{"id":199,"date":"2023-06-25T11:09:20","date_gmt":"2023-06-25T10:09:20","guid":{"rendered":"https:\/\/microregistrar.com\/?p=199"},"modified":"2023-06-25T11:09:20","modified_gmt":"2023-06-25T10:09:20","slug":"plazomicin","status":"publish","type":"post","link":"https:\/\/microregistrar.com\/?p=199","title":{"rendered":"Plazomicin"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\"><strong>Nature of the antibiotic<\/strong><\/h3>\n\n\n\n<p><strong>Class:<\/strong>&nbsp;Next-generation aminoglycoside (neoglycoside), semisynthetic (sisomicin based). It is not inactivated by most aminoglycoside-modifying enzymes (AME).<br><strong>Molecular weight:<\/strong>&nbsp;592.68.<\/p>\n\n\n\n<p>It is synergistic with many antibiotics, including piperacillin-tazobactam.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Mechanism of resistance<\/strong><\/h3>\n\n\n\n<p>Enterobacteriaceae: modification of the ribosomal binding site due to expression of 16S rRNA methyltransferases.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Adverse effect<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ototoxicity \u2013 the\u00a0animal\u00a0study did not show ototoxicity. Few patients had mild vertigo and\u00a0unilateral\u00a0permanent tinnitus in phase II clinical trials [Riddle 2012].<\/li>\n\n\n\n<li>Nephrotoxicity \u2013 Phase II clinical trial showed a\u00a0comparable\u00a0increase in\u00a0creatinine\u00a0when compared to Levofloxacin. Two patients reported azotemia and mild renal insufficiency. [Riddle 2012].<\/li>\n\n\n\n<li>Cardiotoxicity\u00a0\u2013 Statistically significant QT\/QTc prolongation was seen in healthy volunteers but was deemed clinically insignificant.<\/li>\n\n\n\n<li>Mild-to-moderate headache, tinnitus, dizziness, and somnolence.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Spectrum<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Gram-positive<\/td><td>Staphylococcus (MSSA, MRSA, and coag neg Staphylococcus). Streptococcus \u2013 not susceptible. Enterococcus \u2013 More effective on E&nbsp;faecium. E&nbsp;faecalis&nbsp;is usually resistant.<\/td><\/tr><tr><td>Gram-negative<\/td><td>Enterobacteriaceae \u2013 sensitive except NDM + organisms. Morganella, Proteus, Salmonella, Shigella are less sensitive. Non-fermenters- Usually have higher MIC (Pseudomonas, Acinetobacter), but it is more active than other aminoglycosides. Stenotrophomonas maltophilia is resistant.<\/td><\/tr><tr><td>Other organisms<\/td><td>It is active against Francisella, Yersinia and has some activity against Brucella.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Clinical trials<\/strong><\/h3>\n\n\n\n<p><strong>Phase III clinical trial ( EPIC trial)<\/strong>&nbsp;<strong>\u2013<\/strong>&nbsp;compared plazomicin and meropenem for the management of cUTI. Plazomicin demonstrated superiority in composite cure at the test-of-cure visit (achieved enhanced sustained microbiological eradication).<\/p>\n\n\n\n<p><strong>Phase III clinical trial<\/strong>&nbsp;(<a href=\"https:\/\/static1.squarespace.com\/static\/51199d96e4b084d1d0b105c3\/t\/58fb66d917bffcd18b06548e\/1492870886885\/ECCMID+17-CARE_Final.pdf\">CARE trial<\/a>)&nbsp;<strong>\u2013<\/strong>&nbsp;compared plazomicin-based and colistin-based combinations in patients with serious infections due to carbapenem-resistant Enterobacteriaceae. Plazomicin-based combinations were associated with numerically decreased mortality, serious disease-related complications and incidence of nephrotoxicity.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Reference<\/strong><\/h3>\n\n\n\n<p><a href=\"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/full\/10.1002\/phar.2203\">Shaeer et al. Plazomicin: A Next\u2010Generation Aminoglycoside. Pharmacotherapy.<\/a><br><a href=\"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/full\/10.1002\/phar.2203\">Volume39, Issue1, January 2019, Pages 77-93<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nature of the antibiotic Class:&nbsp;Next-generation aminoglycoside (neoglycoside), semisynthetic (sisomicin based). It is not inactivated by most aminoglycoside-modifying enzymes (AME).Molecular weight:&nbsp;592.68. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ngg_post_thumbnail":0,"footnotes":""},"categories":[9],"tags":[28,45],"class_list":["post-199","post","type-post","status-publish","format-standard","hentry","category-antibiotic","tag-antibiotic","tag-plazomicin"],"_links":{"self":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/199","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=199"}],"version-history":[{"count":1,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/199\/revisions"}],"predecessor-version":[{"id":200,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/199\/revisions\/200"}],"wp:attachment":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=199"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=199"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=199"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}