Tedizolid (torezolid) for the treatment of complicated skin and skin structure infections

ABSTRACT

Introduction

Acute bacterial skin and skin structure infections (ABSSSI) are among the most frequent infectious diseases. Recently, several new antibiotics with activity against MRSA have been approved. Tedizolid, a second-generation oxazolidinone approved for ABSSSI offers theoretical advantages over first-generation oxazolidinones.

Areas covered

A comprehensive online search of Medline, ClinicalTrials.gov, and conference presentations was made, selecting articles between January 2000 and April 2020. In this review, the authors discuss the chemical and microbiological properties of tedizolid, summarize its efficacy, safety, and potential role in the treatment of ABSSSI as well as the potential for future indications.

Expert opinion

Tedizolid has proven to be non-inferior compared to linezolid for the treatment of ABSSSI in two registrational phase III clinical trials, being well tolerated. Tedizolid exhibits antibacterial activity against the most important ABSSSI pathogens (including multidrug-resistant strains of MRSA), as well as mycobacteria and Nocardia. It appears to have a safe profile, including decreased myelotoxicity and no significant drug interactions. Preliminary studies with longer duration of therapy seem to confirm these potential benefits. Overall, tedizolid expands the newly acquired armamentarium to treat ABSSSI. The role of tedizolid for other indications is under investigation and has yet to be determined.

KEYWORDS:

• Tedizolid
• acute bacterial skin and skin structure infections
• ABSSSI
• methicillin-resistant Staphylococcus aureus
• MRSA

Article highlights

• Tedizolid is a newly approved oxazolidinone for the treatment of ABSSSI

• In randomized clinical trials, tedizolid for 6 days was non-inferior compared to linezolid for 10 days

• Tedizolid exhibits antibacterial activity against the most important SSSI’s pathogens, as well as mycobacteria and Nocardia

• Tedizolid has theoretical benefits including less myelotoxicity and neuropathies possibly associated with its shorter course of therapy

• Tedizolid seems to have less interactions with serotoninergic or adrenergic agents

• These benefits need to be substantially evaluated in further research. However, initial post marketing observational studies with prolonged therapy and economic analyses confirm that tedizolid is a promising antibacterial agent against severe Gram-positive infections.

Declaration of interest

M.E Stryjewski has declared being a principal investigator for Argentina for an NIH grant (UM1AI104681), a speaker for Pfizer, and a consultant to Basilea; they have been a consultant to Achaogen, Cerexa, Cempra, Furiex, The Medicines Companies, and Theravance. The authors have no other 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

A peer reviewer has declared speaking for Bayer and Merck. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.