What type of drug is Nuzyra (omadacycline)?

Nuzyra (omadacycline) is an aminomethylcycline tetracycline antibiotic.

Nuzyra is a modernized tetracycline designed specifically to overcome tetracycline resistance.

Tetracyclines are a well established class of antibiotics that have been used for over 60 years for their broad spectrum of activity against Gram-positive and Gram-negative pathogens. The earliest tetracyclines (chlortetracycline, oxytetracycline, tetracycline) were natural products isolated from Streptomyces bacteria. Semisynthetic derivatives (such as doxycycline and minocycline) were subsequently developed with improved potency and tolerability, and are widely used today for the treatment of uncomplicated respiratory, urogenital and other infections caused by susceptible bacteria.

Tetracyclines work by binding to bacterial ribosomes and interfering with protein translation. They are usually considered bacteriostatic (inhibit growth of bacteria) rather than bactericidal (cause bacterial cell death).

Resistance to tetracyclines can occur through a number of mechanisms. Nuzyra was designed to overcome the two most common mechanisms of tetracycline resistance: efflux (a process in which bacteria transport the drug outside the cell) and ribosomal protection (cytoplasmic proteins work to free the ribosome from the inhibitory effects of the drug).

Nuzyra is used for the treatment of adult patients with:

• Community-acquired bacterial pneumonia (CABP) caused by caused by the following susceptible microorganisms: Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible isolates), Haemophilus influenzae, Haemophilus
  parainfluenzae, Klebsiella pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.
• Acute bacterial skin and skin structure infections (ABSSSI) caused by the following susceptible microorganisms: Staphylococcus aureus
  (methicillin-susceptible and -resistant isolates), Staphylococcus lugdunensis, Streptococcus pyogenes, Streptococcus anginosus grp., Enterococcus faecalis, Enterobacter cloacae, and Klebsiella pneumoniae.

Nuzyra is given either as an intravenous (IV) infusion or as a once-daily tablet taken by mouth.

Nuzyra has similar warnings to other tetracycline-class antibacterial drugs such as:

• permanent tooth discoloration (yellow-gray-brown) if used in the last half of pregnancy, infancy, and childhood up to the age of 8 years.
• reversible inhibition of bone growth if used in the last half of pregnancy, infancy, and childhood up to the age of 8 years.
• serious allergic reactions
• development of C. difficile diarrhea
• photosensitivity (sun allergy)
• pseudotumor cerebri (pressure inside the skull increases)
• anti-anabolic action (inhibits cell division and new tissue growth) which has led to increased blood urea nitrogen (BUN), azotemia, acidosis, hyperphosphatemia, pancreatitis, and abnormal liver function tests.

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