Zemdri (plazomicin) / Ionis, Achaogen - LARVOL DELTA

Limited Efficacy of Plazomicin Against Carbapenem-Resistant Enterobacterales in a Tertiary Care Centre in Eastern India. (PubMed, Indian J Med Microbiol) - "Whole-genome sequencing identified a high prevalence of 16S rRNA methyltransferase (RMTase) genes, such as armA and rmtB1, which confer high-level resistance to plazomicin. These results suggest that plazomicin may have limited utility against CRE in regions where RMTase-mediated resistance is prevalent."

Journal

Radiolabeled Antimicrobials for Infection Imaging: A Scoping Review. (PubMed, Int J Mol Sci) - "Among preclinical studies, radiolabeled plazomicin and echinocandins (caspofungin and anidulafungin) exhibited the greatest number of preferred characteristics. Many radioligands demonstrate good tissue penetration but suboptimal washout, limiting their diagnostic value. In vivo pharmacokinetic applications during active infections are promising, though significant challenges remain for infection imaging."

Journal • Review • Infectious Disease

Gentamicin triggers fatty acid oxidation-dependent mitochondrial ROS, driving greater nephrotoxicity than apramycin and other aminoglycosides. (PubMed, Free Radic Biol Med) - "Furthermore, we found that only gentamicin and, to a lesser extent, arbekacin and kanamycin induced a prominent increase in the mitochondrial fatty acid oxidation (FAO)-dependent production of H2O2. Apramycin, paromomycin, neomycin, dibekacin, geneticin, amikacin, tobramycin, and plazomicin stimulated neither FAO nor H2O2 production in kidney mitochondria...Gentamicin congener C1, apramycin, and 10 other tested aminoglycosides do not stimulate mitochondrial ROS production, and the use of antioxidants to protect the kidneys against these aminoglycosides is not a reasonable strategy. Cilastatin protects against aminoglycoside-induced glomerular damage independent of the inhibition of aminoglycoside transport into kidney cells."

Journal

Plazomicin susceptibility profile in carbapenem-resistant Enterobacterales (CRE): a laboratory-based cross-sectional study from a tertiary care hospital in North India. (PubMed, Indian J Med Microbiol) - "Plazomicin demonstrated significantly greater in vitro activity than conventional aminoglycosides against CRE, but overall susceptibility remained limited. Its role in high-resistance Indian settings should be selective and guided by phenotypic susceptibility testing rather than empirical use."

Journal • Observational data • Infectious Disease • Pneumonia

In vitro activity of ceftazidime-avibactam, imipenem-cilastatin-relebactam, meropenem-vaborbactam, cefiderocol, and plazomicin against non-fermenting Gram-negative isolates obtained from Bulgarian inpatients. (PubMed, Acta Microbiol Immunol Hung) - "In conclusion, the emergence of MBL-positive P. aeruginosa and the associated ineffectiveness of the novel BL-BLI combinations, as well as the relatively high proportion of CFDC-resistant A. baumannii isolates, are alarming. Therefore, continuous surveillance of AMR concerning newly approved antibiotics should be the mainstay of multifaceted global and national "One Health" strategies and infection control stewardship practices in hospital settings."

Journal • Preclinical • Infectious Disease

Plazomicin Activity against Carbapenem-Resistant Escherichia coli: A Brief Report. (PubMed, Indian J Med Microbiol) - "In contrast, isolates carrying 16S rRNA methyltransferases (RMTs) (e.g., rmtB1, rmtC, rmtF1) exhibited high-level resistance (MICs of ≥256 μg/mL). These findings not only highlight the advantage of plazomicin in AME-positive, RMT-negative strains, but also warn about the threat of emerging 16S RMT-mediated resistance that limit its clinical utility."

Journal • MELTF

Resistance development to new anti-gram negatives during treatment: geographical epidemiology and risk factors. (PubMed, Clin Microbiol Infect) - "Treatment-emergent resistance is a consequence of antibiotic exposure, but its impact is likely underestimated. Preventive strategies include optimization of pharmacokinetic/pharmacodynamic targets, therapeutic drug monitoring, timely and complete source control, and stewardship-driven rational use of novel agents."

