Update on nifurtimox for treatment of Chagas disease

Chagas disease is a vector-borne neglected tropical disease caused by Trypanosoma cruzi. It is a systemic and chronic parasitic infection which is endemic in 21 countries with 10 million cases worldwide and 12,000 annual deaths. Around 70 million people in the Americas are at risk of contracting this disease, and less than 1% of infected people are treated due to low disease awareness and limited access to treatment. The current treatment for Chagas disease consists of benznidazole and nifurtimox under the World Health Organization (WHO) authorization protocol. The current treatment has limitations in terms of efficacy against the chronic phase of infection and side effects associated with prolonged therapy. This review provides an update on nifurtimox progress over the years and its recent approval by the U.S. Food and Drug Administration (FDA) in 2020 for the treatment of Chagas disease in pediatric patients under 18 years of age.

Lascufloxacin hydrochloride to treat bacterial infection

Lascufloxacin hydrochloride (AM-1977) is a novel 8-methoxy fluoroquinolone antibacterial agent with a unique pharmacophore at the 1st and 7th positions of the quinoline nucleus developed by Kyorin Pharmaceutical Co., Ltd. (Tokyo, Japan). It has been approved by the Japanese Ministry of Health, Labour and Welfare (MHLW) for treatment of respiratory tract and ear, nose and throat infections including community-acquired pneumonia and otorhinolaryngological infections, and shows great promise against fluoroquinolone-resistant strains of major pathogens which infect the respiratory tract. It is suitable for treating infections caused by Staphylococcus, Streptococcus, Pneumococcus, Moraxella (Branhamella) catarrhalis, Klebsiella, Enterobacter, Haemophilus influenzae, Legionella pneumophila, Prevotella and Mycoplasma pneumoniae that are sensitive to this drug.

Imipenem/cilastatin sodium/relebactam fixed combination to treat urinary infections and complicated intra-abdominal bacterial infections

Imipenem/cilastatin sodium/relebactam is a combination of imipenem/cilastatin, a U.S. Food and Drug Administration (FDA)-approved antibiotic, and β-lactamase inhibitor relebactam which has been developed for the treatment of complicated urinary tract infection (cUTI) and complicated intra-abdominal infection (cIAI) due to drug-resistant bacterial pathogens. The combination (Recarbrio) has been designated as a qualified infectious disease product (QIDP) and obtained FDA approval in 2019 for the treatment of cUTI and cIAI caused by susceptible Gram-negative microorganisms in adult patients with limited or no alternative treatment options. The product was also approved by the European Medicines Agency (EMA) in 2020 for the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options.

Triclabendazole for the treatment of fascioliasis

Fascioliasis is a neglected tropical disease that is commonly caused by flatworms affecting both domestic ruminants and humans. Fascioliasis currently affects roughly 17 million people globally with additional 180 million people at risk of developing infection. Despite the gigantic patient pool, clinicians typically have very few treatment options available. In this context, triclabendazole (Fasinex, Egaten) is the only medication approved by the Food and Drug Administration (FDA) for the treatment of fascioliasis. The FDA approval has been granted in 2019 although the drug was already utilized in the veterinary setting. Recently, three hits from the Pathogen Box have been identified in vitro as exhibiting potent anti-fascioliasis activity in an effort to identify other drugs active against fascioliasis.

An update on benznidazole for the treatment of patients with Chagas disease

Chagas disease is a vector-borne, systemic and chronic parasitic infection caused by Trypanosoma cruzi with approximately 8 million cases worldwide. The treatment for acute phase of Chagas disease consists of benznidazole and nifurtimox, although this treatment combination falls short in terms of efficacy against chronic phases of infection. This review provides an update on benznidazole progress and approval by the U.S. Food and Drug Administration in 2017 for the treatment of Chagas disease along with its lacunae.

Delamanid for the treatment of pulmonary multidrug-resistant tuberculosis

Out of a handful of new drugs currently in clinical trials for the treatment of tuberculosis, delamanid, a nitro-dihydro-imidazole derivative, has successfully emerged. Delamanid is a novel mycolic acid biosynthesis inhibitor that is equally potent against drug-sensitive as well as drug-resistant Mycobacterium tuberculosis. One of the strongest points for delamanid is its inability to be metabolized by cytochrome P450 enzymes, making it a promising candidate to be used in combination therapies for the treatment of tuberculosis and HIV. Additionally, it has successfully completed phase II efficacy trials and has received conditional marketing authorization from the European Medicines Agency.