Weiss W J, Mikels S M, Petersen P J, Jacobus N V, Bitha P, Lin Y I, Testa R T
Infectious Disease Research Section, Antimicrobial Chemotherapy, Wyeth-Ayerst Research, Pearl River, New York 10965, USA.
Antimicrob Agents Chemother. 1999 Mar;43(3):460-4. doi: 10.1128/AAC.43.3.460.
A series of novel aminomethyl tetrahydrofuranyl (THF)-1 beta-methylcarbapenems which have excellent broad-spectrum antibacterial activities exhibit modest efficacies against acute lethal infections (3.8 mg/kg of body weight against Escherichia coli and 0.9 mg/kg against Staphylococcus aureus) in mice when they are administered orally. In an effort to improve the efficacies of orally administered drugs through enhanced absorption by making use of a peptide-mediated transport system, several different amino acids were added at the aminomethyl THF side chains of the carbapenem molecules. The resulting peptidic prodrugs with L-amino acids demonstrated improved efficacy after oral administration, while the D forms were less active than the parent molecules. After oral administration increased (3 to 10 times) efficacy was exhibited with the alanine-, valine-, isoleucine-, and phenylalanine-substituted prodrugs against acute lethal infections in mice. Median effective doses (ED50s) of < 1 mg/kg against infections caused by S. aureus, E. coli, Enterobacter cloacae, or penicillin-susceptible Streptococcus pneumoniae were obtained after the administration of single oral doses. Several of the peptidic prodrugs were efficacious against Morganella morganii, Serratia marcescens, penicillin-resistant S. pneumoniae, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, and E. coli infections, with ED50s of 1 to 14 mg/kg by oral administration compared with ED50s of 14 to > 32 mg/kg for the parent molecules. In general, the parent molecules demonstrated greater efficacy than the prodrugs against these same infections when the drugs were administered by the subcutaneous route. The parent molecule was detectable in the sera of mice after oral administration of the peptidic prodrugs.
一系列具有出色广谱抗菌活性的新型氨甲基四氢呋喃基(THF)-1β-甲基碳青霉烯类化合物,口服给药时对小鼠急性致死性感染(对大肠杆菌为3.8毫克/千克体重,对金黄色葡萄球菌为0.9毫克/千克体重)显示出适度疗效。为了通过利用肽介导的转运系统增强吸收来提高口服药物的疗效,在碳青霉烯分子的氨甲基THF侧链上添加了几种不同的氨基酸。所得的含L-氨基酸的肽类前药口服给药后疗效提高,而D型的活性低于母体分子。口服后,丙氨酸、缬氨酸、异亮氨酸和苯丙氨酸取代的前药对小鼠急性致死性感染的疗效提高(3至10倍)。单次口服给药后,针对金黄色葡萄球菌、大肠杆菌、阴沟肠杆菌或青霉素敏感的肺炎链球菌引起的感染,半数有效剂量(ED50)<1毫克/千克。几种肽类前药对摩根氏摩根菌、粘质沙雷氏菌、耐青霉素肺炎链球菌、产超广谱β-内酰胺酶的肺炎克雷伯菌和大肠杆菌感染有效,口服给药的ED50为1至14毫克/千克,而母体分子的ED50为14至>32毫克/千克。一般来说,当通过皮下途径给药时,母体分子对这些相同感染的疗效比前药更高。口服肽类前药后,在小鼠血清中可检测到母体分子。