A Novel Antimicrobial Agent Joins the Battle against Resistant Bacteria

Editorials19 January 1999A Novel Antimicrobial Agent Joins the Battle against Resistant BacteriaRobert C. Moellering Jr., MDRobert C. Moellering Jr., MDHarvard Medical School; Boston, MA 02215Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-2-199901190-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Lately, the medical news has featured a disturbing number of reports of the inexorable development of bacterial resistance to almost all available antimicrobial agents (1, 2). Whereas resistant gram-negative bacteria were a major problem in the 1970s, the past decade has seen a crescendo of problems with multidrug-resistant gram-positive bacteria, including methicillin-resistant staphylococci, penicillin-resistant pneumococci, and vancomycin-resistant enterococci (3). The latter are particularly vexing because several strains of vancomycin-resistant enterococci (especially Enterococcus faecium) are resistant to all available antibiotics (4). In the past, the solution to the problem of bacterial resistance has depended primarily on the development of novel antimicrobial ...References1. Gold HS, Moellering RC. Antimicrobial-drug resistance. N Engl J Med. 1996;335:1445-53. CrossrefMedlineGoogle Scholar2. Davies J. Bacteria on the rampage. Nature. 1996;383:219-20. CrossrefMedlineGoogle Scholar3. Moellering RC. Problems with antimicrobial resistance in gram-positive cocci. Clin Infect Dis. 1998;26:1177-8. CrossrefMedlineGoogle Scholar4. Moellering RC. Vancomycin-resistant enterococci. Clin Infect Dis. 1998;26:1196-9. CrossrefMedlineGoogle Scholar5. Moellering RC. Past, present, and future antimicrobial agents. Am J Med. 1995;99:11S-18S. CrossrefMedlineGoogle Scholar6. Weinstein MJ, Luedemann GM, Oden EM, Wagman GH. Everninomicin, a new antibiotic complex from Micromonospora carbonacea. Antimicrob Agents Chemother. Bethesda, MD: American Society of Microbiology; 1965:24-32. Google Scholar7. Linden PK, Pasculle AW, McDevitt D, Kramer DJ. Effect of quinupristin/dalfopristin on the outcome of vancomycin-resistant Enterococcus faecium bacteraemia: comparison with a control cohort. J Antimicrob Chemother. 1997;39 Suppl A 145-51. CrossrefMedlineGoogle Scholar8. Jones RN, Barrett MS, Erwin ME. In vitro activity and spectrum of LY333328, a novel glycopeptide derivative. Antimicrob Agents Chemother. 1997;41:488-93. CrossrefMedlineGoogle Scholar9. Rosen H, Silver L, Hammond M. L-786,392: a releasable pharmacophore carbapenem active on MRS, VISA and VRE [Abstract]. Abstracts of the Infectious Diseases Society of America. 36th Annual Meeting. Denver, CO, 1998. Google Scholar10. Ford CW, Hamel JC, Stapert D, Moerman JK, Hutchinson DK, Barbachyn MR, et al . Oxazolidinones: new antibacterial agents. Trends Microbiol. 1997;5:196-200. CrossrefMedlineGoogle Scholar11. Moellering RC. Antibiotic resistance: lesson for the future. Clin Infect Dis. 1998;27 Suppl 1 S135-40. CrossrefMedlineGoogle Scholar12. Alborn WE, Allen NE, Preston DA. Daptomycin disrupts membrane potential in growing Staphylococcus aureus . Antimicrob Agents Chemother. 1991;35:2282-7. CrossrefMedlineGoogle Scholar13. Brickner SJ. Oxazolidinone antibacterial agents. Current Pharmaceutical Design. 1996;2:175-94. Google Scholar14. Barbachyn MR, Hutchinson DK, Brickner SJ, Cynamon MH, Kilburn JO, Klemens SP, et al . Identification of a novel oxazolidinone (U-100480) with potent antimycobacterial activity. J Med Chem. 1996;39:680-5. CrossrefMedlineGoogle Scholar15. Shinabarger DL, Marotti KR, Murray RW, Lin AH, Melchior EP, Swaney SM, et al . Mechanism of action of oxazolidinones: effects of linezolid and eperezolid on translation reactions. Antimicrob Agents Chemother. 