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HEALTH | NYT NOW
Single Dose of Antibiotic Found Effective in
Quelling MRSA
By RONI CARYN RABIN JUNE 4, 2014
A single infusion of an antibiotic can clear serious bacterial skin infections
including methicillin-resistant Staphylococcus aureus, or MRSA just
as effectively as the 10-day regimen now used to treat patients, researchers
reported Wednesday.
Many patients do not finish the complicated treatment for these
infections, which requires two infusions of antibiotics daily, often in a
hospital. Such incomplete treatments may breed resistance to antibiotics
in surviving bacteria. A single-dose therapy may make it easier to treat
these dangerous infections, said the authors of the new study, published in
The New England Journal of Medicine.
The study was led by researchers at Duke University and designed and
funded by the Medicines Company, the maker of the antibiotic,
oritavancin. The drug, to be sold as Orbactiv, may be approved by the
Food and Drug Administration as early as August under a special fast-
track process, the company said.
This is a bit of a light at the end of a dismal tunnel in the
development of new antibiotics, said Dr. William Schaffner, an infectious
disease specialist at Vanderbilt University, who was not involved in the
new study.
In an editorial accompanying the research, Dr. Henry F. Chambers, a
professor of medicine at the University of California, San Francisco, said
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the one-shot antibiotic infusion could transform the treatment of acute
bacterial skin infections and alter how these infections are managed.
These patients could potentially just get an antibiotic and not be
admitted to the hospital at all, Dr. Chambers said in a telephone
interview.
The big question is, how much money do the drug companies want in
order to be able to do that? he asked. It wont be chump change.
Skin infections are among the most common reasons that doctors use
intravenous antibiotics. Rates of infection have risen significantly in recent
decades: There are an estimated 15 million cases in the United States each
year, and they cause 870,000 hospitalizations.
In the new study, 475 patients with acute bacterial skin infections
received a large single infusion of oritavancin, while 479 similar patients
received vancomycin, the current treatment, twice a day for seven to 10
days. Response rates to the two regimens were similar: 82 percent of the
patients receiving oritavancin and 78.9 percent of those on vancomycin
saw skin lesions shrink or stop spreading, and their fevers disappeared;
additional antibiotics were not required.
The most common side effects among those taking oritavancin were
nausea, headache, vomiting and diarrhea.
Oritavancin is effective because it persists in the body. Though none of
the trial participants developed an allergic reaction to the drug, a serious
reaction could result in extended illness, Dr. Chambers said.
There is no way to stop the treatment if a patient turns out not to have
an drug-resistant infection, some experts noted.
And if patients are sent home after the treatment is administered,
there is a chance that doctors could miss even more serious infections, like
necrotizing fasciitis, the so-called flesh-eating bacteria, said Dr. G. Ralph
Corey of Duke University Medical Center, the lead author of the study.
He suggested that a system should be established in which doctors
check in with patients a day after treatment to avoid such a situation.
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Correction: June 4, 2014
Because of an editing error, an earlier version of this article referred
incompletely to a doctor who noted the risk of physicians missing more
serious infections. He is Dr. G. Ralph Corey, a professor at Duke
University Medical Center and the lead author of the new study.
A version of this article appears in print on June 5, 2014, on page A18 of the New York edition with
the headline: Single Dose of Antibiotic Found Effective in Quelling MRSA.
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