With regard to the other three systemic antibiotics approved by the FDA in the 5 years since the 7-year drought ended, bedaquiline (Sirturo) is the most important globally, because it is indicated for multidrug-resistant tuberculosis. However, few U.S. physicians will have occasion to prescribe it.
Fidaxomicin (Dificid) is an effective drug for Clostridium difficile diarrhea; it’s eight times more potent than vancomycin against C. difficile, has minimal systemic absorption, and offers the major advantage of producing little negative impact on favorable gut flora. Telavancin (Vibativ) is a once-daily agent for hospital-acquired and ventilator-associated bacterial pneumonia.
Dr. Bessesen reported having no conflicts of interest.