Matteo Bassetti, MD, PhD

Infectious Diseases Division

Santa Maria Misericordia University

Hospital

Udine, Italy

Nuovi antibiotici per i Gram-positivi

Disclosures

Research grants

- Astellas, Pfizer, MSD, Gilead

Advisor/consultant

- Angelini, Astellas, AstraZeneca, Bayer, Basilea, Cubist,

Gilead, MSD, Pfizer, Novartis, Shionogi, Vifor,

Medicines company, Tetraphase

Speaker/chairman

- Astellas, AstraZeneca, Pfizer, MSD, Gilead, Angelini,

Vifor, Novartis, Bayer, Cubist

Unmet needs

Broad and narrow spectrum drugs active aganist MDR

Gram-negative rods (enterobacteriaceae, pseudomonas,

and acinetobacter)

- Including those that produce carbapenemase where the only

active agents are tigecycline and colistin (anticipated to increase

over the next decade)

- Oral formulation in addition to IV is a plus

Gram-positive drugs active against MRSA and Coag neg

Staph show improved efficacy in more difficult to treat

infections like osteo, endocarditis and PJI, particularly

drugs taht are more effective, safer and /or more

convenient than current drugs

Drugs for MDR TB; MDR gonorrhea

GRAM + GRAM -

DRUGS HERE AND THOSE COMING Staphylococcus aureus

Drug Here Drug On The Way

Agent Route Agent Class Route

Ceftaroline IV BC-3781 pleuromutilin IV-PO

Ceftobiprole IV Ceftobiprole ceph IV

Daptomycin IV Dalbavancin glycopeptide IV

Linezolid IV-PO Delafloxacin FQ IV-PO

Rifampin IV-PO JNJ-Q2 FQ IV-PO

SMX/TMP IV-PO Oritavancin Glycopeptide IV

Telavancin IV Omedacycline

Tetracycline IV-PO

Tigecycline IV Brilacidin defensin-mimetics IV

Vancomycin IV Tedizolid oxazolidinone IV-PO

Teicoplanin IV, IM Eravacycline Tetracycline IV/PO

Antibiotics approved in

2014-2015

Source CDDEP 2015; WHO 2014 and PAHO

Dalbavancin - Bactericidal in vitro* at plasmatic

concentrations and proposed posology and administration

profile

Dalbavancin

Initial Dose 1000 mg

Dalbavancin

Second Dose 500 mg

Pla

sm

a C

on

ce

ntr

ati

on

(m

g/L

)

(+-

Sta

nd

ard

Devia

tio

n)

Time (Days)

Leighton et al. ANTIMICROB AGENTS CHEMOTHER 2004; 940-945

• Pharmacokinetic

parameters after a single

1000 mg dose

• Effective half-life is

approximately 8.5 days

• Terminal elimination half-

life is 14.4 days

*Pri

ma

ry

en

dp

oin

t fo

r E

MA

;

CE

=C

lin

ica

lly E

va

lua

ble

; IT

T =

Inte

nt

to

Tre

at;

Primary Endpoint: early response at 48-72 hours post initiation of therapy

cessation of spread of the erythema of the lesion, and resolution of fever.

Secondary Endpoint: Clinical Status at End of Therapy (Day 14-15, EMA primary

endpoint).

Dalbavancin - Phase 3 study design

Boucher et al. (2014) N Engl J Med 370:2169

Boucher et al. N Engl J Med 2014; 370:2169

Dalbavancin for infections of the skin compared

to Vancomycin/Linezolid

Dalbavancin - Outcomes by specific Pathogens

Proportion of Patients Achieving ≥ 20% Reduction in Lesion Size at 48-72 Hours by Pathogen, Studies DUR001-301/302 (pooled)

Dalbavancin single dose vs

double doses

Dunne MW et al. Clin Infect Dis. 2016 Mar 1;62(5):545-51

Dalbavancin tolerability in pts treated

more than 10 days

Dunne MW et al. Drug Saf 2016; 39:147–157

BSI: Dalbavancin

Raad. I. CID. 2005

A phase 2, open-label, randomized, controlled, multicenter study

75 adults CR-BSIs

Dalbavancin

1000 500

Vancomycin

1000 bid 14 d

Dalbavancin 33

Dalbavancin: Once a week

Vancomycin 34

67 patients

Dalba Vanco

Overall success at EOT 21/23 (91.3%) 18/28 (64.3%)

Clinical success 20/23 (87%) 14/28 (50%)

Microbiological success 22/23 (95.7%) 22/28 (78.6%)

Adverse events Similar Similar

Revolutionary drugs

Ceftriaxone

- Long half life ( 8h)

- Once a day

- Protein binding (85%)

- Only IV ( IM)

- Milestone of OPAT

- Well telerated

- Many indications

(SSTI, CAP, UTI, etc.)

