.jpg "Lexi DeWitt, PharmD, photo")
Lexi DeWitt, PharmD,
Our Lady of the Lake Regional Medical Center
Baton Rouge, Louisiana
Disclosure information not submitted.
Emily Johnston, PharmD, BCCCP
Critical Care Clinical Pharmacy Specialist
Our Lady of the Lake Regional Medical Center
Baton Rouge, Louisiana, United States
Disclosure information not submitted.
Alaina Dekerlegand, PharmD, BCIDP
Infectious Disease Clinical Specialist
Our Lady of the Lake Regional Medical Center, United States
Disclosure information not submitted.
Title: Evaluation of Clinical Outcomes and Safety of Eravacycline for Its Use in Serious Infections
Introduction: The rise of antimicrobial resistance remains a key challenge, especially for critically ill patients and those with multi-drug resistant (MDR) pathogens. Eravacycline is a novel fluorocycline with a broad spectrum of activity that is FDA-approved for complicated intra-abdominal infections. Limited data exists evaluating its efficacy in other complicated infections. This study aims to evaluate clinical response and safety of eravacycline in complicated infections.
Methods: A retrospective analysis of inpatient eravacycline at Our Lady of the Lake Regional Medical Center from January 1, 2019, to June 30, 2021 was conducted. Patients 18 years or older who received eravacycline for greater than 24 hours for a unique index infection were included. Patients with non-tuberculosis Mycobacteria were excluded from the clinical outcomes’ analysis due to extended treatment duration. The primary outcome evaluated was clinical response defined as complete resolution or significant improvement of signs and symptoms of the index infection. Secondary endpoints included 30-day mortality, 30-day recurrence, and adverse events on therapy.
Results: A total of 78 unique orders for eravacycline were identified, with 45 included for analysis. The average patient was 56 years old, male (67%), 85.2 kilograms, and admitted to an intensive care unit (56%). Average eravacycline dose was 88.9 mg every 12 hours for a median duration of 6 days. Indications for eravacycline included respiratory infection (40%), osteomyelitis (24%), skin and skin structure infection (13%), intra-abdominal infection (9%), bacteremia (9%), and urinary tract infection (4%). Pathogens treated included MDR Acinetobacter (40%), extended spectrum beta-lactamase producers (13%), Mycobacteria (11%), and Stenotrophomonas (16%). Overall, 72% (n=28/39) of patients had a positive clinical response. Recurrence within 30-days was seen in 6% and 30-day mortality in 18% of patients. One premature discontinuation of eravacycline occurred secondary to seizures, although deemed unlikely related to eravacycline by treating physician.
Conclusions: In this retrospective analysis, eravacycline demonstrated high rates of clinical response and safety in various complicated infections, including those caused by MDR pathogens and in critically ill patients.