Methods of Preparing Substituted Tetracyclines with Transition Metal

Total Page:16

File Type:pdf, Size:1020Kb

Methods of Preparing Substituted Tetracyclines with Transition Metal (19) & (11) EP 1 666 454 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: C07C 237/26 (2006.01) C07C 231/12 (2006.01) 07.09.2011 Bulletin 2011/36 A61K 31/65 (2006.01) A61P 31/04 (2006.01) (21) Application number: 06005085.3 (22) Date of filing: 13.09.2000 (54) Methods of preparing substituted tetracyclines with transition metal-based chemistries Verfahren zur Herstellung von substituierten Tetracyclinen mit Hilfe von auf Übergangsmetalle basierten Chemikalien Techniques de preparation de tetracyclines substituees avec des solutions chimiques a base de metal de transition (84) Designated Contracting States: (74) Representative: Nash, David Allan AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU Haseltine Lake LLP MC NL PT SE Redcliff Quay 120 Redcliff Street (30) Priority: 14.09.1999 US 154701 P Bristol 12.09.2000 US 232091 P BS1 6HU (GB) (43) Date of publication of application: (56) References cited: 07.06.2006 Bulletin 2006/23 • AHMAD N ET AL: "Polynuclear Complexes of Bivalent Metal Ions with Antibiotic Tetracycline" (62) Document number(s) of the earlier application(s) in JOURNAL OF THE CHEMICAL SOCIETY OF accordance with Art. 76 EPC: PAKISTAN, CHEMICAL SOCIETY OF PAKISTAN, 00961860.4 / 1 240 133 KARACHI, PK, vol. 12, no. 2, 1990, pages 168-173, XP000943839 ISSN: 0253-5106 (73) Proprietor: TRUSTEES OF TUFTS COLLEGE • KOZA D J: "SYNTHESIS OF 7-SUBSTITUTED Medford MA 02155 (US) TETRACYCLINE DERIVATIVES" ORGANIC LETTERS, ACS, WASHINGTON, DC, US, vol. 2, (72) Inventors: no. 6, March 2000 (2000-03), pages 815-817, • Nelson, Mark L. XP000943852 ISSN: 1523-7060 Wellesley, MA 02481 (US) • Rennie, Glen Remarks: South Weymouth, MA 02190 (US) Thefile contains technical information submitted after • Koza, Darrell the application was filed and not included in this Westerly, RI 02891 (US) specification Note: Within nine months of the publication of the mention of the grant of the European patent in the European Patent Bulletin, any person may give notice to the European Patent Office of opposition to that patent, in accordance with the Implementing Regulations. Notice of opposition shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention). EP 1 666 454 B1 Printed by Jouve, 75001 PARIS (FR) EP 1 666 454 B1 Description BACKGROUND OF THE INVENTION 5 [0001] The development of the tetracycline antibiotics was the direct result of a systematic screening of soil specimens collected from many parts.of the world for evidence of microorganisms capable of producing bacteriocidal and/or bac- teriostatic compositions. The first of these novel compounds was introduced in 1948 under the name chlortetracycline. Two years later oxytetracycline became available. The detailed elucidation of the chemical structure of these agents confirmed their similarity and furnished the analytical basis for the production of a third member of this group in 1952, 10 tetracycline. By 1957, a new family of tetracycline compositions characterized chemically by the absence of the position 6 ring-attached OH group present in the earlier compositions was prepared and became publicly available in 1967; and minocycline was in use by 1972. Individual tetracycline- type agents are structurally compared within Table I below, with reference made the following structural formula: 15 20 25 Table I Congener Substituent(s) At Carbon Position Nos. 30 Chlortetracycline -Cl (7) Oxytetracycline -OH,-H (5) Demeclocycline -OH,-H;-Cl (6;7) Methacycline -OH,-H;=CH2 (5;6) Doxycycline -OH,-H;-CH ,-H (5;6) 35 3 Minocycline -H,-H;-N(CH3)2 (6;7) [0002] More recent research efforts have focused on developing new tetracycline antibiotic compositions effective under varying therapeutic conditions and routes of administration; and for developing new tetracycline analogues which 40 might prove to be equal or more effective then the originally introduced tetracycline families beginning in 1948. Repre- sentative of such developments include U.S. Patent Nos. 3,957,980; 3,674,859; 2,980,584; 2,990,331; 3,062,717; 3,557,280; 4,018,889; 4,024,272; 4,126,680; 3,454,697; and 3,165,531. It will be understood that these issued patents are merely representative of the range of diversity of investigations seeking tetracycline and tetracycline analogue compositions which are pharmacologically active. 