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Solithromycin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Similar to other MLSB antibiotics, solithromycin is active in vitro against M. catarrhalis (Farrell et al., 2010b; Farrell et al., 2010a). Of 21 M. catarrhalis strains, the MIC90 values for the MLSB antibiotics were: 0.06 mg/l for azithromycin, 0.12 mg/l for solithromycin and clarithromycin, 0.25 mg/l for telithromycin and erythromycin, 0.5 mg/l for quinipristin/dalfopristin, and 2 mg/l for clindamycin (Farrell et al., 2010a). Among 313 M. cattarrhalis clinical isolates, solithromycin and telithromycin demonstrated similar MIC ranges (≤ 0.008 – 0.25 mg/l and ≤ 0.06 – 0.25 mg/l) and MIC90 values (0.12 mg/l and 0.25 mg/l) (Farrell et al., 2010b).
Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents
Published in Expert Opinion on Pharmacotherapy, 2018
Maria Gabriella Matera, Paola Rogliani, Josuel Ora, Mario Cazzola
In any case, although present legislation imposes the development of new antibiotics for specific use in children, most antibiotics are developed for adults with the anticipation that they will be used ‘off-label’ in children [113]. Very few drugs are developed exclusively for pediatric use. Many of the new antibiotics will be used to treat children only in the hospital because they only have intravenous formulations. Since it seems impossible to develop new oral antibiotics belonging to the classes of tetracyclines and fluoroquinolones because of their recognized adverse events in children, at the moment the only partially innovative approach is to focus on macrolides. Solithromycin, a new fluoroketolide, is an agent of the macrolide class and is under developed for both outpatient and inpatient pediatric use [113].
Severe community-acquired pneumonia: current management and future therapeutic alternatives
Published in Expert Review of Anti-infective Therapy, 2018
Jose Garnacho-Montero, Irene Barrero-García, Maria de Gracia Gómez-Prieto, Ignacio Martín-Loeches
Solithromycin is a novel macrolide with a potent in vitro activity against the most common pathogens, including macrolide-, penicillin-, and fluoroquinolone-resistant isolates of S. pneumoniae, as well as atypical bacterial pathogens. Solithromycin exhibits higher anti-inflammatory power than macrolides [68], which may constitute an additional benefit for treatment of sCAP. Sequential intravenous and oral solithromycin is noninferior to intravenous to oral moxifloxacin for treatment of CAP though patients with PSI V were excluded from this randomized double-blind clinical trial [69].
Emerging antibiotics for community-acquired pneumonia
Published in Expert Opinion on Emerging Drugs, 2019
Adamantia Liapikou, Catia Cilloniz, Andrea Palomeque, Toni Torres
Pharmacodynamically, solithromycin is 16-times more potent than either azithromycin, clarithromycin, or telithromycin against gram-positive aerobes and both atypical and gram-negative CAP pathogens [58]. It has good oral bioavailability (67%) when given orally and is not influenced by concomitant food intake, it serum protein binding is 81%, and its biologic half-life of 8.5 h, allowing once daily dosing [60]. The major metabolic pathway appears to involve cytochrome P450 (CYP) 3A4, with most of the metabolite undergoing biliary excretion [61].