Evaluation of Eravacycline: A Novel Fluorocycline

Pharmacotherapy. 2020 Mar;40(3):221-238. doi: 10.1002/phar.2366. Epub 2020 Feb 21.

Abstract

Eravacycline (ERV), formerly known as TP-434, is a novel tetracycline (TET) antibiotic that exhibits in vitro activity against various gram-positive, gram-negative aerobic and anaerobic pathogens, including those exhibiting TET-specific acquired resistance mechanisms. Similar to other TETs, it inhibits protein synthesis through binding to the 30S ribosomal subunit. Eravacycline was approved by the United States Food and Drug Administration (FDA) in August 2018 for the treatment of complicated intraabdominal infections (cIAIs) in adults following the Investigating Gram-Negative Infections Treated with Eravacycline (IGNITE)1 and IGNITE4 phase III trials. In these two, double-blind, multicenter clinical trials, ERV was proven noninferior in terms of clinical response in comparison to ertapenem and meropenem, respectively. Eravacycline was well tolerated with nausea, vomiting, and infusion site reactions being the most commonly reported adverse reactions. Clinicians now have ERV as a novel therapeutic option for the treatment of adults with intraabdominal infections, allergies to β-lactam agents, Clostridioides difficile-associated diarrhea, or if tolerability to other agents is a concern.

Keywords: complicated intraabdominal infections; complicated urinary tract infections; eravacycline; multidrug-resistant Enterobacteriaceae; tetracyclines.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Clinical Trials as Topic*
  • Humans
  • Tetracyclines / pharmacokinetics
  • Tetracyclines / pharmacology
  • Tetracyclines / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Tetracyclines
  • eravacycline