1997;41:2132-6. CrossrefMedlineGoogle Scholar16. Murray RW, Schaadt RD, Zurenko GE, Marotti KR. Ribosomes from an oxazolidinone-resistant mutant confer resistance to eperezolid in a Staphylococcus aureus cell-free transcription-translation assay. Antimicrob Agents Chemother. 1998;42:947-50. CrossrefMedlineGoogle Scholar17. Zurenko GE, Yagi BH, Schaadt RD, Allison JW, Kilburn JO, Glickman SE, et al . In vitro activities of U-100592 and U-100766, novel oxazolidinone antibacterial agents. Antimicrob Agents Chemother. 1996;40:839-45. CrossrefMedlineGoogle Scholar18. Stalker DJ, Wajszczuk CP, Batts DH. Linezolid safety, tolerance in pharmacokinetics after intravenous dosing twice daily for 7.5 days [Abstract]. In: Proceedings of the 37th Interscience Conference on Antimicrobials Agents and Chemotherapy, 28 September-1 October 1997, Toronto, Canada. Google Scholar19. Batts DH. Linezolid clinical development program: end of Phase II results [Abstract]. Abstracts of 2nd European Congress of Chemotherapy. Hamburg, Germany, 10-13 May 1998. Google Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School; Boston, MA 02215Disclaimer: Dr. Moellering has served as consultant to and has received grants for basic laboratory (not clinical) research from numerous pharmaceutical and biotechnology companies. He does not have financial interests in any company that manufactures or sells pharmaceutical agents.Corresponding Author: Robert C. Moellering Jr., MD, Harvard Medical School, One Deaconess Road, Boston, MA 02215; e-mail, [email protected]harvard.edu. 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Fraser, MDIs Prevention of Ventilator-Associated Pneumonia Cost EffectiveIs Prevention of Ventilator- Associated Pneumonia Cost Effective?Prevention of Ventilator-Associated PneumoniaSepsis and Organ Dysfunction: An Overview of the New Science and New BiologyQuinupristin/dalfopristin: A therapeutic reviewNew Gram-positive agents in nosocomial infectionSingle dose pharmacokinetics of linezolid in infants and childrenThe millennium bugs — the need for and development of new antibacterialsThe Impact of Changing Pathogens of Serious Infections in Hospitalized PatientsNationwide German Multicenter Study on Prevalence of Antibiotic Resistance in Staphylococcal Bloodstream Isolates and Comparative In Vitro Activities of Quinupristin-DalfopristinThe Influence of Inadequate Antimicrobial Treatment of Bloodstream Infections on Patient Outcomes in the ICU SettingMethicillin-Resistant Staphylococcus aureus: The Other Emerging Resistant Gram-Positive Coccus among Liver Transplant RecipientsAntimicrobial Chemotherapy—TomorrowOxazolidinonesMethicillin-Resistant Staphylococcus aureus Infection in a Renal Allograft Recipient Treated Successfully with a Novel New Antimicrobial Agent (Linezolid): New Treatment Options for Infections Due to Resistant OrganismsRibosomal resistance: Emerging problems and potential solutionsThe efficacy and safety of quinupristin/dalfopristin for the treatment of infections caused by vancomycin-resistant Enterococcus faecium 19 January 1999Volume 130, Issue 2Page: 155-157KeywordsAntimicrobialsBacterial diseasesDrugsGram positive bacteriaMultidrug resistancePneumoniaProtein synthesisSkin infectionsStaphylococcal infectionToxicity Issue Published: 19 January 1999 CopyrightCopyright © 1999 by American College of Physicians. 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