New Antibiotics Debut at IDWeek After Development Drought

Marcia Frellick

September 26, 2017

SAN DIEGO — Promising new antibiotics and insight into antimicrobial resistance top the agenda at IDWeek 2017.

Dr David Andes

After a long gap in drug development, results from more than a dozen phase 3 trials will be presented, said David Andes, MD, from the Infectious Disease Society of America (IDSA) and the University of Wisconsin School of Medicine and Public Health in Madison, who is chair of IDWeek.

"I've been going to these meetings for more than 2 decades and I don't ever remember seeing that many new clinical trials with antibiotics being presented in one place," he said.

I think we'll see some significant advances in our anti-infective armamentarium.

In a "great majority" of these trials, "the antibiotics have been shown to be equivalent or superior, so I think we'll see some significant advances in our anti-infective armamentarium," he added.

A two-part symposium will be devoted to the new drugs. The clinical trials will be introduced on the first day, and the presenters will participate in a panel discussion on the antibiotics pipeline the next day.

Antibiotic stewardship will also be in the spotlight. There will be two presentations on the use artificial intelligence to select the best drugs and dosing regimens for individual patients, based on the clinical scenario, the organism, and the minimal inhibitory concentration of the organism.

"Using the algorithm changed therapy," Dr Andes said.

And a featured oral abstract will look at the prevalence of multidrug-resistant organisms in long-term care facilities and hospitals in a large region in southern California.

Dr Hilary Babcock

Much of the previous research has been focused on multidrug-resistant organisms at a specific hospital; in contrast, this new work looks at the spread of organisms as patients move from a hospital to a long-term-care facility and back to a hospital, said Hilary Babcock, MD, from the Washington University School of Medicine in St. Louis, Missouri, who is the Society for Healthcare Epidemiology of America (SHEA) vice chair of IDWeek.

New research shows that prevention at just one hospital might not be enough, she added.

Again this year, expert will be pitted against expert in debates about some of the hottest issues in the field.

Hot Topics

The overprescription of antibiotics will be addressed in a debate on whether it is better to use technical supports to stop prescribers from prescribing the wrong thing, or whether reaching out to find out why they prescribe the way they do is more effective.

A debate on central line-associated bloodstream infections will examine whether maximum prevention — meaning that the infections left are the ones that cannot be prevented — has been reached, or whether every bloodstream infection is preventable.

A session on whole-genome sequencing will look at sources of infection transmission.

"If we see the same bacteria showing up in two patients on one floor, we tend to think someone didn't wash their hands between patients," Dr Babcock explained. However, in-depth analysis of the genetic makeup of the bacteria in each patient might pinpoint different sources of transmission.

This could affect prevention strategies. "Maybe hand hygiene, patient to patient, isn't the issue. Maybe there are other risk patients are exposed to," she pointed out.

Addressing Outbreaks Globally

Dr Andrew Pavia

The latest on developing outbreaks, including yellow fever in Brazil and the rapid emergence of the often-deadly fungal pathogen Candida auris in hospitals, will be discussed by Andrew Pavia, MD, from the University of Utah in Salt Lake City, who is the IDSA vice chair of the conference.

There will also be updates on the spread of influenza H7N9, which has caused many deaths in China this year, and the latest on a vaccine in development.

We're really beginning to wonder whether H7N9 is poised for emergence as a pandemic strain.

"In spite of all the control measures put in place over the previous 4 years, we're really beginning to wonder whether H7N9 is poised for emergence as a pandemic strain," Dr Pavia said.

After that update, two high-profile speakers will deliver the opening double plenary.

The opening keynote talk on how new technology will help with new infections will be delivered by Anthony Fauci, MD, head of the National Institute of Allergy and Infectious Diseases.

And work done by the Coalition for Epidemic Preparedness Innovations will be discussed by former US Food and Drug Administration Commissioner Margaret Hamburg, MD, who will also look at emerging countermeasures to fight diseases such as Ebola and the Zika virus.

"The idea is to get coalitions so we can do a better job of having vaccines and drugs that we can develop and adapt very quickly," Dr Pavia explained.

Late-breaking abstracts will be spread throughout the program. One will look at all-in-one drugs for HIV that combine the latest integrase inhibitors with what are now state-of-the-art safer versions of older drugs in one pill.

"The results look good, but what's really impressive is the tolerability," said Dr Pavia.

In another, "an intervention your mom probably told you about" has been shown in a randomized trial to be very effective for the prevention of urinary tract infections, he said.

Dr Pavia serves on the data safety and monitoring board for Johnson & Johnson. Dr Andes and Dr Babcock have disclosed no relevant financial relationships.

Follow Medscape on Twitter @Medscape and Marcia Frellick @mfrellick

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