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New antibiotics are a rarity these days, let alone new antibiotic classes. But in August 2019, the FDA approved lefamulin (Xenleta), the first of the broad-spectrum pleuromutilins, for treating patients with bacterial pneumonia.
In one of two industry-sponsored, placebo-controlled studies that led to the drug's approval, investigators randomized 738 ambulatory patients (mean age, 57) with community-acquired pneumonia (CAP) to either oral lefamulin (twice daily for 5 days) or oral moxifloxacin (daily for 7 days). Patients were recruited from 19 countries, primarily in Eastern Europe; 40% were smokers; and most had comorbidities.
Overall, the drugs performed equally well, with about 90% of each group being clinically improved after 4 days and a…