- Cost

Dalbavancin - Long half life ( 5-7 days)

- Weekly drug

- Protein binding (dalba 93%)

- Only IV

- Potential for OPAT

- Well tolerated

- Potential for many indications

- Cost

80s 2016

Potential indications

Label:

- cSSTIs: one-two shots!

- Erysipelas, cellulitis, abscess, skin ulcers,

nosocomial cellulitis

Not-label:

- CBSIs: empiric and targeted use

- Bone and joint infections

- Mediastinitis

- Endocarditis

- CDAD

Potency Against Important Gram Positive

Organisms

US and European isolates collected between 2010-2012

MIC90 (µg/mL)

Pathogen (n) Oritavancin Vancomycin Daptomycin Linezolid

S. aureus (13,336) 0.06 1 0.5 2

MSSA (7,800) 0.06 1 0.5 2

MRSA (5,536) 0.06 1 0.5 1

β streptococci (2,281) 0.12 0.5 0.25 1

E. faecalis (2,132) 0.06 2 1 2

E. faecium (1,237) 0.06 >16 2 2

Randomized double blind trial design with 60 day safety follow

up

PTE Secondary endpoint

EMA

Safety Evaluation

60-day Safety

ECE (48-72 hrs)

Primary endpoint

FDA

Da

y 1

Da

y 7

Da

y 1

0

Oritavancin 1 x 1200mg

Vancomycin 7-10 days

(1g or 15mg/kg BID)

n=1959 Post-Treatment Evaluations

Active drug Placebo

Note: Infusions on days 7-10 were administered at the investigators’ discretion

Legend:

IV

IV IV IV IV IV IV IV

IV IV IV IV IV IV IV

IV IV IV IV IV IV IV

IV IV IV IV IV IV

IV IV

IV

IV

IV IV

IV IV

IV IV IV

IV IV IV

Oritavancin Phase III Clinical Studies

Gram-Positive Therapeutics: Latest Data on IV

Antibiotics Awaiting Approval for ABSSSI

Early Clinical Response (%)a,c PTE Clinical Cure (%)b

ORI VAN ORI VAN

Wound 88.0 85.1 83.4 78.3

Cellulitis 76.0 75.5 76.0 78.8

Major cutaneous abscess

81.5 84.3 85.7 84

Similar safety profile

Oritavancin (ORI)

Phase 3 Study SOLO 1 and 2 pooled analysis

Infection ABSSSI

N 1959

Evaluated IV dose of ORI or vancomycin (VAN) for 7-10 days

Corey GR et al. 24th ECCMID Barcelona, Spain 10-13 May 2014. poster_113642

Wilcox M et al. ICAAC 2013. Denver, Colorado. 10-13 September 2013. Poster L-202

Telavancin is a novel lipoglycopeptide

antibacterial agent

O

O O

O

Me

Me OH

OH OH

OH CI

O O

CI O

HO

O

NH

HO2C

HO OH OH

H N

H

N

H

O

O

H

N

O

N

H

O

OH O

Me

Me

H

N

H2N Me H

N

H N

H

N

H

O

HN OH

OH

P

Lipophilic side-chain

Membrane anchoring

• Improved potency

• Rapid cidality

Hydrophilic side-chain

Favourable PK-ADME properties

• Long half-life

• Renal clearance

Leadbetter et al. J Antibiot 2004

Unique dual mechanism of action

– Bacterial cell wall inhibition:

preventing polymerisation and

crosslinking

– Bacterial cell membrane

disruption

Telavancin: microbiologic

profile

Dual mechanism of action

Broad Gram-positive spectrum

Active against VISA, daptomycin-NS and

linezolid-NS organisms

Potent bactericidal activity

Low potential for emergence of resistance

Telavancin – activity against S. aureus

Pathogen* Agent MIC µg/ml†

CLSI %

Susceptible

EUCAST %

Susceptible 50% 90%

MRSA

(n=5,000)

