UPDATE ON NEWER ANTI-INFECTIVES 2014 AND 2015 11/4/2015

It has been too long since my last Post and I promise to do better through the rest of 2015 and 2016.

New Antibiotics:

      a. Dalvance and Orbactiv (IV).—These are new MRSA Antibiotics. Their unique feature is a very long half life.They can be given 1 time in the case of orbactiv or twice 7 days apart to produce a 14 day blood level. It is intended for MSSA and MRSA Skin and Skin structure infections.The good things are:1.Long half life 2,.Eliminate the need for PICC 3. Useful for patients who have difficulty taking antibiotics by the oral route or in whom compliance is an issue or in whom are not considered good candidates for  a PICC line. The bad thing–These drugs are astronomically expensive 3-4000 .00 a course. They have a narrow sweet spot as per above–that justifies their costs–especially if it can reduce hospital re-admissions.

     b/Silvextro– IV/Oral A new me too drug from Cubist now Merck. Only + is once a day.

Only indication is for Skin and Skin structure infections Gram positive cocci. Astronomically expensive 6 tablets 2,000.00.Now that Zyvox has gone generic with rapidly dropping prices–and a broader package insert–no reason to use.

    c.Mixed bag drugs—Zerbexa and Avycaz—-(IV)  Marketed as Zosyn like drugs. May have a place for multidrug resistant organisms are present.NOt for general use. Not ssure about pricing data on these 2.

Most of these compounds are not on testing batteries for hospitals so without an ability to test for organism susceptibility their usefulness is severely compromised. I do not see them being added to many formularies because of costs and inability to test so that they can be properly utilized.

New Antifungals-Cresembla for Invasive Aspergillosis

New Antiparasitic drugs—Impavido–Leishmaniasis

New Antivirals

       a,HIV–Evotaz and Prescobix

       b.Hepatitis C– A literal explosion of excellent but very expensive drugs. They are cost effective because of their very high cure rates. 95% or greater. Most exciting ID development since the advent of highly effective HIV therapies in the 1990s–at least 20 years. Harvoni, Viekira Pak,Technivie,

Daklinsa

New vaccines—Bexsero—A new vaccine for Type B Meningococcal immunizaiton.

All in all an astonishing 23 months or so with so many new products –it will take a while to determine their places in therapy. Nevertheless as someone who has devoted much of his caeer to antibiotic research—I am delighted to see so many new products come to market.

Questions can be directed to my e mail idelvis2@comcast.net

 

Dr . Smith

 

 

 

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