New bugs, new drugs

I just realized that the article is from early July…still news to me!

Will this beat Zyvox in the price department too? I cant wait for the medical residents in the local general hospital to start writing this shit for viral infections!!!!

You know there are docs that will want to prescribe this just so that they don’t have to deal with abx failure… forget the quinolones or SMX/TMP against MRSA that is sensitive to those, just jump to the big gun so they don’t have to bother dealing with other meds.

It will be great for all the people who actually need it, but like Linda said- how many docs will just jump straight to this w/out giving any other abx a try? It would be like shooting a fly with a cannon!

Whatever the antibiogram says, or whatever the mechanism of action may be, the guiding principle of prescribing, ever since I became a pharmacist, has been “More is better.”

In 1982, I had back pain, and I was prescribed, to start, Clinoril, the NSAID of the day.

Similar back pain in 2006 got me, as a first-line, Celebrex, again,the NSAID of the day.

It’s not medicine, it’s FASHION. It’s in the magazines and its chatted up. How often do you make a reasoned argument with a doctor, and the “evidence based” decision is, “Because I want it?” Maybe to show off to the patient that they’re “with it?” I love my pharmacist colleagues, but I hold my nose when I see how prescribing comes down to us.

This is a pretty exciting drug, because on top of MRSA/VRSA and some VRE coverage it is also very effective against Pseudomonas.

While it there is really no way to fully test it, anecdotal evidence shows that resistance is slow to develop (esp when used correctly). It targets the 2a subset of PBP, which is something that no other cephalosporin does.

Its one big weakness is VRE (it doesnt cover feacium very well at all). Basically its cefepime with MRSA coverage.

There are a lot of good studies out there on Medline if you want to take a look.

Drum roll, please, … and now, let’s hear it from the limiting factors … side-effects….

I’m gonna go with “guaranteed C-Diff”

So, they’ll make it a combo with cleocin….:-)

I can just see the calls to the pharmacy at the hospital I work at. The residents will be yelling they want it and we tell them to talk to the infectious disease docs and the ID clinical pharmacist for approval. Of course the after a few times, if at all, the older and smarter residents will do just that. But there will still be the jerks who think their god and can order anything and we’ll fill it. Not going to happen no matter how much they bitch unless they go through the proper channels.

its another flashy expensive drug that will be overused and will immediatly breed even more resistance. its not even as good vs MRSA as it appears. MIC90 to MRSA is 2 compared to 0.5 to MSSA. As for Pseudomonas its MIC90 is >8 so forget that use too. Its not even active against ESBLs. So basically its another 3rd gen ceph with some temporary MRSA activity. I bet it will last no more than a year before its tossed aside as another expensive and useless drug.

Another blockbuster drug for J&J that is seeking approval is Rivaroxaban, an oral Factor Xa inhibitor (warfarin replacement?). Look it up. And buy up the J&J stock! We’ll see how these two turn out I guess.