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Published Online, 22 March 2005, www.theannals.com, DOI 10.1345/aph.1E397.
 The Annals of Pharmacotherapy: Vol. 39, No. 5, pp. 863-868. DOI 10.1345/aph.1E397
© 2005 Harvey Whitney Books Company.
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NEW DRUG DEVELOPMENTS

Ramoplanin: A Lipoglycodepsipeptide Antibiotic

Debra K Farver, PharmD

Professor of Clinical Pharmacy, College of Pharmacy, South Dakota State University, Yankton, SD

Dennis D Hedge, PharmD

Professor of Clinical Pharmacy, College of Pharmacy, South Dakota State University

Steven C Lee, PharmD

Assistant Professor of Clinical Pharmacy, College of Pharmacy, South Dakota State University

Reprints: Dr. Farver, South Dakota State University College of Pharmacy, SD Human Services Center, PO Box 7600, Yankton, SD 57078-7600, fax 605/668-3222, debra.farver{at}state.sd.us

OBJECTIVE: To review the pharmacology, antimicrobial activity, pharmacokinetics, clinical applications, and safety of ramoplanin, a lipoglycodepsipeptide antibiotic.

DATA SOURCES: Information was obtained from MEDLINE and BIOSIS databases (1984–August 2004) and Oscient Pharmaceuticals using the key words ramoplanin, A 16686, A 16686A, and MDL 62198.

STUDY SELECTION AND DATA EXTRACTION: Available English-based articles and abstracts were reviewed, along with information from Oscient Pharmaceuticals.

DATA SYNTHESIS: Ramoplanin exerts its bactericidal activity against gram-positive aerobic and anaerobic bacteria by blocking peptidoglycan synthesis via lipid II. In vitro susceptibility reports have demonstrated efficacy against antibiotic-resistant gram-positive pathogens. Cross-resistance has not been documented with vancomyin and other glycopeptides. Clinical trials are investigating ramoplanin's oral administration for treatment of Clostridium difficile–associated diarrhea. Previous clinical trials had evaluated the suppression of colonization of vancomycin-resistant Enterococcus with ramoplanin. Adverse effects are minimal, and drug–drug interactions have not been documented.

CONCLUSIONS: The completion of clinical trials will determine whether ramoplanin has a promising role as a treatment option for diarrhea due to C. difficile.

Key Words: ramoplanin, A 16686, A 16686A, MDL 62198

Published Online, March 22, 2005. www.theannals.com, DOI 10.1345/aph.1E397




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