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Microbiological Data for Systemic Antibacterial Drug Products — Development, Analysis, and Presentation

FinalCenter for Drug Evaluation and Research02/07/2018
Quality Control ParametersQuality ControlPK/PD

Description

The purpose of this guidance is to assist sponsors in the development, analysis, and presentation of microbiology data during antibacterial drug development. Specifically, this guidance addresses the Food and Drug Administration’s (FDA’s) current thinking regarding the overall microbiology development program needed to support clinical development and approval of antibacterial drugs administered systemically as well as microbiology information collected after approval.

Key Topics

Terms and concepts identified from this document

Scope & Applicability

Product Classes

3
Systemic Antibacterial Drug

Subject of the guidance document regarding development and analysis

Systemic Antibacterial Drug Products

Guidance title regarding microbiological data development; Subject of the guidance document regarding microbiological data

Fixed-combination drug products

Products requiring demonstration of component contribution per regulations

Stakeholders

3
sponsor

responsible for justifying omission of studies

Sponsors

Assist sponsors in the nonclinical evaluation

Investigator

Responsible for qualifications, training, and trial conduct; Individual responsible for trial conduct and data governance at a site.; May delegate tasks but retains overall responsibility; Person responsible for the conduct of the clinical trial at a trial site; Responsible for trial conduct and participant safety; Responsible for trial conduct, data integrity, and investigational product management.; Individual responsible for trial conduct at a site and informing the institution.; maintaining

Regulatory Context

Regulatory Activities

9
Labeling supplement

Submission to update drug product labeling

Labeling

The primary regulatory activity addressed in the guidance

Pre-Biologics License Application Meeting

Sponsors should discuss the format of microbiology datasets with FDA

Pre-New Drug Application Meeting

Sponsors should discuss the format of microbiology datasets with FDA

IND

Investigational New Drug submissions

NDA

New Drug Application

BLA

Biologics License Application

Investigational New Drug Application

IND for treatment use; Regulatory submission required for clinical trials and expanded access.

New Drug Application

Rule does not apply to products marketed under an NDA

Document Types

6
Labeling

Cybersecurity information should be included in device labeling

Full Prescribing Information

content and format of DI information; The complete labeling document for a drug.; The complete labeling document for prescription drugs; The complete labeling document (FPI) containing detailed drug interaction sections.; Section of drug labeling

Electronic Database

Database for clinical trial subject level data

Study Reports of Spectrum of Activity

Reports including investigator name, location, and standardized methods

Electronic Common Technical Document

eCTD specifications for regulatory submissions

Annual report

Submission of long-term stability data

Attributes

8
Epidemiologic Cutoff

Estimate of the EC of the investigational drug against target bacteria

Susceptibility data

Susceptibility data that are accompanied by the appropriate QC data

Virulence markers

Biological markers characterizing the severity of a pathogen

Phenotypic resistance

Characteristic of bacteria to be presented in labeling

Genotype

Important baseline and prognostic variable for matching control groups.

Phenotype

Characterization of isolates relative to resistance

Mechanism of action

Proposed biological activity of the drug

Inoculum density

Factor influencing in vitro susceptibility test results

Technical Details

Substances

8
Metabolites

Tested if they occur as residues in food and have structural alerts

Systemic Antibacterial Drug Products

The class of products covered by this guidance

Haemophilus influenzae

beta-lactamase-positive Haemophilus influenzae

Staphylococcus aureus

bacteria that causes TSS

Pseudomonas aeruginosa

Microorganism found in contaminated inks that can cause serious infections

Enterobacteriaceae

Indicator organism for facility conditions

Antibacterial drug

Type of drug eligible for QIDP.

Beta-lactamases

Enzymes involved in resistance mechanisms

Testing Methods

10
Animal Models of Infection

Nonclinical studies used to evaluate antibacterial drugs

In vitro testing

used to evaluate drug potency and MIC

Disk Diffusion Methods

Correlation of MIC and disk diffusion methods

Antibacterial Susceptibility Test

Standardized methods used to determine the activity of the antibacterial drug

Microbial kill curves

Studies evaluating microbial killing

Regression analyses

Used to model drug concentrations

In Vitro Antimicrobial Susceptibility Test Methods

Methods used for generating susceptibility data

Error rate bounding method

Method comparing diffusion testing to dilution testing

Checkerboard titration

Method for characterization of antibacterial interaction

Antimicrobial Susceptibility Testing

Methodology used to determine MIC and MBC data

Processes

3
In Vitro Antimicrobial Susceptibility Test

Methods used during drug development to determine activity

Susceptibility Testing

Methods to determine the sensitivity of bacteria to antibacterial drugs

Resistance Studies

Studies conducted during early development to assess resistance

Clinical Concepts

6
Mechanism of Action

elucidation of drug pharmacology

Acute bacterial skin and skin structure infections

Example of a clinical indication for an antibacterial drug

Clinical Response

Overall clinical response such as cure or failure

Microbiological Eradication

Subject's status of microbiological eradication in clinical trials

Emergence of resistance

The development of resistance by bacteria to an antibacterial drug

Intracellular Antimicrobial Concentration Assessment

Assessment of drug ability to reach bacteria inside host cells

Identified Hazards

Hazards

3
Resistance

Phenotypic and/or genotypic characterization of isolates relative to resistance

Clinical infections

Infections caused by bacteria that the drug is intended to treat

Virulence

Characterization of isolates relative to virulence characteristics

Standards & References

External Standards

3
CLSI document M07-A10

Methods for Dilution Antimicrobial Susceptibility Tests

CLSI document M100-S27

Performance Standards for Antimicrobial Susceptibility Testing

Clinical and Laboratory Standards Institute

Organization developing standard methods for in vitro susceptibility testing.

Specifications

10
Susceptibility Test Interpretive Criteria

Synonymous with breakpoints used to interpret AST results.

Minimum Bactericidal Concentration

MBC results in study reports

MIC90

Minimal inhibitory concentrations for the pathogen of interest

Minimum Inhibitory Concentrations

MICs used to measure in vitro susceptibility of B. anthracis.

MIC

minimum inhibitory concentration used for PK/PD relationships

Zone diameter

Measurement used in diffusion susceptibility testing

Provisional AST interpretive criteria

Criteria based on limited information before phase 3 trials

AST interpretive criteria

Criteria used to interpret susceptibility results as susceptible, intermediate, or resistant; Database for final in vitro antibacterial susceptibility test interpretive criteria

Quality control parameters

Parameters used to monitor the performance of susceptibility tests

Minimum inhibitory concentration

target PK/pharmacodynamic (PD) parameters

Related CFR Sections (1)

Related MFDS Guidelines

Korean regulatory guidelines covering similar topics

See Also (1)

Microbiological Data for Systemic Antibacterial Drug Products — Development, Analysis, and Presentation | Guideline Explorer | BioRegHub