Pseudomonas and MRSA

[Guest guest]

Hi,

, you know, I have no personal experience with pseudomonas, but from what I

have read, your doc is only partially right. About 80 percent of the pwcf

culture pseudomonas one time, and only few are able to eradicate it for a long

time. But at least at an early age that is possible, if you stop it in its

roots. The treatment of choice in Denmark now is the combo of Cipro and

Colistin. And resistance is one, but not the major problem with P.a. It becomes

very difficult to treat the bugs, if they become mucoid, which means, that they

start to produce a layer of mucus, in which they hide and the antibiotics can't

reach them any longer. It's not known yet though, when and why this mucus

production begins.

Allie, has Lloyd been given Vancomycin already? That is the only antibiotic,

which works against MRSA. It's heavy stuff and american docs are very reluctant

to use it, but if the MRSA really bothers your son, you should at least mention

it to your docs. And there is a brandnew kind of antibiotic in the pipeline,

which promises to be a new weapon against MRSA. I have copied information about

Zyvox below.

Bye-bye

Torsten, dad of Fiona 3wcf

e-mail: aberdeen95@...

Subject: New Weapon Perhaps!

Novel antibiotic combats superbugs

First new class to be introduced in 35 years

By Charlene Laino

MSNBC

SAN FRANCISCO, Sept. 27 - The first new type of antibiotic in 35 years

may help combat infections that are resistant to all known medications.

Called Zyvox, the novel agent kills germs that stubbornly resist even the

antibiotic of last resort.

STORY CONTINUES BELOW

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WITH CURRENT drugs losing their ability to combat infections that can

quickly spread throughout a hospital or community, the need for new

antibiotics has become critical, experts said here Monday at a meeting of

infectious disease specialists.

While not a miracle medication, Zyvox may help fill the void, they said.

The new drug works just as well as any of the current agents and has the

added benefit of overcoming drug resistance, said Dr. Harold Standiford,

professor of medicine at the University of land in Baltimore.

" This is a major event, " he said. " New antibiotics are crucially needed;

think how scary resistance is. "

Drug resistance is caused by genetic mutation. And when a mutation makes

a person resistant to one member of a class of antibiotics - say, one of

the many forms of penicillin - he also develops cross-resistance to all

the other forms of penicillin.

Unlike current antibiotics, Zyvox blocks bacterial growth by disrupting

initiation of the process the microbe uses to make proteins, Standiford

said. " And if bacteria can't make proteins, they die.

" Current antibiotics sabotage the process once it is underway, while

Zyvox prevents it from starting, " he said.

This totally different mechanism of action than any other antibiotic is

what makes Zyvox so exciting, he said.

" A new mechanism of action means there is a much higher chance that we

will not see cross-resistance with other drugs, " said Dr. Batts,

director of infectious diseases clinical development at Pharmacia &

Upjohn, manufacturer of Zyvox.

The drug has been studied against every other class of antibiotic without

sign of cross-resistance, he noted.

" This might be able to bail us out if a hospital has a situation where a

drug-resistant strain is spreading and killing patients, " Batts said.

Another advantage is that Zyvox can be administered either intravenously

or in tablet form, Standiford said.

Known scientifically as linezolid, Zyvox is the first of the class of

drugs known as oxazolidinones. Pharmacia & Upjohn plans to submit the

study data to the Food and Drug Administration for approval by the end of

the year, according to Standiford.

KILLER BUGS

Killer bugs have become an increasing problem in recent years, with at

least four American children recently dying from a common staph infection

that once easily succumbed to common antibiotics.

Staph had been successfully treated with penicillin since the 1940s, but

strains began showing resistance the next decade. Methicillin was

developed in the 1960s; by 1968, the first cases of methicillin-resistant

staph were reported.

By 1997, 50 percent of staph bacteria infections contracted by hospital

patients were resistant, compared with just 2 percent 25 years earlier.

At the same time, drug-resistant infections, once largely confined to

hospitals and nursing homes, started spreading to communities, according

to the Centers for Disease Control and Prevention.

Then, vancomycin, the last line of defense against staph infections,

failed to protect a Japanese patient. Since then, several more cases of

vancomycin-resistance have been reported on both sides of the globe,

leading to an international race to develop new antibiotics.

Just last week, Americans received another much-needed weapon in the

battle against deadly drug-resistant bacteria, with the Food and Drug

Administration approving a new antibiotic known as Synercid.

But unlike Zyvox, Synercid works similarly to other antibiotics already

on the market. Also, it has been used in Europe in animal feed for years.

Since genetic mutation to bacteria quickly evolve, doctors fear that

Synercid resistance will appear soon, too.

In contrast, Zyvox is a totally synthetic compound designed from scratch

that attacks the microbe in a completely different way, said Dr.

Eliopoulos of Harvard Medical School. " Therefore we think resistance will

be slow to emerge once we start using it clinically. "

THE STUDIES

Zyvox works against so-called gram-positive bacteria, which account for

more than half of infections treated in hospitals. Among them: staph,

strep and enterococci bacteria. They cause ailments ranging from

abscesses and boils to pneumonia and urinary tract infections.

To date, the drug has been studied in more than 5,000 patients, ranging

in age from 1 to 80. Among the findings:

o In 526 patients with community-acquired pneumonia, Zyvox eradicated

the bacteria in 91 percent, compared with 89 percent of patients given

the gold standard antibiotic therapy of IV ceftriaxone followed by oral

cefpodoxime.

o In a study of 397 patients with hospital-acquired pneumonia, Zyvox

plus aztreonam helped 66 percent, compared with a 68 percent success rate

in those given vancomycin plus aztreonam.

Similar results were seen in studies in patients with boils, abscesses

and other skin infections. And in patients with resistance to methicillin

or vancomycin, Zyvox worked in 77 percent and 89 percent, respectively.

Nevertheless, even while doctors here said they welcomed the introduction

of Zyvox, Eliopoulos said that he doubts any antibiotic can ever totally

combat the resistance problem. " We can slow it down, but frankly, I don't

know if we can ever beat it, " he said.