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Nye antibiotika 2006

Nye antibiotika 2006. Martin Steinbakk Ahus. Daptomycin – Chiron/Cubist. Lipopeptid-antibiotikum ( Streptomyces roseosporus ) – utviklet av Eli Lilly ca 1980 Består av 13 aminosyrer (10 i en ringstruktur og 3 i en ”hale”) Virker utelukkende på G+ kokker Må gis iv Proteinbinding >90%

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Nye antibiotika 2006

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  1. Nye antibiotika 2006 Martin Steinbakk Ahus

  2. Daptomycin – Chiron/Cubist • Lipopeptid-antibiotikum (Streptomyces roseosporus) – utviklet av Eli Lilly ca 1980 • Består av 13 aminosyrer (10 i en ringstruktur og 3 i en ”hale”) • Virker utelukkende på G+ kokker • Må gis iv • Proteinbinding >90% • T ½ 8 t

  3. Daptomycin

  4. Binds to the bacterial cell membrane Calcium-dependent insertion of lipid tail Forms potassium channel Efflux of potassium Destroys ion-concentration gradient Cell death due to cessation of DNA, RNA, and Protein synthesis Daptomycin: Mechanism of Action

  5. Daptomycin • Virker ved å depolarisere cystoplasmambranen (Ca++ avhengig) • Bactericid effekt • Virkningsspekter • Staphylococcus spp (også MRSA) • Streptococcus spp (beta- og alfa) • Enterococcus spp (også VRE)

  6. EUCAST BP Daptomycin • Staph aureus 1/1 • Streptococcus spp 1/1 • Enterococcus IE • Pneumococci IE

  7. Daptomycin - resistensbestemmelse • Ca++ - avhengig • 50 mg/L • Kun MIC-bestemmelse • Diffusjon kan IKKE benyttes

  8. Daptomycin – klinisk bruk • Godkjent EMEA • Complicated skin and skin structure infections • Idikasjoner i USA (FDA) • Complicated Skin and Soft Tissue Infections • Endocarditis (pending)?

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