Also I'd like to see CTIX build out its clinical inf adv board---bring on folks (if amenable) like Helen Boucher (Tufts), DeGrado, Klein, Scott, Tew..... The folks who know defensin-mimetics best. Boucher recently quoted in Bloomberg per the Los Angeles scare, and the thin ABX gram-beg pipeline (note; toxicity concerns). A good overview.
Superbug Spread Reveals Thin Pipeline of Newest Antibiotics - Bloomberg http://www.bloomberg.com/news/articles/2015-02-20/superbug-spread-reveals-thin-pipeline-of-newest-antibiotics QUOTE: “We have very little in the advanced-stage pipeline right now that will treat CRE,” Helen Boucher, a physician and director of the infectious diseases fellowship program at Tufts Medical Center in Boston, said in a telephone interview. “We’re forced to use, frankly, toxic drugs. We have to go in and tell patients and families that we’re going to use drugs that may poison their kidneys and have nerve toxicity.”
She is a clinical infectious Big Whig and formerly was a PYMX advisor.
Finally - some Daptomycin ABSSSI data ... Median 10 day therapy IP, 13 days OP. Brilacidin will crush this if results hold. Talk about savings in cut LOSs.
DAPTOMYCIN Daptomycin is a cyclic lipopeptide antibiotic, approved in Europe for the treatment of cSSTIs in 2006 and for the treatment of right-sided infective endocarditis (RIE) due to S. aureus and S. aureusbacteraemia when associated with RIE or with cSSTI in 2007. ***By mid 2010, daptomycin had been used to treat an estimated one million patients*** with serious Gram-positive infections worldwide.[79] Daptomycin has rapid concentration-dependent bactericidal activity against Gram-positive pathogens.[80,81] Its tissue penetration supports its use in the treatment of ABSSSI, and daptomycin was shown to be 'noninferior' to vancomycin and semisynthethic penicillins.[26] The registration studies included 1092 patients between the ages of 18 and 85 years with a complicated skin and skin structure infection (ABSSSI) that was due, at least in part, to Gram-positive organisms that required hospitalization and parenteral antimicrobial therapy for at least 96 h.[82,83] It is suitable for patients suspected to be bacteraemic and with endocarditis.
In recent years, clinical experience data with daptomycin have been captured in a prospective observational study.[81] Daptomycin treatment was documented in 1127 patients with diverse infections, including cSSTIs (33%), bacteraemia (22%), endocarditis (12%) and osteomyelitis (6%). It was used empirically, before microbiological results became available, in 53% of patients. S. aureus was the most common pathogen (34%), with 52% of isolates resistant to methicillin; coagulase-negative staphylococci and enterococci were also frequent, with 22% of Enterococcus faecium isolates resistant to vancomycin. Daptomycin was used as first-line therapy in 302 (27%) patients. When used second line, the most common reasons for discontinuation of previous antibiotic were treatment failure and toxicity or intolerance. The use of concomitant antibiotics was reported in 65% of patients. Most frequent doses were 6 (47%) and 4 mg/kg (32%). *****The median duration of daptomycin therapy was 10 days (range 1–246 days) in the inpatient setting and 13 days (range 2–189 days) in the outpatient setting. The overall clinical success rate was 79%, with a clinical failure rate of less than 10% for all infection types.***** Low failure rates were observed in first and second-line therapy (6% and 8%, respectively). Daptomycin demonstrated a favourable safety and tolerability profile regardless of treatment duration.
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