Xerava (eravacycline) / SOM Biotech, Ewha Womans University, PAION, Everest Medicines, Innoviva - LARVOL DELTA

Eravacycline: evaluation of susceptibility testing methods and activity against multidrug-resistant Enterobacterales and Acinetobacter. (PubMed, Eur J Clin Microbiol Infect Dis) - "Gradient diffusion strip method provides accurate and reproductible eravacycline susceptibility results overall. Eravacycline may be an interesting therapeutical option against MDR Enterobacterales, with activity rate relatively similar to tigecycline and cefiderocol. Against MDR Acinetobacter spp., eravacycline displayed only moderate activity, despite one dilution lower MIC50 than tigecycline."

Journal • Infectious Disease

Critical genomic insights into vancomycin-resistant Enterococcus faecium in Lebanon. (PubMed, Microbiol Spectr) - "Our VRE isolates carried multiple acquired AMR genes and chromosomal mutations, exhibiting resistance to vancomycin, telavancin, ampicillin, erythromycin, norfloxacin, levofloxacin, and nitrofurantoin...Resistance to novel antimicrobials, such as telavancin, dalbavancin, and eravacycline, is alarming and necessitates immediate action to preserve these critical last-resort interventions. Notably, the identification of clonal spread and a novel sequence type (ST2711) within Lebanese hospitals, alongside resistance to last-resort antimicrobials, highlights the dynamic evolution of VRE and the urgent need to strengthen antimicrobial stewardship programs in Lebanon and beyond. Addressing this challenge requires integrated One Health strategies."

Journal • Infectious Disease

In Vitro Susceptibility to Imipenem/Relebactam and Comparators in a Multicentre Collection of Mycobacterium abscessus Complex Isolates. (PubMed, Antibiotics (Basel)) - "The antibiotics yielding the highest susceptibility rates were tigecycline, eravacycline, and omadacycline (100%); followed by imipenem/relebactam and clofazimine (97.6%); and finally amikacin (94.6%). Our data demonstrate that relebactam improved the anti-MABc activity of imipenem, representing a β-lactam for the treatment of MABc infections. Furthermore, imipenem/relebactam demonstrated in vitro synergism with other anti-MABc treatments, thus supporting its use as part of dual regimens."

Journal • Preclinical • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases

171 - New Antibiotics, Untapped Potential: Exploring the Underuse of Recently Approved Agents (IDWeek 2025) - "Learning Objectives: At the conclusion of this session, participants will be able to: recognize situations where new antimicrobial agents may optimize clinical outcomes; describe the place in therapy of imipenem-relebactam relative to other novel beta-lactam/beta-lactamase inhibitors; select clinical situations where tedizolid may be considered over linezolid; compare and contrast omadacycline and eravacycline for infections beyond non-tuberculous mycobacteria."

Infectious Disease • Nontuberculous Mycobacterial Disease

Utility Of Eravacycline And Omadacycline Beyond Non-Tuberculous Mycobacterial Infections (IDWeek 2025) - No abstract available

Nontuberculous mycobacteria • Infectious Disease • Nontuberculous Mycobacterial Disease

Comparative in vitro Activities of Eravacycline and Tigecycline against Carbapenem-resistant Acinetobacter baumannii: Insights from Whole Genome Sequencing Analysis. (PubMed, J Glob Antimicrob Resist) - "ERV is a promising therapeutic option for managing CRAB infections in Singapore. However, the emergence of resistance mediated by novel genetic mutations highlights the need for continuous surveillance and further investigation."

Journal • Preclinical • Infectious Disease

Cefepime-zidebactam therapy for extensively drug-resistant Pseudomonas aeruginosa and Klebsiella pneumoniae infection as a bridge to liver transplantation. (PubMed, JAC Antimicrob Resist) - "Serial clinical isolates recovered from biliary fluid and ascitic fluid were tested for susceptibility to cefiderocol, aztreonam-avibactam, cefepime-taniborbactam, cefepime-zidebactam, and cefiderocol-xeruborbactam by broth microdilution...The patient was treated with a regimen of cefiderocol and eravacycline, with persistent fever and development of hepatic microabscesses on imaging...Antimicrobial therapy with cefepime-zidebactam along with source control allowed successful liver transplantation in a patient with cefiderocol-resistant K. pneumoniae and P. aeruginosa. Cefepime-zidebactam may be a therapeutic option for extensively drug-resistant Gram-negative organisms."

