Magazine article Drug Topics

New Agents, Resistance Worries Dominate ICAAC Meeting

Magazine article Drug Topics

New Agents, Resistance Worries Dominate ICAAC Meeting

Article excerpt

Worries over drug resistance continued to be a dominant theme at the recent Interscience Conference on Antimicrobial Agents & Chemotherapy (ICAAC) in Chicago. But the introduction of new drugs and better ways to use the old ones offer hope.

Among the highlights at the meeting were the following:

*Getting rid of colds. With the Centers for Disease Control & Prevention estimating there are about one billion colds suffered annually in the United States, promising results in phase III trials of pleconaril (Picovir, Aventis and ViroPharma) among 2,096 patients certainly came as good news. Patients were randomized to pleconaril 400 mg t.i.d. or placebo for five days, within 24 hours of the onset of symptoms. The time to reduction in symptom severity to one-half of baseline severity was reduced by greater than 25% in the pleconaril group.

This is the first antiviral against the picornaviruses, which cause about half of the common colds, as well as accounting for other more serious respiratory illnesses such as sinusitis, otitis media, and exacerbations of asthma and chronic obstructive pulmonary disease (COPD).

*Shorter antibiotic treatment is just as good. Short-term therapy with several drugs was shown to be as efficacious as longer term treatment. An interim analysis of an open-label study to assess the effect of once-weekly epoetin alfa (Procrit, Ortho Biotech) versus thrice-weekly dosing in anemic HIV-positive patients receiving antiretroviral therapy showed a significant improvement in hemoglobin levels in both arms of the study.

Another study involved 52 patients and a second-generation glycopeptide for the treatment of serious gram-positive hospital infections, dalbavancin, manufactured by Versicor. The study showed that dalbavancin has the potential to become the first available once-weekly hospital antibiotic, according to Timothy Henkel, M.D., Ph.D., the firm's executive v.p. "Once=weekly dosing means that some patients require fewer IV lines, which translates into fewer opportunities for local infection and bacteremia," he said. Current drugs require single or multiple doses to treat infections caused by staphylococci bacterial strains, with treatment lasting up to six weeks.

*Another anthrax worry. Concern that long-term use of antibiotics against anthrax may cause resistance has experts testing this possibility. Itzhak Brook, M.D., of the Armed Forces Radiobiology Research Institute, lead investigator, found that in in vitro studies Bacillus anthracis had less resistance to doxycycline and to clarithromycin than to the other five antimicrobial agents in the study. …

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