Introduction

Antimicrobial resistance continues to be a major public health concern due to the emergence and spread of multi-drug resistant (MDR) organisms, including extended spectrum ß-lactamase (ESBL) and carbapenemase producing Enterobacterales. Plazomicin is a novel aminoglycoside that demonstrates activity against MDR gram-negatives, including those producing ESBLs and most carbapenemases, and retains activity against aminoglycoside modifying enzymes as a result of structural modifications. The information discussed is meant to assist in identifying plazomicin’s place in therapy and to expand the clinician’s armamentarium.

Areas covered

Herein, we review the pharmacology, microbiology, clinical efficacy, and safety of plazomicin. To gather relevant information, a literature search was performed using PubMed, Ovid, and Google Scholar electronic databases. Search terms used include plazomicin, ACHN-490, extended spectrum ß-lactamase, ESBL, CRE, aminoglycoside modifying enzymes, and AME. Additional information was obtained from FDA review documents and research abstracts presented at international conferences.

Expert opinion

Plazomicin is a promising carbapenem or β-lactam/β-lactamase inhibitor-sparing alternative for the treatment of complicated urinary tract infections caused by MDR Enterobacterales. Although robust data for bloodstream infections and bacterial pneumonias are lacking, plazomicin may be considered in individual clinical scenarios if combination therapy is warranted provided supportive microbiological data and therapeutic drug monitoring are available.

中文翻译：

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Plazomicin：一种用于治疗复杂尿路感染的静脉内氨基糖苷类抗菌剂。

介绍

由于多重耐药性（MDR）生物的出现和传播，包括扩大范围的β-内酰胺酶（ESBL）和产生碳青霉烯酶的肠杆菌，抗生素耐药性仍然是主要的公共卫生问题。Plazomicin是一种新型的氨基糖苷，对MDR革兰氏阴性菌（包括产生ESBLs和大多数碳青霉烯酶的革兰氏阴性菌）具有活性，并由于结构修饰而保留了对氨基糖苷修饰酶的活性。所讨论的信息旨在帮助确定吡唑米星在治疗中的位置，并扩大临床医生的武器库。

覆盖区域

本文中，我们综述了吡唑米星的药理学，微生物学，临床疗效和安全性。为了收集相关信息，使用PubMed，Ovid和Google Scholar电子数据库进行了文献检索。使用的搜索词包括吡唑米星，ACHN-490，超广谱β-内酰胺酶，ESBL，CRE，氨基糖苷修饰酶和AME。从国际会议上提交的FDA审查文件和研究摘要中获得了更多信息。

专家意见

Plazomicin是一种有前途的碳青霉烯或β-内酰胺/β-内酰胺酶抑制剂替代品，可用于治疗由耐多药肠杆菌引起的复杂尿路感染。尽管缺乏有关血流感染和细菌性肺炎的可靠数据，但如果有必要提供联合微生物学数据和治疗药物监测，则有必要进行联合治疗时，在个别临床情况下可考虑使用吡唑米星。