#1: What Makes Delafloxacin a Unique Antibiotic for Skin Infections?
Antibiotic resistance has become a major clinical challenge in both the hospital and community setting with multidrug resistant pathogens becoming more common. Skin and skin structure infections account for over 7 million cases annually in the community with almost 2% of cases admitted to hospital. Staphylococcus aureus
), both methicillin susceptible (MS) and resistant (MR), are the most causative species; however, Gram-negative species are emerging in certain patient types.
Almost all antibiotics are written empirically so choices should include agents with an appropriate spectrum. The US Food and Drug Administration (FDA) recently approved delafloxacin (BAXDELA) for acute bacterial skin and skin structure infections in adults. This new fluoroquinolone is available in both tablet, 450 mg, and intravenous, 300 mg, formulations and can be dosed for 5-14 days twice daily.
In common with other fluoroquinolones delafloxacin carries label warnings for tendonitis, tendon rupture, peripheral neuropathy, central nervous system effects and avoidance of delafloxacin in myasthenia gravis patients. Unlike some other class members there are no issues with QTc interval or other cardiac events and phototoxicity. Equally, the only drug-drug interaction of note is the usual chelation agents, antacids and sulcralfate. There is no interaction with CYP450 isoforms or a range of hepatic and renal transporters with exception of P-gp and BCRP inhibitors, the relevance of this is unknown.
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