Plazomicin: A promising novel antimicrobial in the era of bacterial resistance (Review)

Gram‑negative bacterial infections that are multidrug‑resistant are on the rise and present a severe risk to patients and the general population. These infections can be challenging to treat and cause severe morbidities and multiple mortalities. A semisynthetic antimicrobial called plazomicin received approval from the US Food and Drug Administration for the treatment of adults with severe complicated urinary tract infections (cUTIs) caused by bacterial pathogens, in cases where the patients have no or limited other therapeutic options. In treating cUTIs, plazomicin has demonstrated that it is comparable to meropenem, and is a practical treatment option for outpatient antibiotic treatment settings (given intravenously, once daily, with a brief 30 min administration duration). In addition, plazomicin shows low frequency side effects including nephrotoxicity and ototoxicity. Except for the approved use of plazomicin to treat cUTIs, there is a gap in the literature regarding the role of plazomicin in therapy for patients with aggressive and life‑threatening bacterial infections including Enterobacterales. Plazomicin is a reasonably expensive drug that should be used sparingly. In the present review, the molecular characteristics, chemical properties, mechanism of action, antibacterial spectrum, pharmacokinetics, clinical therapeutic indications, side effects, role in therapy and special considerations of plazomicin are discussed.