Investigational drugs in phase I and phase II clinical trials for the treatment of community-acquired pneumonia

ABSTRACT

Introduction: Community acquired pneumonia is one of the main infections, remaining as a global cause of considerable morbidity and mortality. Successful treatment hinges on expedient delivery of appropriate antibiotic therapy tailored to both the likely pathogens and the severity of disease. Although antibiotic resistance is increasing and pharmaceutical companies continue to debate the profitability of introducing new antibacterial agents, an encouraging number of new molecules have recently been unveiled which target multidrug-resistant bacteria.

Areas covered: Herein, the authors summarize the actual situation of novel antibiotics for CAP in phase I & II of development. For each set of compounds, the medical significance and possible clinical placement are discussed. Current treatment options from the most important international guidelines are also reviewed.

Expert opinion: Our review shows that the new antibiotics in the pipeline belong to existing antibiotic classes as β-lactams, macrolides, quinolones, oxazolidinones, tetracyclines, lipoglycopeptides, and cyclic lipopeptides and a few with a narrow spectrum of activity are novel compounds directed against novel targets. With rising outpatient antibiotic resistance in pneumonia, some of the compounds discussed are being considered for more rapid advancement in the pipeline, helping to increase the number of agents in later stages of development.

KEYWORDS:

• Antibiotics
• community acquired pneumonia
• avarofloxacin
• radezolid

Article highlights

• CAP is a common lethal respiratory infection. Its causative pathogens include Gram (+) and GNB and even MDRs.

• The new Macrolide TP-271 is under a phase I RCT for CAP. The ketolide nafithromycin is under a phase I RCT for CAP, in comparison to moxifloxacin

• New quinolones, such as WCK-2349/WCK-771, KPI 10, JNJ-Q2,Gepotidacin have improved activity against respiratory pathogens, including MRSA.

• Oxazolidones such as per os radezolid also showed excellent activity against a number of key CAP pathogens.

• Further research is warranted in order to assess potential superiority of new antibiotics compared to already approved ones and strategy that promotes research from Pharmaceutical Industries and International Organizations also.

• Alternatives to antibiotics were defined by us as non compound approaches as antibodies, probiotics, and vaccines in phase 2 and phase 3 trials

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.