Antimicrobials
Eravacycline

Eravacycline

Spectrum of Activity

Dosing

General Information

Preparation

  • Reconstitute vial with 5mL of NS or SWFI giving concentration of 10 mg/mL (50mg vial) or 20 mg/mL (100mg vial)
  • Swirl vial gently, do not shake, to avoid foaming
  • Must be further diluted for IV administration to final concentration of 0.2-0.6 mg/mL
  • Final product should be clear and yellow or orange colored
  • Do not shake bag

Administration

  • Administer IV solution over ~ 60 minutes
  • Via Y-site or dedicated line
  • Flush line with NS before and after if sharing line

Compatibility

  • NS
  • Not tested in D5W or LR
  • Complicated intra-abdominal infections are the only current labeled indications
  • Gram-negative bacterial infections

Tier Three

  • Last line option, but will be used more commonly in practice for specific cases of 1st line option inadequacy
  • Strategies used: ASP Prospective Audit with Feedback, Criteria-for-use

Use Criteria

  • For complicated intra-abdominal infections due to susceptible organisms or for off-label indications prescribed by ID physician
  • Infections due to documented or highly suspected drug resistant organisms such as Acinetobacter and ESBL organisms
  • Cannot be used for Morgonella species, Pseudomonas, Proteus or Providencia species

Hepatic function periodically

  • Infusion site reactions
  • N/V/D
  • Hypotension
  • Wound dehiscence
  • Methoxyflurane, enhances nephrotoxic effect
  • Mecamylamine, enhances neuromuscular-blocking activity
  • Retinoic acid derivatives, enhances toxic and adverse effects
  • Strong CYP3A4 inducers decrease Eravacycline serum concentration

Tetracycline derivative (fluorocycline) that binds to the 30S ribosomal subunit, inhibiting protein synthesis by blocking peptide prolongation

  • Half-life of 20 hours
  • Excreted in urine and feces (~37% total unchanged)