Delafloxacin for the treatment of adult patients with community-acquired bacterial pneumonia

ABSTRACT

Introduction

Delafloxacin is a novel fluoroquinolone with peculiar characteristics such as a weak acid character, frequent in vitro activity against methicillin-resistant Staphylococcus aureus (MRSA), and a low potential for resistance selection compared with other fluoroquinolones.

Areas covered

The present narrative review summarizes the available data on the use of delafloxacin for the treatment of community-acquired bacterial pneumonia (CABP).

Expert opinion

Delafloxacin is a novel fluoroquinolone with a unique profile and some interesting characteristics for the treatment of CABP, such as its marked activity against gram-positive bacteria, including MRSA, the possible use as monotherapy (owing to anti-Gram-negative and anti-atypical bacteria activity), the retained activity against many Gram-positive organisms resistant to other fluoroquinolones, and the availability of both oral and intravenous formulations. The results of the DEFINE-CABP phase-3 randomized controlled trial have shown noninferiority of delafloxacin vs. moxifloxacin for the treatment of CABP, thereby providing a further option for this indication. Against this background, future post-marketing experiences remain of crucial importance for further refining the place in therapy of delafloxacin in the real-life management algorithms of CABP, either as first-line option or step-down/outpatient treatment.

KEYWORDS:

• Community-acquired pneumonia
• CAP
• CABP
• delafloxacin
• MRSA
• fluoroquinolones

Article highlights

• Delafloxacin is a novel fluoroquinolone with peculiar characteristics such as a weak acid character, frequent in vitro activity against MRSA, and a low potential for resistance selection compared with other fluoroquinolones

• Delafloxacin has shown potent activity against the most common causative agents of CABP in in vitro studies

• As other fluoroquinolones, delafloxacin has an excellent pulmonary distribution, testified by a 13:1 mean penetration ratio into the lung epithelial lining fluid in comparison to delafloxacin free plasma concentration

• Noninferiority of delafloxacin vs. moxifloxacin for the treatment of CABP in adults has been demonstrated in DEFINE-CABP, a multicenter, multicontinental, double-blind, noninferiority, phase-3 RCT

• Post-approval real-life experiences remain crucial to continuously refine the use of delafloxacin in patients with CABP, aiming at further improving their care

Declaration of interests

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.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was not funded.