Photo source: Tetraphase Pharmaceuticals, Inc.
KEY POINTS
- Eravacycline (Xerava) is a synthetic tetracycline antibiotic that works via inhibition of the 30S ribosomal subunit
- Less effected by tetracycline-specific resistance mechanisms (e.g., efflux pumps)
- FDA-approved August 27, 2018 for complicated intra-abdominal infection (cIAI) in adults 18 years and older
- Investigated for use with urinary tract infection, but outcomes were not favorable
- Has activity versus Gram negative bacteria, including some multidrug-resistant isolates
- In general, reserve for suspected or confirmed drug-resistant bacteria
- Can have activity versus some carbapenem-resistant organisms and extended-spectrum beta-lactamase producing organisms
- Has activity versus Acinetobacter baumannii, but acks activity versus Pseudomonas aeruginosa
- Has activity versus some Gram positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE)
- Has activity versus many anaerobic bacteria
- Studied in injectable and oral formulations, but only injectable is currently FDA-approved
- Dose is 1 mg/kg IV administered over 60 minutes, dosed every 12 hours
- No dose adjustment needed for renal impairment
- Adjust dose in severe hepatic impairment (Child Pugh C)
- The most common adverse effects include GI effects (e.g., nausea & vomiting) and infusion site reactions
- May cause tooth discoloration & enamel hypoplasia or inhibit bone growth during development (up to 8 years of age)
RESOURCES
- Eravacycline Package Insert
- Tetraphase FDA-Approval Announcement
- Xerava.com
- Eravacycline for the treatment of intra-abdominal infections [EOID 2014]
- Review of Eravacycline, a Novel Fluorocycline Antibacterial Agent [Drugs 2016]
- Antibacterial Efficacy of Eravacycline In Vivo against Gram-Positive and Gram-Negative Organisms [AAC 2016]
- Assessing the Efficacy and Safety of Eravacycline vs Ertapenem in Complicated Intra-abdominal Infections in the Investigating Gram-Negative Infections Treated With Eravacycline (IGNITE 1) Trial: A Randomized Clinical Trial [JAMA SURG 2017]
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