Telavancin 0.03 0.06 100‡ 100

Vancomycin 1 1 99.9 99.9

Teicoplanin ≤2 ≤2 >99.9 98.7

Daptomycin 0.25 0.5 99.9 99.9

Linezolid 1 2 >99.9 >99.9

MSSA

(n=5,000)

Telavancin 0.03 0.06 100‡ 100

Vancomycin 1 1 100 100

Teicoplanin ≤2 ≤2 100 99.9

Daptomycin 0.25 0.5 100 100

Linezolid 2 2 100 100

Mendes et al. Antimicrob Agents Chemother, 2010

Mendes et al. Diagnostic Microbiology and Infectious

Disease, 2015

*Global (N America, EU, Latin America, Asia-West Pacific) isolates; †MICs determined using CLSI microdilution methodology;

‡Based upon FDA approved breakpoint of ≤1 µg/mL for S. aureus

MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus

23

Telavancin in Uncomplicated S. aureus

Bacteremia ASSURE Trial

• Comparators:

Telavancin 10 mg/kg IV q24h

Vancomycin 1 g IV q12h or

Nafcillin 2 g IV q6h or

Oxacillin 2 g IV q6h, or

Cloxacillin 2 g IV q6h

• Treatment duration: 14 days

Double-blind, randomized comparison of telavancin vs standard therapy for treatment of “uncomplicated” S. aureus blood stream infection

• Primary Endpoint: Clinical Cure at 84 days

• Continuation criteria used to identify complicated cases (deep-seated infection [eg, endocarditis, osteomyelitis] requiring > 2 weeks treatment)

• 60 patients enrolled in this exploratory study at ~30 sites in 8 countries

• 3,000 patients screened over 3+ years

1. Stryjewski ME, BMC Infect Dis. 2014 May 23;14(1):289.

24

Cure Rates ATT and CE Populations

Analysis Population Telavancin

(n=30) Standard

Therapy (n=30)

All-treated population (AT) 29 (97%) 29 (97%)

Ineligible patients 14 (47%) 13 (43%)

All-treated target population (ATT) 15 (50%) 16 (53%)

Clinically evaluable population (CE) 8 (27%) 9 (30%)

1. Stryjewski ME, BMC Infect Dis. 2014 May 23;14(1):289.

Corey RG et al. Clin Infect Dis 2015; DOI: 10.1093/cid/ciu971

Cure Rates in Patients With Bacteremia in

Clinical Studies With Telavancin

Corey RG et al. Clin Infect Dis 2015; DOI: 10.1093/cid/ciu971

Locke et al. CID 2014

Prokocimer et al. AAC 2012

Pharmacokinetic and relative penetration ratios for

single doses of tedizolid and linezolid in the murine

pneumonia model under various conditions

Drug Model Blood fAUCb ELF AUC

ELF

penetration

ratio

Tedizolid Immunocomp

etent 4.7 (0.1)c 43.9 (2.8)c 9.34

Neutropenic 3.35 (0.1)c 35.6 (0.2)c 10.63

Uninfected 2.77 (0.1)c 17.0 (0.1)c 6.14

Linezolid Immunocomp

etent 115.9 (44.0)d 155.8 (14.2)d 1.34

Neutropenic 53.4 (4.7) 61.4 (17.9) 1.15

Uninfected 36.3 (0.9) 62.5 (17.7) 1.72

Keel RA et al. Antimicrob. Agents Chemother 2012; 56: 3420-3422

Tedizolid: Novel Oxazolidinone

NDA=new drug application; IV=intravenous; HAP=hospital-acquired pneumonia; VAP=ventilator-associated pneumonia.

1. www.Cubist.com ; assessed December 17, 2013.

• Proposed indication: treatment of acute

bacterial skin and skin structure infections

(ABSSSI)

• Clinical development program – ABSSSI

• Under regulatory review

– Hospital-acquired/ventilator associated bacterial

pneumonia (HABP/VABP) • Late stage development

Gram-Positive Therapeutics: Latest Data on

Oral Antibiotics Awaiting Approval for ABSSSI

Based on the observed minimum inhibitory concentrations, tedizolid was four-to eight-fold more active than linezolid against Staphylococcus spp including MRSA, and Streptococcus spp.

