Eravacycline: a comprehensive review of in vitro activity, clinical efficacy, and real-world applications

ABSTRACT

Introduction

The escalating threat of multidrug-resistant organisms necessitates constant exploration for novel antimicrobial agents. Eravacycline has emerged as a promising solution due to its unique chemical structure, which enhances potency and expands its spectrum of activity.

Area covered

This review provides a thorough examination of eravacycline, encompassing its in vitro activity against Gram-positive and Gram-negative aerobes, carbapenem-non-susceptible organisms, anaerobes, and other bacterial strains. Additionally, it evaluates evidence from clinical studies to establish its clinical effect and safety.

Expert opinion

Eravacycline, a synthetic fluorocycline, belongs to the tetracyclines class. Similar to other tetracycline, eravacycline exerts its antibacterial action by reversibly binding to the bacterial ribosomal 30S subunit. Eravacycline demonstrates potent in vitro activity against many Gram-positive and Gram-negative aerobes, anaerobes, and multidrug-resistant organisms. Randomized controlled trials and its associated meta-analysis affirm eravacycline’s efficacy in treating complicated intra-abdominal infections. Moreover, real-world studies showcase eravacycline’s adaptability and effectiveness in diverse clinical conditions, emphasizing its utility beyond labeled indications. Despite common gastrointestinal adverse events, eravacycline maintains an overall favorable safety profile, reinforcing its status as a tolerable antibiotic. However, ongoing research is essential for refining eravacycline’s role, exploring combination therapy, and assessing its performance against biofilms, in combating challenging bacterial infections.

KEYWORDS:

• Eravacycline
• in vitro
• randomized controlled study
• meta-analysis
• carbapenem
• multidrug-resistant organism

Article highlights

• Eravacycline demonstrates potent in vitro activity against many Gram-positive and Gram-negative aerobes, anaerobes, and multidrug-resistant organisms.

• Meta-analysis of randomized controlled trials affirms eravacycline’s efficacy in treating complicated intra-abdominal infections, positioning it as a commendable therapeutic option.

• Real-world studies showcase eravacycline’s adaptability and effectiveness in diverse clinical conditions, emphasizing its utility beyond labeled indications.

• Despite some gastrointestinal adverse events, eravacycline maintains an overall favorable safety profile, reinforcing its status as a tolerable antibiotic.

• Ongoing research is essential for refining eravacycline’s role, exploring combination therapy, and assessing its performance against biofilms, contributing to its continued success in combating challenging bacterial infections.

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.

Reviewer disclosures

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

Additional information

Funding

This paper was not funded.