Saxena D, Kaul G, Dasgupta A, Chopra S
Division of Microbiology, CSIR-Central Drug Research Institute, Lucknow, India.
Drugs Today (Barc). 2020 Sep;56(9):583-598. doi: 10.1358/dot.2020.56.9.3168445.
Acute bacterial skin and skin structure infections (ABSSSIs) are one of the most common types of infections due to methicillin-resistant Staphylococcus aureus (MRSA). The standard of care for ABSSSI includes glycopeptides such as vancomycin, teicoplanin, oxazolidinones and fluoroquinolones, which are potent broad-spectrum antibacterial agents. Unfortunately, due to indiscriminate utilization, resistance to these agents is rising and identification of novel agents is an urgent unmet medical need. In this context, levonadifloxacin (WCK-771) is a novel, hydrate arginine salt of nadifloxacin with improved bactericidal activity against MRSA as well as fluoroquinolone-resistant S. aureus by targeting bacterial DNA supercoiling enzymes DNA gyrase and topoisomerase IV. Levonadifloxacin displays a broad-spectrum bactericidal activity against Gram-positive and Gram-negative bacteria, atypical bacteria, anaerobic bacteria and bioterror pathogens with a very low frequency of mutation. Levonadifloxacin also displays improved activity under low pH biofilm environments. The drug has successfully completed phase I, phase II and phase III clinical trials in India. The U.S. Food and Drug Administration (FDA) granted a Qualified Infectious Disease Product (QIDP) designation to levonadifloxacin for the treatment of MRSA infections in August 2014.
急性细菌性皮肤及皮肤结构感染(ABSSSIs)是耐甲氧西林金黄色葡萄球菌(MRSA)引起的最常见感染类型之一。ABSSSI的护理标准包括糖肽类药物,如万古霉素、替考拉宁、恶唑烷酮类和氟喹诺酮类,这些都是强效的广谱抗菌剂。不幸的是,由于滥用,对这些药物的耐药性正在上升,因此识别新型药物是一项迫切未满足的医疗需求。在这种背景下,左氧氟沙星(WCK-771)是一种新型的那氟沙星水合精氨酸盐,通过靶向细菌DNA超螺旋酶DNA回旋酶和拓扑异构酶IV,对MRSA以及耐氟喹诺酮金黄色葡萄球菌具有更强的杀菌活性。左氧氟沙星对革兰氏阳性菌、革兰氏阴性菌、非典型菌、厌氧菌和生物恐怖病原体具有广谱杀菌活性,且突变频率极低。左氧氟沙星在低pH生物膜环境下也表现出更强的活性。该药物已在印度成功完成了I期、II期和III期临床试验。2014年8月,美国食品药品监督管理局(FDA)授予左氧氟沙星合格传染病产品(QIDP)认定,用于治疗MRSA感染。