New Health Concerns Distinguish ICAAC This Year

By McCann, Jean | Drug Topics, October 21, 2002 | Go to article overview

New Health Concerns Distinguish ICAAC This Year


McCann, Jean, Drug Topics


HEALTH-SYSTEM EDITION

CLINICAL PRACTICE

It wasn't your usual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), which took place in San Diego, this year.

Yes, there were talks on promising new drugs and clinical trials of treatments for the more mundane diseases. But one poster showed, in color, the difference between smallpox and chickenpox, while the Centers for Disease Control & Prevention announced that it had taken 16 calls regarding suspected smallpox from physicians from 12 states and New York City so far this year.

Also, in the annual ICAAC lecture, Anthony Fauci, M.D., a director from the National Institutes of Health, spoke on "Bioterrorism in the Spectrum of Emerging and Reemerging Diseases."

In talks and posters, more immediate concerns, such as the HIV epidemic, its treatment, and treatment side effects, drew much attention.

But the drugmakers have not forgotten the primary concern, which is to treat more run-of-the-mill infections such as those that cause pneumonia and bronchitis, as well as develop new ways to deal with the continuing problem of drug resistance.

What follows are some highlights from the meeting.

Fighting the bad guys

Vancomycin-resistant S. aureus (VRSA) is a new superbug, the first reported to be fully resistant to that former drug of last resort, vancomycin. The investigational drug daptomycin for injection (Cidecin, Cubist) was shown by Michael Rybak, Pharm.D., of Wayne State University to achieve close to a 6.0loglO reduction in bacterial density of a VRSA strain, compared with none for vancomycin.

Francis Tally, M.D., chief scientific officer at Cubist, said the company is exploring daptomycin also for S. aureus infective endocarditis and bacteremia and for VRE infections.

In what was rightly called a "mega" trial of 24,137 patients with community-acquired respiratory tract infections, the safety and effectiveness of telithromycin (Aventis) were compared with those of amoxicillin/clavulanate for seven to 10 days for community-acquired pneumonia and acute bacterial exacerbation of chronic bronchitis, and for five days for acute sinusitis, in an open-label trial. In terms of the need for hospitalization and days off from work, the two regimens were comparable, according to researchers from the Danbury Hospital in Danbury, Conn., and Aventis.

The first clinical data for the treatment of chronic hepatitis B infection in 40 patients randomized to a novel L-nucleoside (Beta-L-Fd4C, Achillion Pharmaceuticals) or placebo showed that giving the drug orally once daily resulted in a sharp drop in HBV replication in the treated group, with no change in the control arm, said Nezam Afdhal, M.

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New Health Concerns Distinguish ICAAC This Year
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