Journal • Infectious Disease • Pneumonia • Transplantation

Activity of ampicillin-sulbactam, sulbactam-durlobactam, and comparators against Acinetobacter baumannii-calcoaceticus complex strains isolated from respiratory and bloodstream sources: results from ACNBio study. (PubMed, Antimicrob Agents Chemother) - "Minocycline susceptibility was <50%, while tigecycline and eravacycline MIC50/90 were 1/2 and 0.5/1 µg/mL, respectively. Susceptibility rates of clinically utilized antimicrobials against a US collection of ABC isolates ranged from 23% to 97%, with meropenem displaying the lowest rate and sulbactam-durlobactam demonstrating the highest overall rate. Sulbactam-durlobactam activity was preserved against sulbactam, carbapenem, and cefiderocol non-susceptible isolates among respiratory tract and bloodstream isolates."

Journal • Critical care • Infectious Disease

i-DENV: development of QSAR based regression models for predicting inhibitors targeting non-structural (NS) proteins of dengue virus. (PubMed, Front Pharmacol) - "Model robustness was supported through scatter plots, chemical clustering, statistical analyses, decoy set etc. Virtual screening identified Micafungin, Oritavancin, and Iodixanol as top hits for NS2B/NS3 protease, and Cangrelor, Eravacycline, and Baloxavir marboxil for NS5 polymerase. However, further in vitro and in vivo studies are essential to validate their therapeutic potential. The i-DENV web server is freely accessible at http://bioinfo.imtech.res.in/manojk/idenv/, offering a structure-specific drug prediction platform for DENV research and antiviral drug discovery."

Journal • Dengue Fever

Acinetobacter baumannii treatment strategies: a review of therapeutic challenges and considerations. (PubMed, Antimicrob Agents Chemother) - "Consistent with the 2024 Infectious Diseases of America (IDSA) update, sulbactam-durlobactam, in combination with background carbapenem therapy, remains the combination with the greatest reduction in mortality for pulmonary infections and has promising outcomes in bloodstream infections with CRAB...Certain agents have been highlighted in the literature for suboptimal outcomes, primarily pulmonary infections treated with cefiderocol, tigecycline, and eravacycline. Studies including non-pulmonary infections, specifically bacteremia and central nervous system (CNS) infections, are overall limited to case series and subgroup analyses. Important areas for further research include breakpoint evaluations for eravacycline and minocycline as well as subclinical resistance in cefiderocol."

Journal • Review • Infectious Disease • Respiratory Diseases

Eravacycline as a last resort for difficult-to-treat resistant Acinetobacter baumannii infections in critically ill patients: three case reports with pharmacokinetic insights. (PubMed, JAC Antimicrob Resist) - "Eravacycline was administered at 1 mg/kg q12h in combination with IV colistin or as primary therapy. Eravacycline showed promise as a salvage therapy for DTR A. baumannii VAP in critically ill patients. Further studies are needed to confirm its efficacy and optimal dosing in this setting."

Journal • PK/PD data • Infectious Disease • Pneumonia • Respiratory Diseases

In vitro Activity of Eravacycline and Risk Factors for Carbapenem-Resistant Acinetobacter Baumannii Infections in Patients with Respiratory Diseases: A Retrospective Cohort Study. (PubMed, Infect Drug Resist) - "Current the medications are recommended therapies, including Colistin and Tigecycline, face significant limitations, such as nephrotoxicity and inadequate lung tissue penetration...Resistance to β-lactam antibiotics exceeded 96% (Ceftazidime: 96.56%, Ceftriaxone: 97.14%)...Serum amyloid A (SAA) and interleukin-6 (IL-6) are important prognostic biomarkers that facilitate risk stratification. The implementation of infection control measures that prioritize intubation-associated practices is essential for alleviating the burden of CRAB infections."

