Superbug antibiotics: What's out there

There are more than 100 different kinds of antibiotics, but most come from only a few types of drugs. Those who have children prone to ear infections are probably very aware of penicillin-based antibiotics such as the commonly prescribed amoxicillin. Others include fluoroquinolones such as ciprofloxacin (Cipro), levofloxacin (Levaquin) and ofloxacin (Floxin); Sulfonamides such as co-trimoxazole (Bactrim) and trimethoprim (Proloprim). You can find a full list here.

The problem, of course, is the more they are prescribed, the better the chance that the surviving bacteria will mutate into one immune to the antibiotic. This is why doctors often switch antibiotics and also why they are discouraged from overprescribing them if, for example, the patient has a flu with no accompanying infection.

One drug that was recently approved was Dificid (fidaxomicin), developed by San Diego-based Optimer Pharmaceuticals. It's an orally administered medication to treat clostridium difficile, an infection that causes diarrhea and can lead to colitis and other intestinal conditions. C. diff bacteria are found in the stool of an infected person, and others can become infected if they touch items or surfaces contaminated with the bacteria or spores and then touch their mouths. Dificid will be marketed to hospitals, where the bugs are typically found. It's the first new antibiotic for C. diff infections in a quarter of a century.

Optimer says it's seeking a premium for its antibiotic, with a price of $2,800 for a 10-day course of treatment, compared with the $1,000 cost of similar treatment with vancomycin.

Cubist Pharmaceuticals, based in Lexington, MA, is co-promoting the drug while it works on its own antibiotic against C. diff infections. The drug, for now known as CB-183,315, has shown that it is on par with vancomycin, the long-used antibiotic for C. diff infections. But it did not show it was superior to vancomycin in treating a particularly dangerous strain of C. diff called NAP-1, something that might have separated Cubist's drug from the latest crop of similar treatments--including Optimer's Dificid. Cubist has not yet decided whether it will move CB-183,315 forward.

Meanwhile, though, Cubist will is moving forward with another antibiotic into late-stage clinical testing. The drug, named CXA-201, treats complex infections of the urinary tract and abdomen. Those trials are expected to begin by the end of 2011.

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Superbug antibiotics: What's out there
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