India-discovered levonadifloxacin & alalevonadifloxacin: A review on susceptibility testing methods, CLSI quality control and breakpoints along with a brief account of their emerging therapeutic profile as a novel standard-of-care
- PMID:36509611
- DOI: 10.1016/j.ijmmb.2022.11.005
India-discovered levonadifloxacin & alalevonadifloxacin: A review on susceptibility testing methods, CLSI quality control and breakpoints along with a brief account of their emerging therapeutic profile as a novel standard-of-care
Abstract
Background: Levonadifloxacin (intravenous) and alalevonadifloxacin (oral prodrug) are novel antibiotics based on benzoquinolizine subclass of fluoroquinolone, licensed for clinical use in India in 2019. The active moiety, levonadifloxacin, is a broad-spectrum antibiotic with a high potency against methicillin-resistant Staphylococcus. aureus, multi-drug resistant pneumococci and anaerobes.
Objective: This review, for the first time, critically analyses the antimicrobial susceptibility testing methods, Clinical Laboratory & Standards Institute (CLSI)-quality control of susceptibility testing and breakpoints of levonadifloxacin. Further, the genesis, discovery and developmental aspects as well as therapeutic profile of levonadifloxacin and alalevonadifloxacin are briefly described.
Contents: In order to aid the scientific and clinician communities with a single comprehensive overview on all the key aspects of levonadifloxacin and alalevonadifloxacin, the present article covers the reference MIC and disk diffusion methods for levonadifloxacin susceptibility testing that were approved by CLSI and the reference ranges for quality control strains published in the CLSI M100 document. The breakpoints of levonadifloxacin were derived in concordance to US FDA, European Committee on Antibiotic Susceptibility Testing (EUCAST) and CLSI approaches. Further, the article provides a brief account of challenges encountered during the discovery stages of levonadifloxacin and alalevonadifloxacin, activity spectrum and safety benefits accruing from structural novelty-linked mechanism of action. Further, the review also covers in vitro and in vivo activities, registrational clinical studies and patient-friendly features of levonadifloxacin/alalevonadifloxacin. Cumulatively, levonadifloxacin has a potential to offer a long awaited new standard-of-care treatment for the resistant Gram-positive bacterial infections.
Keywords: Alalevonadifloxacin; Antibiotic susceptibility test methods; Levonadifloxacin; MRSA; S. aureus.
Copyright © 2023 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.
Comment in
- Editorial: MDR pathogens in India are difficult to treat.Wattal C.Wattal C.Indian J Med Microbiol. 2023 Jan-Feb;41:81-82. doi: 10.1016/j.ijmmb.2022.10.013. Epub 2022 Nov 28.Indian J Med Microbiol. 2023.PMID:36456380No abstract available.
Comment on
- Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis.Antimicrobial Resistance Collaborators.Antimicrobial Resistance Collaborators.Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0. Epub 2022 Jan 19.Lancet. 2022.PMID:35065702Free PMC article.
Similar articles
- Levonadifloxacin, a Novel Broad-Spectrum Anti-MRSA Benzoquinolizine Quinolone Agent: Review of Current Evidence.Bhagwat SS, Nandanwar M, Kansagara A, Patel A, Takalkar S, Chavan R, Periasamy H, Yeole R, Deshpande PK, Bhavsar S, Bhatia A, Ahdal J, Jain R, Patel M.Bhagwat SS, et al.Drug Des Devel Ther. 2019 Dec 24;13:4351-4365. doi: 10.2147/DDDT.S229882. eCollection 2019.Drug Des Devel Ther. 2019.PMID:31920285Free PMC article.Review.
- Treatment challenges in the management of difficult-to-treat gram-positive infections: A consensus view apropos therapeutic role of novel anti-MRSA antibiotics, levonadifloxacin (IV) and alalevonadifloxacin (oral).Saseedharan S, Dubey D, Singh RK, Zirpe K, Choudhuri AH, Mukherjee DN, Gupta N, Sahasrabudhe S, Soni S, Kulkarni S, Walse P, Vora AC, Thomas J, Tayade A, Bhadarke G, Kishore K, Paliwal Y, Patil P, Reddy PK, Nagvekar V, Veeraraghavan B.Saseedharan S, et al.Indian J Med Microbiol. 2024 Jan-Feb;47:100528. doi: 10.1016/j.ijmmb.2024.100528. Epub 2024 Jan 21.Indian J Med Microbiol. 2024.PMID:38228227
- Assessment of antibacterial activity of levonadifloxacin against contemporary gram-positive clinical isolates collected from various Indian hospitals using disk-diffusion assay.Baliga S, Mamtora DK, Gupta V, Shanmugam P, Biswas S, Mukherjee DN, Shenoy S.Baliga S, et al.Indian J Med Microbiol. 2020 Jul-Dec;38(3 & 4):307-312. doi: 10.4103/ijmm.IJMM_20_307.Indian J Med Microbiol. 2020.PMID:33154240
- In vitro activity of a novel antibacterial agent, levonadifloxacin, against clinical isolates collected in a prospective, multicentre surveillance study in India during 2016-18.Appalaraju B, Baveja S, Baliga S, Shenoy S, Bhardwaj R, Kongre V, Dattatraya GS, Dhole T, Verma B, Mukherjee DN, Gupta S, Shanmugam P, Iravane J, Mishra SR, Barman P, Chopra S, Hariharan M, Surpam R, Pratap R, Joshi P, Khande H, Mane A, Jain R, Bhagwat S.Appalaraju B, et al.J Antimicrob Chemother. 2020 Mar 1;75(3):600-608. doi: 10.1093/jac/dkz493.J Antimicrob Chemother. 2020.PMID:31840170
- A comparative assessment of clinical, pharmacological and antimicrobial profile of novel anti-methicillin-resistantStaphylococcus aureus agent levonadifloxacin: Therapeutic role in nosocomial and community infections.Bakthavatchalam YD, Rao SV, Isaac B, Manesh A, Nambi S, Swaminathan S, Nagvekar V, Nangia V, John PV, Veeraraghavan B.Bakthavatchalam YD, et al.Indian J Med Microbiol. 2019 Oct-Dec;37(4):478-487. doi: 10.4103/ijmm.IJMM_20_34.Indian J Med Microbiol. 2019.PMID:32436868Review.
Cited by
- Antibiotics in the clinical pipeline as of December 2022.Butler MS, Henderson IR, Capon RJ, Blaskovich MAT.Butler MS, et al.J Antibiot (Tokyo). 2023 Aug;76(8):431-473. doi: 10.1038/s41429-023-00629-8. Epub 2023 Jun 8.J Antibiot (Tokyo). 2023.PMID:37291465Free PMC article.Review.
- Treatment of MRSA Infection: Where are We?Nazli A, Tao W, You H, He X, He Y.Nazli A, et al.Curr Med Chem. 2024;31(28):4425-4460. doi: 10.2174/0109298673249381231130111352.Curr Med Chem. 2024.PMID:38310393Review.
Publication types
MeSH terms
Substances
Related information
LinkOut - more resources
Full Text Sources
Medical