Journal • Review • Infectious Disease

Susceptibility Studies of Novel Antimicrobial Drugs Against Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae. (PubMed, J Evid Based Med) - "Cefiderocol appears highly promising as a therapy for CR-hvKP infections. Our findings will not only effectively address the challenge of CR-hvKP resistance, but also provide evidence to support the optimization of clinical therapeutic strategies and further promote the development and application of novel antimicrobial drugs."

Journal • Infectious Disease • Pneumonia

Molecular resistance mechanisms to newly approved antibiotics (2017-2025) in WHO priority pathogens. (PubMed, Front Microbiol) - "This review systematically summarizes the molecular resistance mechanisms that World Health Organization (WHO) priority bacterial pathogens have already deployed against the 15 new antibiotics approved between 2017 and 2025, including β-lactam/β-lactamase inhibitors (cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam), tetracycline derivatives (eravacycline, omadacycline), a pleuromutilin (lefamulin), an aminoglycoside (plazomicin), and a fluoroquinolone (delafloxacin). Preserving the efficacy of these essential drugs thus necessitates a multifaceted, globally coordinated "One Health" strategy. Finally, we discuss how the growing complexity of AMR mechanisms is driving the need for advanced diagnostic tools, exploring the pivotal role of bioinformatics and artificial intelligence in predicting resistance and closing knowledge gaps."

Journal • Review

Ceftazidime/avibactam and aztreonam combined with an aminoglycoside combat metallo-β-lactamase-producing Klebsiella pneumoniae. (PubMed, Antimicrob Agents Chemother) - "Combination regimens with aminoglycosides (amikacin or plazomicin) occasionally demonstrated synergy using traditional definitions based on viable colony counting, but they were able to consistently reduce bacterial turbidity and the emergence of filamentous cells that were observed during exposure to ceftazidime/avibactam + aztreonam. Combinations between ceftazidime/avibactam, aztreonam, and an aminoglycoside are a potentially promising therapeutic strategy to combat the rising threat posed by MBL-producing K. pneumoniae."

Journal • Infectious Disease • Pneumonia

Plazomicin in multidrug-resistant complicated urinary tract infections: a scoping review. (PubMed, Ther Adv Infect Dis) - "In vitro data showed susceptibility rates for plazomicin ranging from 87% to 99.8% against Enterobacteriaceae, with superior activity over gentamicin, amikacin, and tobramycin. Plazomicin demonstrated synergistic effects with colistin, meropenem, and fosfomycin against extensively drug-resistant isolates and carbapenem-resistant Enterobacteriaceae. This review underscores plazomicin as a promising treatment for MDR cUTIs. However, limited data from low- and middle-income countries like India highlight the need for real-world studies on its efficacy, safety, and cost-effectiveness in such countries."

Journal • Infectious Disease • Nephrology • Renal Disease

Plazomicin: A promising novel antimicrobial in the era of bacterial resistance (Review). (PubMed, Exp Ther Med) - "In treating cUTIs, plazomicin has demonstrated that it is comparable to meropenem, and is a practical treatment option for outpatient antibiotic treatment settings (given intravenously, once daily, with a brief 30 min administration duration). Plazomicin is a reasonably expensive drug that should be used sparingly. In the present review, the molecular characteristics, chemical properties, mechanism of action, antibacterial spectrum, pharmacokinetics, clinical therapeutic indications, side effects, role in therapy and special considerations of plazomicin are discussed."

Journal • Review • Infectious Disease • Nephrology

Enhanced activity of apramycin and apramycin-based combinations against Mycobacteroides abscessus. (PubMed, J Antimicrob Chemother) - "Apramycin exhibits more potent in vitro activity against a diverse set of M. abscessus and other rapidly growing mycobacteria than currently recommended aminoglycosides."

Journal • Infectious Disease • Nontuberculous Mycobacterial Disease • Otorhinolaryngology

Plazomicin Pharmacokinetics in Indian Complicated Urinary Tract Infections Patients: A Subgroup Analysis From Phase 2 Study. (PubMed, Clin Pharmacol Drug Dev) - "Dose-normalized AUC0-24 and Cmax point estimates were 110% and 103%, respectively. This showed comparable plazomicin exposure in Indian and non-Indian patients."