Early Clinical Responsea (%)

PTEb Clinical Success (%)

TED LIN TED LIN

Wound 85.6 83.7 84.5 89.8

Cellulitis 74.8 71.9 88.1 82.0

Major cutaneous abscess

80 85.7 83.0 87.8

TEAEs Similar rates

Tedizolid (TED)1

Phase 3 Study ESTABLISH-1

Infection ABSSSI

N 667

Evaluated 6-day oral tedizolid vs 10-day oral linezolid therapy

a Early clinical evaluation or response endpoints occurred at 48-72 hours after treatment initiation b Post therapy evaluation (PTE) occurred at 7-14 days after end of therapy . 1.Prokocimer P et al. JAMA. 2013;309(6):559-69

Platelet Counts– Pooled Phase 3

Studies

TEAE=treatment-emergent adverse events; GI=gastrointestinal; LLN=lower limit of normal; TZP=tedizolid; LZD=linezolid.

aPlatelet counts were collected on Study Day 7-9, Study Day 11-13, and after the last dose of study drug.

1. DeAnda C, et al. Integrated results from 2 phase 3 studies comparing tedizolid phosphate 6 days vs. linezolid 10 days in patients with ABSSSI. Poster presented at: 53rd Interscience

Congress on Antimicrobial Agents and Chemotherapy (ICAAC); September 10-13, 2013; Denver, CO. (L-203).

At any post-baseline assessment through last dose of study druga

6.4

2.1

12.6

4.5

0

10

15

20

Below LLN Substantially Abnormal (<75% of LLN)

Pa

tie

nts

Wit

h T

EA

Es (

%)

6-Day TZP 200 mg once daily 10-Day LZD 600 mg twice daily

P=.0002

P=.0175

5

Omadacycline

SPA-Approved Phase 3 Trial Design for ABSI -

1108 (OASIS)

[1] 655 Randomized Subjects, 10 subjects were randomized, but never treated [2] Early Clinical Response = primary end point for FDA. [3] PTE end point = Co-primary end points confirmed through EMA scientific advice.

d2-3

FDA - Early Clinical

Response[2]

d7 to d14

End of Treatment

d1

Omadacycline

IV

Omadacycline

IV or Oral

Linezolid

IV

Linezolid

IV or Oral

ABSS

SI 645 treated

subjects[1]

7-14d after last treatment day

EMA - Post-Treatment

Evaluation[3]

3

Primary Endpoints Achieved for Both FDA and

EMA

84,8 86,1

96,3

85,5 83,6 93,5

0

10

20

30

40

50

60

70

80

90

100

Early Clinical Response

mITT PTE - Clinical Success

CE-PTE - Clinical Success

Early C

linic

al S

uccess, %

Omadacycline

EMA Co-Primary Endpoints

Delta (95% CI)

-0.7 (-6.9, 4.9) Delta (95% CI)

+2.5 (-3.2, 8.2)

Delta (95% CI)

+2.8 (-1.0, 6.9)

FDA Primary Endpoint

Plasma and Intrapulmonary

Concentrations of Eravacycline

Connors KP, et al. Antimicrob Agents Chemother 2014;58:2113-2118

Sample Site AUC0-12

(ug-h/mL)

Site:Unbound Plasma Ratio

Plasma (total) 4.56

Plasma (unbound) 0.77

ELF 4.59 6.44

AM 39.53 51.63

Eravacycline 1.0 mg/kg IV q12h

for a total of seven doses

Eravacycline

Pros

Broad spectrum (Gram+

[MRSA], Gram- [including

P. aeruginosa, ESBLs,

KPC, NDMs], anaerobes)

Favorable safety and

tolerability profile expected

Q12-Q24 interval

Oral dosing

Good lung penetration

Con

Contraindicated in

pregnancy and in children

Failed in cUTI P3 trial

Oral formulation: low

avialability

Relative to tigecycline:

2-4× more potent; 2× higher AUC AUC, area under the plasma drug concentration-time curve; NDM, New Delhi metallo-β-lactamase

Ceftaroline in vitro & in animal models

Active & bactericidal vs.

- Staphylococci, including MRSA

- Streptococci including penR pneumococci

- H. influenzae and M. catarrhalis including ß-lactamase-producers

- Enterobacteriaceae EXCEPT if ESBL, high level AmpC or carbapenemase

- Not active vs non-fermenters, Bacteroides

High affinity for PBP2a in S. aureus; PBP2x/2a/2b in S. pneumoniae

Hard to select resistance in MRSA1,2

In vivo efficacy vs.