45 [0003] Historically, soon after their initial development and introduction, the tetracyclines, regardless of specific for- mulation or chemical structure, were found to be highly effective pharmacologically against rickettsiae; a number of gram-positive and gram-negative bacteria; and the agents responsible for lymphogranuloma venereum, inclusion con- junctivitis, and psittacosis. Hence, tetracyclines became known as "broad spectrum" antibiotics. With the subsequent establishment of their in vitro antimicrobial activity, effectiveness in experimental infections, and pharmacological prop- 50 erties, the tetracyclines as a class rapidly became widely used for therapeutic purposes. However, this widespread use of tetracyclines for both major and minor illnesses and diseases led directly to the emergence of resistance to these antibiotics even among highly susceptible bacterial species both commensal and pathogenic - as for example pneumo- cocci and Salmonella. The rise of tetracycline-resistant organisms has resulted in a general decline in use of tetracyclines and tetracycline analogue compositions as antibiotics of choice. 55 2 EP 1 666 454 B1 SUMMARY OF THE INVENTON [0004] The present invention is directed to a minocycline-based compound selected from a compound having the following minocycline core structure: 5 10 15 in which R is selected from methyl, ethyl or propyl and which is substituted or derivatized at the 9- position by a substituent selected from alkynyl, cycloalkyl, aryl, alkylcarbonyl, arylcarbonyl, aryloxycarbonyl, hydroxy, cyano, alkoxy, aryloxy, 20 carboxyl, carboxamido, carboxy ester, and carbocyclic or heterocyclic groups; and 9-[3’-(E)-butylpropenoate] minocycline. [0005] In an embodiment, R is methyl. [0006] In another embodiment, the compound is 9-phenyl minocycline. [0007] Also described are novel chemistries which allow for the production of substituted tetracycline compounds 25 including substituted tetracycline compounds which exhibit significant antibacterial activity. The methods disclosed herein utilize reactive tetracycline-based precursor compounds, reactive organic substituent precursors and transition metals or transition metal catalysts under conditions such that a tetracycline compound substituted with the desired organic substituent is formed. A substituted tetracycline compound may be prepared by combining a reactive tetracycline- based precursor compound such as an arene tetracycline diazonium salt, and a reactive organic substituent precursor, e.g., 30 alkenes, substituted alkenes, vinyl monomers, aromatics and heteroaromatics, in the presence of a transition metal catalyst, such as palladium chloride, under conditions such that a tetracycline compound substituted with the organic substituentis formed. A substituted tetracycline compound may be prepared by contacting a reactive tetracycline chemical complex comprising a reactive tetracycline- based precursor compound and a transition metal or transition metal catalyst forming a reactive chemical intermediate with a reactive organic substituent precursor under conditions such that a 35 tetracycline compound substituted with the organic substituent is formed. [0008] Described herein are reactive tetracycline chemical complexes comprising a reactive tetracycline-based pre- cursor compound and a transition metal catalyst forming a chemical intermediate, which can advantageously be used in the methods described herein. [0009] Also described are substituted tetracycline analogs, wherein the substituent (denoted herein as "Z") at the 40 desired position, e.g., 7, 9, 13, is connected with a -C-C- linkage, and wherein the substituent comprises an aromatic or heteroaromatic moiety. The substituent may also comprise a -C=C- bond adjacent to the -C-C- linkage, e.g., 45 50 wherein R2 and R 3 are each independently hydrogen, alkyl, alkenyl, alkynyl, cycloalkyl, aryl, alkylcarbonyl, arylcarbonyl, alkoxycarbonyl, aryloxycarbonyl, amino, hydroxy, cyano, alkoxy, aryloxy, carboxyl, alkoxycarbonyl, aryloxycarbonyl; or R2 and R3, taken together, form a substituted or unsubstituted carbocyclic or heterocyclic ring having 5 to 15 atoms in the ring. 55 [0010] The methods and chemical intermediates disclosed herein allow for novel substituted tetracycline-type com- pounds and therapeutic methods and pharmaceutical compositions that comprise such compounds. [0011] The method includes providing Z substituents, above, on the basic tetracycline ring structure through a process involving forming a reactive intermediate (comprising a tetracycline arenediazonium salt in a preferred embodiment) at 3 EP 1 666 454 B1 the desired position and adding a reactive compound, e.g., a π-bond containing compound in the presence of a transition metal catalyst to that position. The reactive intermediate may be formed in situ. In an advantageous embodiment such substituents are provided on the D ring of the basic tetracycline ring structure, e.g., positions 7 and/or 9. In another advantageous embodiment, such substitutions may be made at position 13. Such synthetic schemes are heretofore 5 new in this art and advantageously allow for direct substitution
