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奥马环素的体外和体内抗菌活性,一种新型的氨甲基环素。

In vitro and in vivo antibacterial activities of omadacycline, a novel aminomethylcycline.

机构信息

Paratek Pharmaceuticals, Inc., Boston, Massachusetts, USA.

出版信息

Antimicrob Agents Chemother. 2014;58(2):1127-35. doi: 10.1128/AAC.01242-13. Epub 2013 Dec 2.

Abstract

Omadacycline is the first intravenous and oral 9-aminomethylcycline in clinical development for use against multiple infectious diseases including acute bacterial skin and skin structure infections (ABSSSI), community-acquired bacterial pneumonia (CABP), and urinary tract infections (UTI). The comparative in vitro activity of omadacycline was determined against a broad panel of Gram-positive clinical isolates, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Lancefield groups A and B beta-hemolytic streptococci, penicillin-resistant Streptococcus pneumoniae (PRSP), and Haemophilus influenzae (H. influenzae). The omadacycline MIC90s for MRSA, VRE, and beta-hemolytic streptococci were 1.0 μg/ml, 0.25 μg/ml, and 0.5 μg/ml, respectively, and the omadacycline MIC90s for PRSP and H. influenzae were 0.25 μg/ml and 2.0 μg/ml, respectively. Omadacycline was active against organisms demonstrating the two major mechanisms of resistance, ribosomal protection and active tetracycline efflux. In vivo efficacy of omadacycline was demonstrated using an intraperitoneal infection model in mice. A single intravenous dose of omadacycline exhibited efficacy against Streptococcus pneumoniae, Escherichia coli, and Staphylococcus aureus, including tet(M) and tet(K) efflux-containing strains and MRSA strains. The 50% effective doses (ED50s) for Streptococcus pneumoniae obtained ranged from 0.45 mg/kg to 3.39 mg/kg, the ED50s for Staphylococcus aureus obtained ranged from 0.30 mg/kg to 1.74 mg/kg, and the ED50 for Escherichia coli was 2.02 mg/kg. These results demonstrate potent in vivo efficacy including activity against strains containing common resistance determinants. Omadacycline demonstrated in vitro activity against a broad range of Gram-positive and select Gram-negative pathogens, including resistance determinant-containing strains, and this activity translated to potent efficacy in vivo.

摘要

奥马环素是临床开发的首个用于治疗多种传染病的静脉注射和口服 9- 氨基甲基环素,包括急性细菌性皮肤和皮肤结构感染(ABSSSI)、社区获得性细菌性肺炎(CABP)和尿路感染(UTI)。奥马环素的比较体外活性针对广泛的革兰氏阳性临床分离株进行了测定,包括耐甲氧西林金黄色葡萄球菌(MRSA)、万古霉素耐药肠球菌(VRE)、Lancefield 组 A 和 B 溶血性链球菌、青霉素耐药肺炎链球菌(PRSP)和流感嗜血杆菌(H. influenzae)。MRSA、VRE 和溶血性链球菌的奥马环素 MIC90 分别为 1.0μg/ml、0.25μg/ml 和 0.5μg/ml,PRSP 和 H. influenzae 的奥马环素 MIC90 分别为 0.25μg/ml 和 2.0μg/ml。奥马环素对表现出两种主要耐药机制(核糖体保护和主动四环素外排)的生物体具有活性。奥马环素的体内疗效通过小鼠腹腔感染模型得到证实。单次静脉注射奥马环素对肺炎链球菌、大肠杆菌和金黄色葡萄球菌具有疗效,包括携带 tet(M) 和 tet(K) 外排基因的菌株和 MRSA 菌株。获得的肺炎链球菌的 50%有效剂量(ED50)范围为 0.45mg/kg 至 3.39mg/kg,金黄色葡萄球菌的 ED50 范围为 0.30mg/kg 至 1.74mg/kg,大肠杆菌的 ED50 为 2.02mg/kg。这些结果表明,奥马环素具有强大的体内疗效,包括对含有常见耐药决定因素的菌株的活性。奥马环素对广泛的革兰氏阳性和选定的革兰氏阴性病原体具有体外活性,包括含有耐药决定因素的菌株,并且这种活性转化为强大的体内疗效。

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