Journal • Preclinical • Retrospective data • Infectious Disease • Respiratory Diseases • CRP • IL6

A Study to Evaluate the Safety and Tolerability of Eravacycline in Pediatric Patients Aged 8 to 17 With Complicated Intra-abdominal Infections (cIAI) (clinicaltrials.gov) - P2 | N=35 | Recruiting | Sponsor: Innoviva Specialty Therapeutics | Trial completion date: Oct 2029 ➔ Mar 2029 | Trial primary completion date: Oct 2029 ➔ Mar 2029

Trial completion date • Trial primary completion date • Infectious Disease • Pediatrics

Efficacy and Safety of Eravacycline Combination Therapy for Carbapenem-Resistant Acinetobacter baumannii Pneumonia in ICU Patients: A Retrospective Study. (PubMed, Infect Drug Resist) - "Eravacycline demonstrated non-inferior efficacy to tigecycline in CRAB pneumonia treatment, with a favorable safety profile. Prompt consultation with infectious disease specialists and timely initiation of eravacycline therapy following the index culture are crucial factors in enhancing clinical outcomes."

Journal • Retrospective data • Critical care • Infectious Disease • Pneumonia • Respiratory Diseases

In Vitro Activity of Novel Antibiotics Against Corynebacterium spp. Clinical Isolates Responsible for Difficult-to-Treat Infections. (PubMed, Microb Drug Resist) - "The activity of ceftaroline (MIC90 >2 mg/L), ceftobiprole (MIC90 >8 mg/L), and delafloxacin (MIC90 >1 mg/L) was limited. By contrast, other molecules tested showed higher activity with low MIC90 values: linezolid (MIC90 ≤0.5 mg/L), tedizolid (MIC90 = 0.12 mg/L), dalbavancin (MIC90 = 0.12 mg/L), tigecycline (MIC90 = 0.12 mg/L), eravacycline (MIC90 = 0.06 mg/L), and omadacycline (MIC90 = 0.5 mg/L). One C. striatum strain exhibited a high level of daptomycin resistance after antibiotic exposure (MIC >16 mg/L). The in vitro activity of most of these novel antibiotics is excellent against Corynebacterium clinical isolates. They could represent a real alternative for treating DTT infections due to Corynebacterium spp."

Journal • Preclinical • Infectious Disease

Evaluation of the In Vitro Activity of Eravacycline to Standard Therapies Against Stenotrophomonas maltophilia Clinical Isolates (ASM Microbe 2025) - "Eravacycline (ERV) is a novel tetracycline that demonstrates potential in vitro activity against S. maltophilia...We evaluated the in vitro activity of ERV against S. maltophilia clinical isolates compared to minocycline (MIN), trimethoprim/sulfamethoxazole (TMP/SMX), and levofloxacin (LEV)... ERV demonstrated excellent in vitro activity against both susceptible and multidrug-resistant S. maltophilia strains. ERV may provide an alternative treatment option for S. maltophilia infections. Further pharmacokinetic/pharmacodynamic and in vivo studies are warranted to determine ERV role in therapy."

Preclinical • Infectious Disease

Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections. (PubMed, Infect Dis Ther) - "S. maltophilia infections are challenging to treat because of limited options. An analysis of 41 patients indicates ERV may be an acceptable treatment option, but more clinical studies are needed to evaluate its efficacy and safety."

Clinical data • Journal • Infectious Disease • Respiratory Diseases

Retrospective Study on the Efficacy and Safety of Eravacycline Based on Real-world Data (ChiCTR) - P=N/A | N=300 | Not yet recruiting | Sponsor: Sun Yat-sen Memorial Hospital, Sun Yat-sen University; Sun Yat-sen Memorial Hospital, Sun Yat-sen University

New trial • Real-world evidence • Infectious Disease • Respiratory Diseases

TREAT-GNB: Optimising TREATment for Severe Gram-Negative Bacterial Infections (clinicaltrials.gov) - P4 | N=600 | Recruiting | Sponsor: National University of Singapore

