title: Ramoplanin: a topical lipoglycodepsipeptide antibacterial agent.
abstract: Ramoplanin, a novel antibiotic with activity against aerobic and anaerobic gram-positive bacteria, acts to prevent cell wall peptidoglycan formation by binding to a key intermediate moiety, lipid II. It has been fast-tracked by the US FDA for the prevention of enterococcal infections and the treatment of Clostridium difficile. The minimum inhibitory concentration(90s) have been < or = 1.0 microg/ml against gram-positive organisms examined. In carriers of vancomycin-resistant enterococci, a double-blind, placebo-controlled Phase II trial of two doses of ramoplanin versus placebo showed proof of concept. A second Phase II trial also demonstrated the equivalence of ramoplanin compared with vancomycin for the treatment of C. difficile colitis. The clinical value and place in therapy of ramoplanin is dependent upon the results of Phase III trials addressing its utility in suppressing carriage of target organisms in the gastrointestinal tract or in the nares.
authors.affiliation: Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, USA. pfulco@mcvh-vcu.edu
authors.forename: Patricia
authors.initials: P
authors.lastname: Fulco
authors.forename: Richard P
authors.initials: RP
authors.lastname: Wenzel
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002473:Cell Wall / Q000187:drug effects / Q000378:metabolism; D016360:Clostridioides difficile / Q000187:drug effects; D047630:Depsipeptides / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004760:Enterocolitis / Q000188:drug therapy; D006801:Humans; D010457:Peptidoglycan / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D047630:Depsipeptides; D010457:Peptidoglycan; C041438:ramoplanin