Systematic review of antibacterial activity of eravacycline: a novel fluorocycline against clinically obtained Gram-negative bacteria

ISSN Eravacycline (TP-434 or 7-fluoro-9-pyrrolidinoacetamido-6-demethyl-6-deoxytetracycline) is a novel fluorocycline antibiotic, which was designed to overcome tetracyclinespecific resistance mechanisms. This study aimed to analyze the in-vitro activity of eravacycline against Gram-negative bacteria in published literature, to contribute to the international data on the antimicrobial stewardship programs. A systematic literature review was performed through the electronic databases from January of 2000 to December 2017 to cover all published articles relevant to our scope. Finally, nine studies met our inclusion criteria that were subjected to data extraction and review. The highest activity of eravacycline was against Escherichia coli isolates since in all reports eravacycline at a concentration of 0.5 mg/ml or less inhibited 90% of isolates. In contrast, the lowest activity was seen against Proteeae isolates since except for one report eravacycline at a concentration of at least 2 mg/ml inhibited 90% of isolates. The antibacterial activity of eravacycline against 13 collections of carbapenem-resistant bacteria consists of 1057 isolates was showed that eravacycline at a concentration of 2 mg/ml or less inhibited 90% of isolates. The only exception was for carbapenemresistant Proteeae which 90% of isolates were inhibited at a concentration of at least 4 mg/ml. In summary, eravacycline has a promising in-vitro antibacterial property against several nosocomial pathogens. This was an encouraging result that provides an option for treatment of infections caused by Gram-negative bacteria, regardless of resistance phenotype. However, further clinical studies are necessitate to provide clinical evidence to support these observations. Copyright 2019 Wolters Kluwer Health, Inc. All rights reserved.