New antibiotics

Abstract

Aim: to review the major pharmacological characteristics and therapeutic uses of antibiotics approved in the last five years, and the general features of those in advanced clinical trials.

Data sources: new drug approvals by the United States Food and Drug Administration were checked, and the article search was done using MEDLINE database (1990-2002) and the abstracts from the Interscience Conference on Antimicrobial Agents and Chemotherapy (1997-2002).

Article selection: FDA-approved antibiotics from 1998 to 2002, and those currently in phase II or III clinical trials, were chosen. 115 pertinent references about pharmacology, microbiology and clinical trials were found.

Data extraction: references were classified by type (abstract, basic or clinical research paper, update), compiled, analyzed, and then the review was prepared.

Data synthesis and conclusions: among the new antibiotics are linezolid and quinupristindalfopristin, active against multidrug-resistant Gram positive cocci. There are also three new quinolones (trovafloxacin, gatifloxacin and moxifloxacin), a long-half-life carbapenem (ertapenem), and two oral third-generation cephalosporins (cefdinir and cefditoren), with spectrum and administration differences in comparison with traditional agents. In clinical trials there are more quinolones, ketolides, glycopeptides, lipopeptides, everninomycins, and glycylcyclines, directed mainly against Gram positive bacteria; and natural antimicrobial peptides, also effective against Gram negative ones.