- MRSA & VISA in lung, endocarditis and other models1,2

- Penicillin-resistant S. pneumoniae (PRSP) in a rabbit pneumonia3

1. Zhanel G et al. Drugs. 2009;69:809–831. 2. Kanafini ZA. Future Microbiol. 2011;6:9–18. 3. Croisier-Bertin D et al. Antimicrob Agents Chemother. 2011;55:3557–3563.

Ceftaroline penetration

CSF penetration: 14% +/- 5%

Lung penetration: 42.0 +/- 11.2%

Cottanoud et al. 50th ICAAC Boston 2010- Abstract B702

Jacqueline C et al. 46th ICAAC San Francisco 2006 Abstract A-1938

Garrison et al. Expt Rev Anti Infect Ther 2012

CANVAS 1 & 2: Evidence of an early

treatment effect with Ceftaroline may help

subsequent treatment decisions

Friedland HD et al. Antimicrob Agents Chemother. 2012;56:2231–2236.

Ceftaroline

Use off licensed indications

CNS

Orthopaedic

Endocarditis

• Ceftobiprole medocaril is the prodrug of the active moiety ceftobiprole.

• Ceftobiprole shows predictable and linear pharmacokinetics across the dose range of 125–1000 mg, with low variability (< 30%) and no accumulation.

• Distribution restricted to the extracellular water compartment (Vss = 18 L).

• Half-life of 3–4 hours.

• Eliminated primarily unchanged by renal excretion (glomerular filtration), with minimal metabolism to an open-ring metabolite.

• No relevant hepatic metabolism.

• Dose adjustment in renal impairment (CLCR < 50 mL/min), no dose adjustment in hepatic impairment.

• Low plasma protein binding of ~16%.

• Low potential for drug–drug interactions.

Zevtera Summary of Product Characteristics; MHRA Zevtera Public Assessment Report 2013

Clinical pharmacology of ceftobiprole

43

Ceftobiprole Activity vs Gram-positive pathogens Europe, Turkey & Israel 2005-2010

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

E. faecium (2,222)

E. faecalis (3,968)

VGS (1,264)

BHS (2,981)

Ceftriaxone RSP (20)

Ceftriaxone NSP (202)

PRSP (11)

PISP (209)

PNSP (217)

PSSP (4,223)

S. pneumoniae (4,443)

MR-CoNS (4,246)

MS-CoNS (1,317)

CoNS (5,563)

MRSA (4,147)

MSSA (11,279)

S. aureus (15,426)

% Susceptible % Resistant Adapted from Farrell et al. AAC. 2014; 58(7):3882-8

2 mg/L

% strains inhibited

99.5

100

98.3

93.1

100

91.0

99.3

99.8

90.0

92.8

36.4

85.6

15.0

100

94.1

95.9

6.8

CoN

S

S. pn

eum

on

iae

44

S. au

reu

s O

ther

4 mg/L

2 mg/L

0.5 mg/L

MIC

0.25 mg/L

0.5 mg/L

Activity against clinical isolates of Staphylococcus aureus

including MRSA from European surveillance

SENTRY study: N=15426, EU: 2005-

2010

27% of isolates are MRSA as defined by oxacillin resistance

Adapted from Farrell et al. AAC 2014; 58(7):3882-8 45

Potency against MSSA is similar to that of oxacillin and

superior to other extended-spectrum cephalosporins

0

10

20

30

40

50

60

70

80

90

100

Cu

mu

lativ

e %

in

hib

ite

d

MIC mg/L

SENTRY, EU, 2010 (CLSI broth microdilution), N=1974

Ceftobiprole

Oxacillin

Cefepime

Ceftriaxone

Ceftazidime

Basilea Pharmaceutica International Ltd.: Data on file 46

Activity against S. aureus with reduced

susceptibility or resistance to the major anti-

MRSA agents

Adapted from Farrell et al. Int J Antimicrob Agents 2014; 43(4):323-7 47

MIC (mg/L) %Susc. / %Resistant

Resistant subset (no. tested) / antimicrobial agent

50% 90% Range EUCAST

All MRSA (216)

