Peptide antibiotic aimed specifically at resistant Pseudomonas aeruginosa. Its intravenous version was abandoned because of kidney damage in phase 3.
Regulatory status
Not approved
Family
Peptidomimetic antibiotic (LptD inhibitor)
Scientific evidence
Low
Number of findings
2
Where it acts
Immunity and defense
Also known as
murepavadin, POL7080, RG7929
Regulatory status
FDA (US): Not approved (intravenous phase 3 stopped in 2019 because of kidney toxicity)
EMA (EU): Not approved
Dose
There is no established dose in humans.
Safety
In the phase 3 trial in hospital-acquired pneumonia, about 56% of treated patients developed acute kidney injury, more than expected, and the studies were stopped (Polyphor, 2019). Research only.
Differences between women and men
The single-dose phase 1 study was conducted only in healthy males. View the study →
Effect by goal · level of evidence
In vitro activity against extremely resistant Pseudomonas
improvesLowin vitro (A)animals / laboratory
96.7% of strains inhibited
In 785 clinical strains of extremely resistant Pseudomonas, murepavadin inhibited 96.7% at low concentrations (≤0.5 mg/L).
Randomized phase 1 with single and multiple intravenous doses: half-life of about 2.5–5 hours. These data did not anticipate the kidney toxicity later seen in critically ill patients.
Binds to LptD, a protein that Pseudomonas needs to assemble its outer membrane. Without it, the bacterium cannot place lipopolysaccharide on its surface and dies. It acts only on this bacterium, not on others.
What the evidence says
In people
Pharmacokinetics and safety in healthy volunteers. Randomized phase 1 with single and multiple intravenous doses: half-life of about 2.5–5 hours. These data did not anticipate the kidney toxicity seen later in critically ill patients. PubMed 29437621
In animals or the laboratory
In vitro activity against extensively resistant Pseudomonas. In 785 clinical strains of extensively resistant Pseudomonas, murepavadin inhibited 96.7% at low concentrations (≤0.5 mg/L). PubMed 29901750