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Topical retapamulin in the management of infected traumatic skin lesions.

Shawar R, Scangarella-Oman N, Dalessandro M, Breton J, Twynholm M, Li G, Garges H - Ther Clin Risk Manag (2009)

Bottom Line: In vitro studies show that retapamulin has high potency against the Gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes, and coagulase-negative staphylococci) commonly found in skin and skin-structure infections (SSSIs), including S. aureus strains with resistance to agents such as macrolides, fusidic acid, or mupirocin, and other less common organisms associated with SSSIs, anaerobes, and common respiratory tract pathogens.A 1% concentration of retapamulin ointment has been approved for clinical use as an easily applied treatment with a short, convenient dosing regimen for impetigo.Given the novel mode of action, low potential for cross-resistance with established antibacterial agents, and high in vitro potency against many bacterial pathogens commonly recovered from SSSIs, retapamulin is a valuable enhancement over existing therapeutic options.

View Article: PubMed Central - PubMed

Affiliation: Infectious Disease Center for Excellence in Drug Discovery, GlaxoSmithKline, Collegeville, PA, USA;

ABSTRACT
Retapamulin is a novel semisynthetic pleuromutilin antibiotic specifically designed for use as a topical agent. The unique mode of action by which retapamulin selectively inhibits bacterial protein synthesis differentiates it from other nonpleuromutilin antibacterial agents that target the ribosome or ribosomal factors, minimizing the potential for target-specific cross-resistance with other antibacterial classes in current use. In vitro studies show that retapamulin has high potency against the Gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes, and coagulase-negative staphylococci) commonly found in skin and skin-structure infections (SSSIs), including S. aureus strains with resistance to agents such as macrolides, fusidic acid, or mupirocin, and other less common organisms associated with SSSIs, anaerobes, and common respiratory tract pathogens. Clinical studies have shown that twice-daily topical retapamulin for 5 days is comparable to 10 days of oral cephalexin in the treatment of secondarily infected traumatic lesions. A 1% concentration of retapamulin ointment has been approved for clinical use as an easily applied treatment with a short, convenient dosing regimen for impetigo. Given the novel mode of action, low potential for cross-resistance with established antibacterial agents, and high in vitro potency against many bacterial pathogens commonly recovered from SSSIs, retapamulin is a valuable enhancement over existing therapeutic options.

No MeSH data available.


Related in: MedlinePlus

Patients with secondarily infected dermatitis treated with topical retapamulin, 1%, twice daily for 5 days, or with oral cephalexin, 500 mg, twice daily for 10 days, recorded a marked preference for topical therapy over oral therapy in both treatment arms. Drawn from data of Parish et al.31
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f4-tcrm-5-0041: Patients with secondarily infected dermatitis treated with topical retapamulin, 1%, twice daily for 5 days, or with oral cephalexin, 500 mg, twice daily for 10 days, recorded a marked preference for topical therapy over oral therapy in both treatment arms. Drawn from data of Parish et al.31

Mentions: In the SITL clinical trials, compliance with the retapamulin regimen was greater than that for cephalexin (Figure 3). In the ITT clinical population, 8.0% (51/636) of patients taking oral cephalexin took <80% of the prescribed dose, compared with 0.4% (5/1268) of patients applying retapamulin ointment.30 In the SID study, compliance was similar for the two treatment arms.31 Patients with SID were asked during their end-of-treatment visit whether they preferred oral or topical therapy, or had no preference for treatment. The majority of patients in each treatment group (60.6% and 56.8% in the retapamulin and cephalexin groups, respectively) preferred topical medication. Oral medication was preferred by fewer than 20% of patients in both treatment groups (Figure 4).31 The shorter treatment course for retapamulin compared with cephalexin – 5 days versus 10 days – may have influenced treatment preference. These results suggest that there is a preference for topical over oral antibacterial therapy for the treatment of SSSIs, a conclusion that has been reported by others.48,49


Topical retapamulin in the management of infected traumatic skin lesions.