Journal • P2 data • PK/PD data • Infectious Disease • Nephrology

The novel plasmid pCF1 can be acquired by sensitive Pseudomonas aeruginosa in the lungs of people with CF and cause extreme tobramycin resistance (NACFC 2025) - "This gene also produced resistance to kanamycin and gentamicin; but neither the aac(3)-like gene nor aph(3)-Ib gene conferred resistance to amikacin, netilmicin, apramycin, and plazomicin. The novel pCF1 plasmid encodes a novel aminoglycoside N-acetyltransferase that produces eTobR and can be transferred to sensitive Pa strains from other organisms within the lungs of PwCF. The plasmid produces minimal fitness costs to host Pa and is highly stable even in the absence of antibiotics. These characteristics make pCF1 acquisition a particular threat to the health of PwCF."

Infectious Disease

Synergistic action between peptide-neomycin conjugates and polymyxin B against multidrug-resistant gram-negative pathogens. (PubMed, Front Microbiol) - "The combination of aminoglycosides and colistin is often used to treat pneumonia caused by multidrug-resistant bacteria...Most A. baumannii strains are resistant to amikacin, gentamicin, tobramycin, and plazomicin, and approximately half are susceptible to neomycin...Resistance to the combination of R-, C-, or RC-NEO conjugates and PB did not develop over a 14-day period in neomycin-susceptible strains of A. baumannii, K. pneumoniae, and P. aeruginosa. Based on this survey of the peptide-neomycin library, circumvention of aminoglycoside-modifying enzymes and alluding to bacterial resistance is an important step toward the design and development of peptide aminoglycoside-based motifs for antimicrobial drug development."

Journal • Infectious Disease • Pneumonia • Respiratory Diseases

Performance evaluation of plazomicin susceptibility testing of Enterobacterales on VITEK 2 and VITEK 2 Compact Systems. (PubMed, J Clin Microbiol) - "There are three species, Klebsiella pneumoniae, Escherichia coli, and Serratia marcescens, for which the trend is ≥ 30% and therefore addressed as a note in the US label. The plazomicin test met the ISO and FDA criteria of ≥95% reproducibility and ≥95% quality control (QC) results within acceptable ranges for QC organisms.IMPORTANCEThe VITEK 2 AST-GN plazomicin test is a new, automated alternative to the BMD reference method for determining minimum inhibitory concentrations (MIC) of Enterobacterales, expanding the range of automatic AST testing."

Journal • Infectious Disease • Pneumonia

Nephrotoxicity of New Antibiotics: A Systematic Review. (PubMed, Toxics) - "The agents assessed included aztreonam/avibactam, cefepime/enmetazobactam, cefiderocol, ceftobiprole, contezolid, gepotidacin, imipenem/cilastatin/relebactam, lascufloxacin, lefamulin, levonadifloxacin, plazomicin, and sulbactam/durlobactam. There is a need for post-marketing studies to better characterize renal safety. Clinicians should remain vigilant and continue to monitor for and report renal-related adverse events."

Journal • Review

Meropenem/Vaborbactam Combinations with Aminoglycosides Overcome KPC-Producing Klebsiella pneumoniae (ASM Microbe 2025) - "M/V, gentamicin (GENT) and plazomicin (PLZ) pharmacokinetic profiles that approximated antibiotic exposures in the ELF were used. GENT and PLZ displayed limited activity as monotherapy against susceptible KPC-Kp isolates. M/V alone was bactericidal, but resistance emerged during treatment. Combining an AMG with M/V enhanced bacterial killing and protected against the emergence of resistance."

Infectious Disease • Pneumonia • Respiratory Diseases

Meropenem/Vaborbactam Combinations with Aminoglycosides Overcome KPC-Producing Klebsiella pneumoniae (ASM Microbe 2025) - "M/V, gentamicin (GENT) and plazomicin (PLZ) pharmacokinetic profiles that approximated antibiotic exposures in the ELF were used. GENT and PLZ displayed limited activity as monotherapy against susceptible KPC-Kp isolates. M/V alone was bactericidal, but resistance emerged during treatment. Combining an AMG with M/V enhanced bacterial killing and protected against the emergence of resistance."

