, international trial by Boix et al, surotomycin failed to meet the criteria for noninferiority versus vancomycin for the primary and key secondary endpoints.
Surotomycin demonstrated a statistically non-significant reduction in C difficile associated diarrhoea recurrence rates and improved clinical response in BI/NAP1/027-positive case when compared to vancomycin.

Dose used in clinical trials (Phase II-III) 125mg – 250 mg BD.

Adverse effect:
Study-drug related adverse effects reported in the clinical trials – Headache, abdominal cramp, elevated CK. nausea, vomiting, dizziness, increased ALT etc

Mohammed Zahidul Alam et al, Mode of Action and Bactericidal Properties of Surotomycin against Growing and Nongrowing Clostridium difficile, Aug 2015, 59 (9) 5165-5170

Daley et al, Surotomycin versus vancomycin in adults with Clostridium difficile infection: primary clinical outcomes from the second pivotal, randomized, double-blind, Phase 3 trial, Journal of Antimicrobial Chemotherapy, Volume 72, Issue 12, December 2017, Pages 3462–3470

Boix et al, Primary Outcomes From a Phase 3, Randomized, Double-Blind, Active-Controlled Trial of Surotomycin in Subjects With Clostridium difficile Infection, Open Forum Infectious Diseases, Volume 4, Issue 1, Winter 2017, ofw275

M. Lindsay Grayson. Kucers’ The Use of Antibiotics: A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs. 7th Edition. Boca Raton : CRC Press, 2017