Approximately two million patients in the USA alone contract infections in hospital each year and this contributes to mortality in 90,000 cases. In this setting, where antibiotics are used extensively, more than 60% of Gram +ve infections can be caused by bacteria such as MRSA, VISA, VRE and PRSP, which are resistant to many of the major classes of antibacterials. Drug resistance is closely associated with mortality.
For many years vancomycin has been the major therapeutic approach for infections caused by multi-drug resistant strains such as MRSA. However, tolerance to vancomycin (in staphylococci) and resistance (in enterococci) has increased to problematic levels and alternatives are needed. Some new therapies have been targeted at this area including the oxazolidinones (Linezolid) and lipopeptides (daptomycin), however no available therapy is ideal in terms of spectrum of activity, convenience of administration and side-effect profile. Furthermore, resistance to the newly introduced agents is already arising.
There remains a strong need for new agents for Gram-positive nosocomial infections which do not exhibit cross-resistance with existing classes and which have a good prognosis for resistance development. Cantab has selected NVB333 as an injectable drug candidate for systemic treatment of Gram-positive infections. NVB333 has an excellent spectrum of activity covering drug resistant Gram-positive bacteria encountered in the hospital setting, including those resistant to the newer agents such as daptomycin and linezolid. The mode-of-action of NVB333 makes it intrinsically promising from the perspective of resistance development.