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新型胃肠外广谱头孢菌素FK037的体内抗菌活性

In vivo antibacterial activity of FK037, a novel parenteral broad-spectrum cephalosporin.

作者信息

Mine Y, Watanabe Y, Sakamoto H, Hatano K, Wakai Y, Kamimura T, Tawara S, Matsumoto S, Matsumoto F, Kuwahara S

机构信息

Product Development Laboratories, Fujisawa Pharmaceutical Co., Ltd., Osaka, Japan.

出版信息

J Antibiot (Tokyo). 1993 Jan;46(1):88-98. doi: 10.7164/antibiotics.46.88.

Abstract

FK037 has potent therapeutic activity against lethal systemic infections and experimental local infections due to a wide variety of Gram-positive and Gram-negative bacteria such as staphylococci, Streptococcus pneumoniae, Enterobacteriaceae and Pseudomonas aeruginosa in mice. In murine systemic infections, FK037 was the most effective of the cephalosporins and imipenem tested against highly methicillin-resistant Staphylococcus aureus (H-MRSA). It was more effective than ceftazidime against selected strains of S. aureus and Enterobacteriaceae, except Serratia marcescens and P. aeruginosa against which FK037 was as effective as ceftazidime and was as effective as cefpirome against all organisms tested, except MRSA and P. aeruginosa against which FK037 was more effective than cefpirome. These results correlated well with its in vitro activity. In murine local infections, with few exceptions, FK037 was more effective than ceftazidime and cefpirome against Klebsiella pneumonia in ED50 values and against methicillin-sensitive S. aureus (MSSA) subcutaneous abscess, pyelonephritis with Staphylococcus epidermidis, E. coli and P. aeruginosa, intrauterine infections with S. aureus and E. coli in reducing the number of viable bacteria in the abscess, kidneys and uterus. It is noteworthy that the therapeutic effects of FK037 were more potent than had been anticipated from its in vitro activity against local infections with staphylococci and P. aeruginosa when compared with ceftazidime or cefpirome. In addition, the therapeutic effects of FK037 were equipotent or superior to those of cefpirome and ceftazidime against pneumonia due to MSSA, K. pneumoniae and P. aeruginosa in reducing the number of viable bacteria in the lungs in mice using an in vivo pharmacokinetic model simulating human plasma concentrations after drip infusion of usual clinical doses (0.25 to 1.0 g for MSSA, 0.063 to 0.125 g for K. pneumoniae and 1.0 to 2.0 g for P. aeruginosa). FK037 induced an in vivo post-antibiotic effect (PAE) of 3.4 hours against a thigh infection with MSSA in neutropenic mice. These results strongly suggest that it has potential for clinical use against various infections due to bacteria which include staphylococci and P. aeruginosa.

摘要

FK037对小鼠因多种革兰氏阳性和革兰氏阴性细菌(如葡萄球菌、肺炎链球菌、肠杆菌科细菌和铜绿假单胞菌)引起的致死性全身感染和实验性局部感染具有强大的治疗活性。在小鼠全身感染中,FK037是所测试的头孢菌素和亚胺培南中对高耐甲氧西林金黄色葡萄球菌(H-MRSA)最有效的药物。在针对金黄色葡萄球菌和肠杆菌科的某些菌株时,FK037比头孢他啶更有效,但对粘质沙雷氏菌和铜绿假单胞菌无效,在这两种菌上FK037与头孢他啶效果相当,在针对所有测试菌株时,FK037与头孢匹罗效果相当,但对MRSA和铜绿假单胞菌无效,在这两种菌上FK037比头孢匹罗更有效。这些结果与其体外活性密切相关。在小鼠局部感染中,除少数例外情况,在半数有效剂量(ED50)值方面,FK037对肺炎克雷伯菌比头孢他啶和头孢匹罗更有效,在针对甲氧西林敏感金黄色葡萄球菌(MSSA)皮下脓肿、表皮葡萄球菌、大肠杆菌和铜绿假单胞菌引起的肾盂肾炎、金黄色葡萄球菌和大肠杆菌引起的子宫内感染时,FK037在减少脓肿、肾脏和子宫内活菌数量方面更有效。值得注意的是,与头孢他啶或头孢匹罗相比,FK037对葡萄球菌和铜绿假单胞菌局部感染的治疗效果比根据其体外活性预期的更强。此外,在使用模拟常规临床剂量(MSSA为0.25至1.0 g、肺炎克雷伯菌为0.063至0.125 g、铜绿假单胞菌为1.0至2.0 g)静脉滴注后人血浆浓度的体内药代动力学模型中,FK037在减少小鼠肺部因MSSA、肺炎克雷伯菌和铜绿假单胞菌引起的肺炎活菌数量方面,其治疗效果与头孢匹罗和头孢他啶相当或更优。FK037在中性粒细胞减少小鼠中对MSSA大腿感染诱导了3.4小时的体内抗生素后效应(PAE)。这些结果强烈表明,它在临床上有治疗包括葡萄球菌和铜绿假单胞菌在内的各种细菌感染的潜力。

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