1220. In Vitro Activity of Lefamulin Against a Global Collection of Bacterial Pathogens Commonly Causing Community-Acquired Bacterial Pneumonia (CABP, SENTRY 2015)
Session: Poster Abstract Session: Expanded Spectrum - New Antimicrobial Susceptibility Testing
Friday, October 6, 2017
Room: Poster Hall CD
  • Poster_ID Week 2017_Lefamulin CABP pathogens_FINAL.pdf (376.4 kB)
  • Background: CABP is the number one reason for death by infectious diseases worldwide and emerging resistance complicates its treatment. Lefamulin is the first semi-synthetic pleuromutilin antibiotic for IV and oral use in humans. It is currently in Phase 3 trials for the treatment of CABP in adults. Lefamulin effectively and selectively inhibits bacterial translation by binding to the peptidyl transferase center (PTC) via four H-bonds and other interactions at the A- and P-site resulting in an “induced fit.” This study investigated the activity of lefamulin and comparators against a contemporary set of bacterial pathogens associated with community-acquired respiratory infections collected worldwide.

    Methods: Unique patients’ isolates (n=2817) were collected globally in US (19.7%), Europe (36.9%), Latin America (5.7%) and Asia-Pacific region (37.6%) (30 countries, 116 sites) from adult and paediatric patients with respiratory tract infection (88.0%), bloodstream infections (5.5%) and other infections (2.4%).  Lefamulin and comparators were tested by CLSI broth microdilution and susceptibility was determined using the CLSI (2017) breakpoints.

    Results: LEF was the most potent compound tested, with 99.7% of all S. pneumoniae isolates being inhibited at a concentration of ≤0.25 mg/L (MIC50/90 values of 0.06/0.12 mg/L) and its activity was not affected by resistance to other antibiotic classes.  S. pneumoniae isolates were largely susceptible to levofloxacin (99.1%) and ceftriaxone (96.5%), while 34.5%, 23.3% and 16.8% of isolates were resistant to macrolides, tetracycline and clindamycin, respectively.  Lefamulin also showed potent activity against H. influenzae (MIC50/90 of 0.5/1 mg/L), including 22.0% of ß-lactamase producing strains, and M. catarrhalis (0.06/0.12 mg/L).

    Conclusion: Lefamulin demonstrated potent in vitro activity against this global collection of contemporary respiratory pathogens and its activity was unchanged regardless of resistance phenotype to the other antibiotic classes including macrolides, ß-lactams, tetracyclines or fluoroquinolones. These data support the continued clinical development of lefamulin for the treatment of respiratory tract infections, including CABP.

    Susanne Paukner, PhD1, Helio S. Sader, MD, PhD2, Jennifer M. Streit, BS3, Robert K. Flamm, PhD3 and Steven P. Gelone, PharmD4, (1)Nabriva Therapeutics, Wien, Austria, (2)JMI Laboratories, North Liberty, IA, (3)JMI Laboratories, Inc., North Liberty, IA, (4)Nabriva Therapeutics US, Inc., King of Prussia, PA


    S. Paukner, Nabriva Therapeutics: Employee and Shareholder , Salary

    H. S. Sader, Nabriva Therapeutics: Research Contractor , Research grant

    J. M. Streit, Nabriva Therapeutics: Research Contractor , Research grant

    R. K. Flamm, Nabriva Therapeutics: Research Contractor , Research grant

    S. P. Gelone, Nabriva Therapeutics: Employee and Shareholder , Salary

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