New Antibiotics, Emerging Disease Threats Ahead at IDWeek

Marcia Frellick

September 24, 2018

SAN FRANCISCO — Five new antibiotics that are in clinical development and will likely progress to big clinical trials will be in the spotlight at the upcoming IDWeek 2018.

Cesar Arias

"These are drugs that really explore new mechanisms for very resistant bugs," said Cesar Arias, MD, PhD, from the University of Texas School of Public Health in Houston and the Infectious Diseases Society of America, who is vice chair of the meeting.

One of the drugs is a bacteriophage first-in-class lysin that is being investigated as a potential treatment for Staphylococcus aureus. Phase 2 results will be presented during the pipeline session.

This is a big deal in the era of resistance and superbugs.

"This is a big deal in the era of resistance and superbugs," said Arias. "Phage therapies are promising to change the way we treat infections with multidrug-resistant organisms."

The drug development pipeline for new antibiotics was largely dormant until last year.

Infectious disease threats in Latin America, other than the Zika virus, will be examined in a symposium co-organized by the Panamerican Society of Infectious Diseases and the Brazilian Society of Infectious Diseases.

Speakers will present the latest information on chikungunya, dengue (including controversies about the vaccine), and the ongoing yellow fever outbreaks in Brazil and their potential threat to the Americas.

In light of the Zika epidemic, "it will be important to pay attention," said Arias.

Promising New Flu Drug for High-Risk Patients

Findings from the phase 3 CAPSTONE-2 study assessing the safety and efficacy of baloxavir marboxil in people at high risk for complications from the flu will be presented as a late-breaking oral presentation.

Jeanne Marrazzo

Jeanne Marrazzo, MD, who is chair of the HIV Medical Association, said this is one of the abstracts she is most looking forward to.

"We haven't had anything in a long time, since Tamiflu," she told Medscape Medical News.

Another clinical trial result that could garner a lot of attention centers on children with HIV-positive mothers who were exposed to efavirenz in utero. These data are part of a birth outcome surveillance study being conducted at eight government hospitals in Botswana, which previously reported that dolutegravir-based antiretroviral therapy used from the time of conception might be linked to neural-tube defects (N Engl J Med. 2018;379:979-981).

People had been moving toward dolutegravir, but with the Botswana data, concerns were raised, Marrazzo reported.

Sepsis in the Spotlight

Ebbing Lautenbach

A retrospective study looking at the incidence of sepsis-related hospital deaths and potential prevention will be interesting, said Ebbing Lautenbach, MD, who is chair of the Society for Healthcare Epidemiology of America. It will delve into the emphasis hospitals place on identifying patients who might develop sepsis and the importance of early intervention with antibiotics, he explained.

In addition, two posters and a meet-the-professor session will look at the problem of patients with a diagnosis of allergy to penicillin or β-lactam antibiotics who are not really allergic to those antibiotics. Because they had an allergic reaction years ago that was noted in their electronic medical record or previously experienced adverse effects rather than a true allergic reaction, these patients now receive less-effective antibiotics.

"That happens fairly regularly," Lautenbach said. "The goal of incorporating allergy testing into a stewardship program is something that has gotten a lot of publicity recently."

Clostridium difficile will be addressed in dozens of sessions and posters. There is substantial interest not only in treatment for C diff, but also in strategies for early identification and prevention, he pointed out.

One abstract he highlighted is on the overtesting of hospitalized patients for C diff, which can result in unnecessary treatment.

Arias reports receiving grant support from Merck and MeMed Diagnostics. Lautenbach and Marrazzo have disclosed no relevant financial relationships.

Follow Medscape on Twitter @Medscape and Marcia Frellick @mfrellick

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