Shawar R, Scangarella-Oman N, Dalessandro M, Breton J, Twynholm M, Li G, Garges H - Ther Clin Risk Manag (2009)

Patients with secondarily infected dermatitis treated with topical retapamulin, 1%, twice daily for 5 days, or with oral cephalexin, 500 mg, twice daily for 10 days, recorded a marked preference for topical therapy over oral therapy in both treatment arms. Drawn from data of Parish et al.31
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2697516&req=5

f4-tcrm-5-0041: Patients with secondarily infected dermatitis treated with topical retapamulin, 1%, twice daily for 5 days, or with oral cephalexin, 500 mg, twice daily for 10 days, recorded a marked preference for topical therapy over oral therapy in both treatment arms. Drawn from data of Parish et al.31
Mentions: In the SITL clinical trials, compliance with the retapamulin regimen was greater than that for cephalexin (Figure 3). In the ITT clinical population, 8.0% (51/636) of patients taking oral cephalexin took <80% of the prescribed dose, compared with 0.4% (5/1268) of patients applying retapamulin ointment.30 In the SID study, compliance was similar for the two treatment arms.31 Patients with SID were asked during their end-of-treatment visit whether they preferred oral or topical therapy, or had no preference for treatment. The majority of patients in each treatment group (60.6% and 56.8% in the retapamulin and cephalexin groups, respectively) preferred topical medication. Oral medication was preferred by fewer than 20% of patients in both treatment groups (Figure 4).31 The shorter treatment course for retapamulin compared with cephalexin – 5 days versus 10 days – may have influenced treatment preference. These results suggest that there is a preference for topical over oral antibacterial therapy for the treatment of SSSIs, a conclusion that has been reported by others.48,49

Bottom Line: In vitro studies show that retapamulin has high potency against the Gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes, and coagulase-negative staphylococci) commonly found in skin and skin-structure infections (SSSIs), including S. aureus strains with resistance to agents such as macrolides, fusidic acid, or mupirocin, and other less common organisms associated with SSSIs, anaerobes, and common respiratory tract pathogens.A 1% concentration of retapamulin ointment has been approved for clinical use as an easily applied treatment with a short, convenient dosing regimen for impetigo.Given the novel mode of action, low potential for cross-resistance with established antibacterial agents, and high in vitro potency against many bacterial pathogens commonly recovered from SSSIs, retapamulin is a valuable enhancement over existing therapeutic options.

View Article: PubMed Central - PubMed

Affiliation: Infectious Disease Center for Excellence in Drug Discovery, GlaxoSmithKline, Collegeville, PA, USA;

ABSTRACT
Retapamulin is a novel semisynthetic pleuromutilin antibiotic specifically designed for use as a topical agent. The unique mode of action by which retapamulin selectively inhibits bacterial protein synthesis differentiates it from other nonpleuromutilin antibacterial agents that target the ribosome or ribosomal factors, minimizing the potential for target-specific cross-resistance with other antibacterial classes in current use. In vitro studies show that retapamulin has high potency against the Gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes, and coagulase-negative staphylococci) commonly found in skin and skin-structure infections (SSSIs), including S. aureus strains with resistance to agents such as macrolides, fusidic acid, or mupirocin, and other less common organisms associated with SSSIs, anaerobes, and common respiratory tract pathogens. Clinical studies have shown that twice-daily topical retapamulin for 5 days is comparable to 10 days of oral cephalexin in the treatment of secondarily infected traumatic lesions. A 1% concentration of retapamulin ointment has been approved for clinical use as an easily applied treatment with a short, convenient dosing regimen for impetigo. Given the novel mode of action, low potential for cross-resistance with established antibacterial agents, and high in vitro potency against many bacterial pathogens commonly recovered from SSSIs, retapamulin is a valuable enhancement over existing therapeutic options.

No MeSH data available.


Related in: MedlinePlus