New P4 trial • Infectious Disease • Pneumonia • Respiratory Diseases

A Study to Evaluate the Safety and Tolerability of Eravacycline in Pediatric Patients Aged 8 to 17 With Complicated Intra-abdominal Infections (cIAI) (clinicaltrials.gov) - P2 | N=35 | Recruiting | Sponsor: Innoviva Specialty Therapeutics | Trial completion date: Feb 2026 ➔ Oct 2029 | Trial primary completion date: Feb 2026 ➔ Oct 2029

Trial completion date • Trial primary completion date • Infectious Disease • Pediatrics

Antibacterial activity of eravacycline against Klebsiella pneumoniae isolates: an in vitro study. (PubMed, Microbiol Spectr) - "Eravacycline, a novel tetracycline antibiotic, may be an effective treatment option for Klebsiella pneumoniae infections. The present study evaluated the in vitro activity of eravacycline against CRKP strains, including carbapenemase producers, and explored synergistic interactions with existing antibiotics. By determining the efficacy spectrum and combinatorial potential for eravacycline, this study will directly guide clinical strategies to combat infections caused by CRKP and optimize treatment regimens for high-risk populations."

Journal • Preclinical • Infectious Disease • Pneumonia

Hidden in Plain Sight: Identifying Mycobacterium Abscessus as the Covert Cause of Chronic Lung Cavitary Lesions (ATS 2025) - "Description: A 74-year-old male with history of ulcerative colitis, previously treated with Ustekinumab, presented with hemoptysis...Due to suspicion for MAC, the patient was started on Augmentin and doxycycline for two weeks...A peripherally inserted central catheter (PICC) was placed for three months of amikacin and eravacycline infusions, alongside azithromycin and clofazimine...Standard management includes long-term antibiotic regimens and regular assessments, although surgical resection may be required for localized infections. Our case underscores the necessity of including MABC in the differential for patients presenting with cavitary lung lesions to expedite diagnosis and treatment, avoiding the risk for worsening antibiotic resistance."

Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Nontuberculous Mycobacterial Disease • Oncology • Respiratory Diseases • Ulcerative Colitis • Vasculitis

Eravacycline as a Rescue Therapy for Carbapenem-resistant Gram-negative Bacterial Pneumonia in the Early Post-lung Transplantation Period (ATS 2025) - "It shows promise for treating difficult infections, especially from Stenotrophomonas maltophilia and Burkholderia cepacia. However, treatment should be individualized, and larger studies are needed to validate its efficacy and safety."

Gram negative • Infectious Disease • Pneumonia • Respiratory Diseases • Septic Shock • Transplantation

Septic shock caused by Elizabethkingia miricola in an elderly trauma patient: a case report and systematic literature review. (PubMed, Front Med (Lausanne)) - "We report a case of pulmonary infection caused by E. miricola in a 90-year-old trauma patient, marking the first documented instance of treatment with eravacycline...The present case and literature review provide options for the diagnosis and treatment of similar cases in the future and serve as a reference for preventing and controlling the occurrence and spread of nosocomial infections. https://pubmed.ncbi.nlm.nih.gov/, https://www.webofscience.com/wos/."

Journal • Critical care • Infectious Disease • Mood Disorders • Respiratory Diseases • Septic Shock

Occurrence and assessment of antibiotic resistance and virulence of Enterococcus spp. strains isolated from fecal samples of wild animals. (PubMed, Sci Rep) - "The frequency of occurrence of vancomycin-resistant enterococci (VRE) phenotypes, high-level streptomycin resistance (HLSR), high-level gentamicin resistance (HLGR), and high-level aminoglycoside resistance (HLAR) was also determined...The majority of strains exhibited resistance to eravacycline, while the least resistance was observed against ampicillin...The virulence factors were present in the tested strains, and the most frequently detected gene was agg encoding aggregation substance. We have provided evidence that healthy wild animals can be reservoirs of pathogenic Enterococcus strains, including MDR strains and with many VGs, which can be transmitted to humans."

Journal • Infectious Disease