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Plazomicin structure.svg
Clinical data
Trade namesZemdri
Other namesACHN-490,
License data
Routes of
Intravenous infusion
Drug classAminoglycoside
Legal status
Legal status
CAS Number
PubChem CID
PubChem SID
PDB ligand
Chemical and physical data
Molar mass592.691 g·mol−1
3D model (JSmol)

Plazomicin, sold under the brand name Zemdri, is an aminoglycoside antibiotic used to treat complicated urinary tract infections.[1] As of 2019 it is only recommended in those in who alternatives are not an option.[1] It is given by injection into a vein.[1]

Common side effects include kidney problems, diarrhea, nausea, and blood pressure changes.[1] Other severe side effects include hearing loss, Clostridium difficile-associated diarrhea, anaphylaxis, and muscle weakness.[1] Use during pregnancy may harm the baby.[1] Plazomicin works by decreasing the ability of bacteria to make protein.[1]

Plazomicin was approved for medical use in the United States in 2018.[2] It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[3] The price of 10 days of treatment in the United States costs about US$6,600.[4]

Medical uses[edit]

Plazomicin is approved by the U.S. Food and Drug Administration (FDA) for adults with complicated urinary tract infections (cUTI), including pyelonephritis, caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Enterobacter cloacae, in patients who have limited or no alternative treatment options. Zemdri is an intravenous infusion, administered once daily.[5][6][7] The FDA declined approval for treating bloodstream infections due to lack of demonstrated effectiveness.[8]

Plazomicin has been reported to demonstrate in vitro synergistic activity when combined with daptomycin or ceftobiprole versus methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA) and against Pseudomonas aeruginosa when combined with cefepime, doripenem, imipenem or piperacillin/tazobactam.[9] It also demonstrates potent in vitro activity versus carbapenem-resistant Acinetobacter baumannii.[10] Plazomicin was found to be noninferior to meropenem.[11][12]


In 2012, the U.S. Food and Drug Administration (FDA) granted fast track designation for the development and regulatory review of plazomicin.[13] FDA approved plazomicin for adults with complicated UTIs and limited or no alternative treatment options in 2018.[14]

Society and culture[edit]


It is derived from sisomicin by appending a hydroxy-aminobutyric acid (HABA) substituent at position 1 and a hydroxyethyl substituent at position 6'.[15][9]


Plazomicin is the international nonproprietary name (INN).[16]


  1. ^ a b c d e f g "Plazomicin Sulfate Monograph for Professionals". American Society of Health-System Pharmacists. Retrieved 10 October 2019.
  2. ^ "Drugs@FDA: FDA Approved Drug Products". Food and Drug Administration (FDA). pp. New Drug Application (NDA): 210303. Retrieved 22 January 2019.
  3. ^ "World Health Organization model list of essential medicines: 21st list 2019". 2019. hdl:10665/325771. Cite journal requires |journal= (help)
  4. ^ "Zemdri Prices, Coupons & Patient Assistance Programs". Retrieved 10 October 2019.
  5. ^ "plazomicin (Rx)". Medscape. Retrieved 14 September 2019.
  6. ^ Brown T (3 May 2018). "FDA Panel Recommends Plazomicin for cUTI but Not BSI". Medscape. Retrieved 14 September 2019.
  7. ^ "BioCentury - FDA approves plazomicin for cUTI, but not blood infections". Retrieved 28 June 2018.
  8. ^ "Drugs@FDA: FDA Approved Drug Products". Food and Drug Administration (FDA). Retrieved 28 June 2018.
  9. ^ a b Zhanel GG, Lawson CD, Zelenitsky S, et al. (April 2012). "Comparison of the Next-Generation Aminoglycoside Plazomicin to Gentamicin, Tobramycin and Amikacin". Expert Rev Anti Infect Ther. 10 (4): 459–73. doi:10.1586/eri.12.25. PMID 22512755.
  10. ^ García-Salguero C, Rodríguez-Avial I, Picazo JJ, et al. (October 2015). "Can Plazomicin Alone or in Combination Be a Therapeutic Option against Carbapenem-Resistant Acinetobacter baumannii?" (PDF). Antimicrob Agents Chemother. 59 (10): 5959–66. doi:10.1128/AAC.00873-15. PMC 4576036. PMID 26169398. Retrieved 27 April 2016.
  11. ^ Clinical trial number NCT02486627 for "A Study of Plazomicin Compared With Meropenem for the Treatment of Complicated Urinary Tract Infection (cUTI) Including Acute Pyelonephritis (AP) (EPIC)" at
  12. ^ Wagenlehner FM, Cloutier DJ, Komirenko AS, et al. (21 February 2019). "Once-Daily Plazomicin for Complicated Urinary Tract Infections". N. Engl. J. Med. 380 (8): 729–740. doi:10.1056/nejmoa1801467. ISSN 0028-4793. PMID 30786187. Lay summaryCenter for Infectious Disease Research and Policy (CIDRAP) (21 February 2019).
  13. ^ "Achaogen Announces Plazomicin Granted QIDP Designation by FDA" (Press release). Achaogen, Inc. 8 January 2015. Retrieved 27 April 2016 – via GlobeNewswire.
  14. ^ "Plazomicin" (PDF). Retrieved 11 October 2019.
  15. ^ Aggen JB, Armstrong ES, Goldblum AA, et al. (November 2010). "Synthesis and Spectrum of the Neoglycoside ACHN-490" (PDF). Antimicrob Agents Chemother. 54 (11): 4636–4642. doi:10.1128/AAC.00572-10. PMC 2976124. PMID 20805391.
  16. ^ "International Nonproprietary Names for Pharmaceutical Substances (INN). Recommended INN: List 68". WHO Drug Information. World Health Organization (WHO). 26 (3): 314. September 2012. Retrieved 27 April 2016.

Further reading[edit]