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This study evaluated eravacycline, a 3rd generation tetracycline, using MIC testing and pharmacokinetic/pharmacodynamic experiments in the hollow fiber system model (HFS-MAB). Despite low MICs (MIC range 0.0075–0.3 mg/L), efficacy outcomes were constrained, with an exposure target based on AUC/MIC and limited target attainment and cumulative response in virtual patient simulations. Overall, MIC alone did not predict clinical-grade efficacy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/eravacycline-pharmacokineticspharmacodynamics-in-the-hollow-fiber-system-model-of-mycobacterium-abscessus-lung-disease/446598/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/eravacycline-pharmacokineticspharmacodynamics-in-the-hollow-fiber-system-model-of-mycobacterium-abscessus-lung-disease/446598.png","ImageObject",300,407,{"name":92,"@type":93},"McGucket","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is treating Mycobacterium abscessus pulmonary disease challenging?","Question",{"text":112,"@type":113},"The document states that intrinsic resistance to many antibiotics makes treatment difficult and often requires prolonged intravenous therapy with severe side effects.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did the study measure for eravacycline in MAB pulmonary disease?",{"text":117,"@type":113},"It measured eravacycline MICs (including MIC50/MIC90) and performed static concentration-response testing, then evaluated dose-relevant exposures using the hollow fiber system model of MAB (HFS-MAB).",{"name":119,"@type":110,"acceptedAnswer":120},"Did low MIC values reliably indicate strong efficacy for eravacycline?",{"text":121,"@type":113},"No. The summary explicitly states that an MIC pattern does not accurately inform tetracycline efficacy and that efficacy must be determined using preclinical PK/PD designs; HFS-MAB results suggested limited therapeutic outcome probability despite low MICs.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446598,1790766215,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1236954412713,"https://us-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","| Mycobacteriology | Research Article  \nEravacycline pharmacokinetics/pharmacodynamics in the hollow fiber system model of Mycobacterium abscessus lung disease  \nSanjay Singh,1 Avneesh Shrivastava,1 Gunavanthi D. Boorgula,1 Mary C. Long,2 Brian Robbins,2 Tawanda Gumbo,3 Shashikant Srivastava1,4  \nAUTHOR AFFILIATIONS See affiliation list on p. 11.  \nABSTRACT Treatment of Mycobacterium abscessus (MAB) pulmonary diseases is challenging due to intrinsic resistance to many antibiotics and requires prolonged intravenous therapy with drugs that have severe side effects. The treatment guidelines include tetracyclines as part of the combination. We tested a 3rd generation tetracycline, eravacycline, for its potential role in MAB pulmonary disease. Eravacycline minimum inhibitory concentration (MIC) (ATCC\\#19977 strain and 59 clinical isolates) ranged between 0.0075 and 0.3 mg/L, and the MIC50 and MIC90 were 0.15 and 0.3 mg/L, respectively. In the static concentration-response studies, eravacycline killed 5.58 + 0.34 log 10 CFU/mL MAB, and EC50 (concentration associated with 50% of the maximal effect [Emax]) was 0.05 ± 0.01 mg/L. In the hollow fiber system model of Mycobacterium abscessus (HFS-MAB), examining eight eravacycline human-equivalent lung exposures, the ratio of area under the concentration-time curve to MIC (AUC 0-24/MIC) of 3,588 was identified as EC80 or the optimal exposure target for MAB kill. The probability of target attainment even with eravacycline doses of 4 mg/kg twice a day (8 mg/kg/day) falls below 90% at an MIC of 0.125 mg/L, and the cumulative fraction of response was only 30.56% in the 10,000 virtual patient trial. In summary, a MIC pattern does not accurately inform whether a tetracycline (in this study, eravacycline) has good efficacy, which must be determined using preclinical models applying a pharmacokinetics/pharmacodynamics study design. The HFS-MAB results suggest that, despite low MICs, the probability of better therapeutic outcomes with eravacycline is limited.  \nIMPORTANCE Treatment of Mycobacterium abscessus (MAB) pulmonary diseases is challenging due to intrinsic resistance to many antibiotics. The ATS/IDSA guidelines include tetracyclines as part of the combination. Eravacycline is a new tetracycline approved for the treatment of complicated intra-abdominal bacterial infections with better tolerability and low gastrointestinal adverse events compared to tigecycline. We performed an eravacycline pharmacokinetics (PK)-pharmacodynamics (PD) study for dose optimization with respect to the MAB pulmonary disease mimicking the intrapulmonary PKs in the hollow fiber model system of MAB (HFS-MAB) . While eravacycline MICs and static concentrations suggest great potential and even activity better than omadacycline and tigecycline, the drug only killed 0.56 log 10 CFU/mL below stasis in the HFS-MAB. Monte Carlo simulation experiments suggested that optimal doses for MAB pulmonary disease are likely in the range that would not be tolerated by patients.  \nKEYWORDS MIC, probability of target attainment, Monte Carlo experiments  \nMycobacterium abscessus (MAB) is a fast-growing nontuberculous mycobacteria  \n(NTM) associated with chronic pulmonary disease (1) . There are three subspecies  \nEditor Aude A. Ferran, Innovations Therapeutiqueset Resistances, Toulouse, France  \nAddress correspondence to Shashikant Srivastava, [Shashi.kant@uthct.edu](Shashi.kant@uthct.edu).  \nBrian Robbins and Mary C. Long are employees of  \nreported commonly as causing disease, MAB subsp. abscessus, MAB subsp. massiliense, and MAB subsp. bolletii (1) . Treatment of MAB pulmonary diseases is challenging due to intrinsic resistance to many antibiotics, requiring prolonged intravenous (IV) therapy with drugs that have severe side effects (2, 3) . As a result, the treatment regimens for MAB pulmonary disease vary widely (4) . The ATS/IDSA guidelines include tetracyclines as part of the combination. Tetracyclines inhibit bacterial protein s","cbCaiqh0J1mAGsqh","https://ap.wps.com/l/cbCaiqh0J1mAGsqh","pdf",1174301,13,"English","# Abstract\n# Importance\n# Background and rationale\n# Methods: hollow fiber system model\n# Findings and exposure targets\n# Conclusions","[{\"question\":\"Why is treating Mycobacterium abscessus pulmonary disease challenging?\",\"answer\":\"The document states that intrinsic resistance to many antibiotics makes treatment difficult and often requires prolonged intravenous therapy with severe side effects.\"},{\"question\":\"What did the study measure for eravacycline in MAB pulmonary disease?\",\"answer\":\"It measured eravacycline MICs (including MIC50/MIC90) and performed static concentration-response testing, then evaluated dose-relevant exposures using the hollow fiber system model of MAB (HFS-MAB).\"},{\"question\":\"Did low MIC values reliably indicate strong efficacy for eravacycline?\",\"answer\":\"No. The summary explicitly states that an MIC pattern does not accurately inform tetracycline efficacy and that efficacy must be determined using preclinical PK/PD designs; HFS-MAB results suggested limited therapeutic outcome probability despite low MICs.\"}]","Eravacycline pharmacokinetics/pharmacodynamics in the hollow fiber system model of Mycobacterium abscessus lung disease | PDF",1790716256,33]