Infectious Disease Book

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Eravacycline

Aka: Eravacycline, Xerava
  1. See Also
    1. Tetracycline
  2. Mechanism
    1. Tetracycline Class drug
    2. Fluorocycline Antibiotic
  3. Indications
    1. NOT indicated in complicated Urinary Tract Infections
    2. Intraabdominal infections
      1. Bacteroides species
      2. Citrobacter freundii
      3. Clostridium perfringens
      4. Enterobacter cloacae
      5. Enterococcus faecalis
      6. Enterococcus faecium
      7. Escherichia coli
      8. Klebsiella oxytoca
      9. KlebsiellaPneumoniae
      10. Parabacteroides distasonis
      11. Staphylococcus aureus
      12. Streptococcus anginosus
  4. Contraindications
    1. Pregnancy and Children <8 years old
      1. Permanent Tooth Discoloration
      2. Enamel Hypoplasia
      3. Inhibited bone growth
  5. Dosing: Adult
    1. Eravacycline 1 mg/kg every 12 hours
    2. Adjustments
      1. Strong Cytochrome P-450 3A3/4 Isoenzyme Inducers (see below)
      2. Severe Liver Disease
        1. Start with 1 mg/kg every 12 hours on day 1, then 1 mg/kg every 24 hours
  6. Drug Interactions
    1. Strong Cytochrome P-450 3A3/4 Isoenzyme Inducers (e.g. Rifampin)
      1. Decreased serum levels of Eravacycline
      2. Increase dose of Eravacycline to 1.5 mg/kg every 12 hours
  7. Adverse Effects
    1. Metabolic
      1. Azotemia (including increased BUN)
      2. Metabolic Acidosis
      3. Hyperphosphatemia
    2. Tetracycline class effects
      1. Hepatotoxicity
      2. Pancreatitis
      3. Photosensitivity
      4. Pseudotumor Cerebri
      5. Clostridium difficile
    3. Miscellaneous Reactions (<10%)
      1. Infusion-Site Reaction
      2. Nausea
      3. Vomiting
      4. Diarrhea
      5. Hypotension
  8. Resources
    1. Eravacycline (FDA Drug Label pdf)
      1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/211109lbl.pdf
  9. References
    1. LoVecchio (2019) Crit Dec Emerg Med 33(5): 32
    2. Sutcliffe (2013) Antimicrob Agents Chemother 57(11): 5548-555 +PMID: 23979750 [PubMed]
      1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811277/

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