Infectious Disease • Pneumonia • Respiratory Diseases

Enhanced Activity of Apramycin and Apramycin-Based Combinations Against Mycobacteroides abscessus. (PubMed, bioRxiv) - "The goal of this study was to compare apramycin's in vitro activity with amikacin and other aminoglycosides against a large collection of M. abscessus clinical isolates, both alone and in combination with clofazimine or linezolid...Plazomicin was inactive, and organisms were rarely susceptible to tobramycin...Apramycin was similarly potent against other rapidly growing mycobacteria tested. Apramycin exhibits more potent in vitro activity against a diverse set of M. abscessus and other rapidly growing mycobacteria than approved aminoglycosides."

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

Efficacy and Safety of Antimicrobial Medications in Treating Infections Caused by Extended-Spectrum; -Lactamase-Producing Enterobacteriaceae: A Systematic Review and Network Meta-analysis (ISPOR 2025) - "In these pairwise comparisons, Sitafloxacin and Ceftolozane-tazobactam showed the best clinical outcomes in comparison to piperacillin-tazobactam, while Plazomicin excelled in microbiological cure. However, Ertapenem and Cefepime were associated with higher ADRs and mortality, respectively.Keywords: Network meta-analysis, Extended-Spectrum β-Lactamase, Enterobacteriaceae, Efficacy and Safety"

Retrospective data • Review • Infectious Disease

The newly identified grdA gene confers high-level plazomicin resistance in Salmonella enterica serovars. (PubMed, Antimicrob Agents Chemother) - "Here, we report that Salmonella enterica strains containing the newly identified gentamicin resistance gene (grdA) are highly resistant to plazomicin. Heterologous expression of grdA in Escherichia coli ΔtolC resulted in plazomicin resistance with minimum inhibitory concentration (MIC) > 256 µg/mL. These findings reveal that GrdA confers significantly higher resistance to plazomicin than the previously known plazomicin-resistant AMEs AA (2)-Ia and APH (2″)-Iva."

Journal • Infectious Disease • Nephrology

Newly developed antibiotics against multidrug-resistant and carbapenem-resistant Gram-negative bacteria: action and resistance mechanisms. (PubMed, Arch Microbiol) - "Porin modifications reduce the influx of antibiotics, whereas overexpression of efflux pumps, particularly those in the resistance-nodulation-cell division (RND) family, actively expels antibiotics from bacterial cells, significantly lowering intracellular drug concentrations and leading to treatment failure.This review examines the mechanisms of action, resistance profiles, and pharmacokinetic/pharmacodynamic characteristics of newly developed antibiotics designed to combat infections caused by MDR and carbapenem-resistant Gram-negative pathogens. The antibiotics discussed include ceftazidime-avibactam, imipenem-relebactam, ceftolozane-tazobactam, meropenem-vaborbactam, aztreonam-avibactam, delafloxacin, temocillin, plazomicin, cefiderocol, and eravacycline."

Journal • Review • Critical care • Infectious Disease

Comparative phenotypic and genotypic antimicrobial susceptibility surveillance in Achromobacter spp. through whole genome sequencing. (PubMed, Microbiol Spectr) - "Newer agents like delafloxacin, plazomicin, and omadacycline showed little or no activity, while minimum inhibitory concentrations were low for eravacycline. In general, the species other than A. xylosoxidans showed lower MIC50 and MIC90, especially to carbapenems and β-lactamase inhibitor combinations like piperacillin-tazobactam, meropenem-vaborbactam, and imipenem-relebactam...Our study provides phenotypic data regarding identification and susceptibility testing and correlates this with the genotypic characterization of 109 clinical isolates belonging to Achromobacter spp. This comprehensive study sheds light on the phenotypic and genotypic character of this bacteria, that is of increasing clinical relevance in hospital-acquired infections."

Journal • Infectious Disease