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


METHODS
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.


METHODS
Available English-based articles and abstracts were reviewed, along with information from Oscient Pharmaceuticals.


RESULTS
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.
Farver
Debra K
DK
College of Pharmacy, South Dakota State University, Yankton, SD 57078-7600, USA. debra.farver@state.sd.us
Hedge
Dennis D
DD
Lee
Steven C
SC
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D016360:Clostridioides difficile / Q000187:drug effects* / Q000472:pathogenicity; D047630:Depsipeptides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D003967:Diarrhea / Q000188:drug therapy*; D006801:Humans; D008826:Microbial Sensitivity Tests
D000900:Anti-Bacterial Agents; D047630:Depsipeptides; C041438:ramoplanin