Ceftobiprole 1 2 0.12 – 4 97.3 / 2.7

Vancomycin 1 2 ≤0.12 – >16 91.2 / 8.8

Daptomycin 0.5 2 0.12 – 4 81.0 / 19.0

Linezolid 1 2 0.25 – >8 90.7 / 9.3

Teicoplanin ≤2 4 ≤2 – >8 89.8 / 10.2

Ceftobiprole

Linezolid non-susceptible (21)c 1 2 0.25 – 2 100.0 / 0.0

Daptomycin-non-susceptible (32) 0.5 2 0.25 – 2 100.0 / 0.0

VISA (12) 2 2 1 – 2 100.0 / 0.0

hVISA (32) 2 2 0.5 – 2 100.0 / 0.0

VRSA (10) 0.5 1 0.12 – 2 100.0 / 0.0

SCCmec type I (21) 2 4 2 – 4 71.4 / 28.6

SCCmec type II (22) 1 2 0.25 – 2 100.0 / 0.0

SCCmec type III (22) 2 2 1 – 2 100.0 / 0.0

SCCmec type IV (44) 1 1 0.5 – 1 100.0 / 0.0

c. LZD=linezolid. One S. aureus isolate (MIC at 4 mg/L) was positive for cfr rRNA methyltransferase. MIC Source: Adapted from Farrel et al. [Farrel 2014].

Clinical cure at TOC (CE)

69%

78%

38%

71% 76%

56%

0%

20%

40%

60%

80%

100%

% p

ati

en

ts w

ith

c

lin

ica

l c

ure

at

the T

OC

vis

it (

CE

)

Ceftobiprole Ceftazidime/Linezolid

N=251 N=244 N=198 N=185 N=53 N=59

All patients VAP HAP (excl. VAP)

48

Ceftobiprole vs Ceftazidime/Linezolid:

Difference (95% CI): -2.0% (-10.0; 6.1) 1.6% (-6.9; 10.4) -18.2% (-36.4; 0.0)

Awad et al. Clin Infect Dis 2014; 59(1):51-61

HAP (excl. VAP):

Post-hoc analysis of early improvement at Day 4

(CE)

87% 87% 95%

78% 74%

53%

0%

20%

40%

60%

80%

100%

% p

ati

en

ts w

ith

cli

nic

al c

ure

at

the

TO

C v

isit

Ceftobiprole Ceftazidime/Linezolid

N=198 N=185 N=61 N=69 N=19 N=19

All patients MRSA at baseline Gram-positive at baseline

Adapted from Scheeren et al., DIVI 2014; Poster P/06/06 49

:

Difference (95% CI): 8.5% (0.9; 16.1) 13.0% (−0.4; 26.4) 42.1% (17.5; 66.7)

HAP (excl. VAP):

Outcomes in patients with baseline bacteraemia

(ITT)

Welte et al., ERS 2014; Presentation 4643

29%25%

21%17%

30%

24%

37%41%

0%

10%

20%

30%

40%

50%

60%

%withoutcome

Ce obiprole Ce azidime/Linezolid

24

Allpa ents AllICUpa ents

Number 12171227 2724 17AllICUpa ents

Allpa ents

Clinical cure (TOC visit) 30-day all-cause

mortality

50

Pros and cons of new antimicrobials for cSSTI

Drug Pros Cons

Daptomycin Rapid bactericidal activity

Antibiotic film

Good tolerability profile

Only intravenous

Spectrum limited to Gram positives

Tigecycline Broad spectrum of activity Only intravenous

Bacteriostatic

Linezolid Oral formulation allows treatment of outpatients and early

oral-switch

Bacteriostatic

Spectrum limited to Gram positives

Drug-Drug interactions

Important adverse effects

Tedizolid Oral formulation allows treatment of outpatients and early

oral-switch

Once-daily administration

Low drug interactions

Low myelotoxicity

Bacteriostatic

Spectrum limited to Gram positives

Dalbavancin Once-weekly administration

Good penetration into cortical bone and auricular tissues

Good tolerability profile

Spectrum limited to Gram positives

Only intravenous

Oritavancin Single-dose treatment

Good tolerability profile

Spectrum limited to Gram positives

Only intravenous

Ceftaroline Broad-spectrum activity

Good tolerability profile

Only intravenous

Bassetti M, et al. Curr Opin Infect Dis 2016;29(2):99-108.