Emerging treatments

Omadacycline

Omadacycline is a tetracycline antibiotic available in the US for treatment of acute bacterial skin and skin structure infections (ABSSSIs) due to Staphylococcus aureus (including MRSA), Staphylococcus lugdunensis, Streptococcus anginosus group, Streptococcus pyogenes, Enterococcus faecalis, Klebsiella pneumoniae, and Enterobacter cloacae.[68][69] A submission was also made to the European Medicines Agency (EMA) in 2018 on the basis of two phase 3 studies in patients with ABSSSIs.[70][71] However, the application was withdrawn by the manufacturer in 2019.

Prostaglandin E1

The 2007 TASC II consensus document on the management of peripheral arterial disease (PAD) does not recommend prostaglandin E1 or any other prostanoids for the management of limb-threatening ischaemia.[62] One Cochrane review showed no effect of prostanoids on the incidence of total amputations (high-quality evidence).[72] However, in patients with advanced PAD unsuitable for any other form of intervention, prostanoids have been shown to relieve rest pain and ulcer healing, although with a higher incidence of adverse events (moderate-quality evidence).[72]

Stimulation of angiogenesis

This treatment involves the administration of angiogenic growth factors, as recombinant protein or naked DNA, to augment the collateral circulation and enhance blood flow to ischaemic tissues. Another approach is the autologous implantation of bone marrow mononuclear cells to stimulate angiogenesis, or multiple intramuscular injections of autologous granulocyte colony-stimulating factor.[73]

Use of this content is subject to our disclaimer