Recommended publications
  • Evaluating Risks from Antibacterial Medication Therapy
    University of Pennsylvania ScholarlyCommons Publicly Accessible Penn Dissertations Summer 2010 Evaluating Risks from Antibacterial Medication Therapy Sharon B. Meropol University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations Part of the Therapeutics Commons Recommended Citation Meropol, Sharon B., "Evaluating Risks from Antibacterial Medication Therapy" (2010). Publicly Accessible Penn Dissertations. 424. https://repository.upenn.edu/edissertations/424 A version of Chapter 3 has been published: Meropol SB, Chen Z, Metlay JP. Reduced antibiotic use for acute respiratory infections in adults and children. Br J Gen Prac. Oct. 2009; 59(567)3321-328.DOI:10.3399/ bjgp09X472610. E321-328 PMID: 19843412 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations/424 For more information, please contact [email protected]. Evaluating Risks from Antibacterial Medication Therapy Abstract ABSTRACT EVALUATING RISKS FROM ANTIBACTERIAL MEDICATION THERAPY USING AN OBSERVATIONAL PRIMARY CARE DATABASE Sharon B. Meropol Joshua P. Metlay Virtually everyone in the U.S. is exposed to antibacterial drugs at some point in their lives. It is important to understand the benefits and risks elatedr to these medications with nearly universal public exposure. Most information on antibacterial drug-associated adverse events comes from spontaneous reports. Without an unexposed control group, it is impossible to know the real risks for treated vs. untreated patients. We used an electronic medical record database to select a cohort of office visits for non-bacterial acuteespir r atory tract infections (excluding patients with pneumonia, sinusitis, or acute exacerbations of chronic bronchitis), and compared outcomes of antibacterial drug-exposed vs.
    [Show full text]
  • Pharmaceuticals As Environmental Contaminants
    PharmaceuticalsPharmaceuticals asas EnvironmentalEnvironmental Contaminants:Contaminants: anan OverviewOverview ofof thethe ScienceScience Christian G. Daughton, Ph.D. Chief, Environmental Chemistry Branch Environmental Sciences Division National Exposure Research Laboratory Office of Research and Development Environmental Protection Agency Las Vegas, Nevada 89119 [email protected] Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada Why and how do drugs contaminate the environment? What might it all mean? How do we prevent it? Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada This talk presents only a cursory overview of some of the many science issues surrounding the topic of pharmaceuticals as environmental contaminants Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada A Clarification We sometimes loosely (but incorrectly) refer to drugs, medicines, medications, or pharmaceuticals as being the substances that contaminant the environment. The actual environmental contaminants, however, are the active pharmaceutical ingredients – APIs. These terms are all often used interchangeably Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada Office of Research and Development Available: http://www.epa.gov/nerlesd1/chemistry/pharma/image/drawing.pdfNational
    [Show full text]
  • Antibiotics and Antibiotic Resistance
    This is a free sample of content from Antibiotics and Antibiotic Resistance. Click here for more information on how to buy the book. Index A Antifolates. See also specific drugs AAC(60)-Ib-cr, 185 novel compounds, 378–379 ACHN-975 overview, 373–374 clinical studies, 163–164 resistance mechanisms medicinal chemistry, 166 sulfamethoxazole, 378 structure, 162 trimethoprim, 374–378 AcrAB-TolC, 180 Apramycin, structure, 230 AcrD, 236 Arbekacin, 237–238 AdeRS, 257 Avibactam, structure, 38 AFN-1252 Azithromycin mechanism of action, 148, 153 resistance, 291, 295 resistance, 153 structure, 272 structure, 149 Aztreonam, structure, 36 AIM-1, 74 Amicoumacin A, 222 Amikacin B indications, 240 BaeSR, 257 structure, 230 BAL30072, 36 synthesis, 4 BB-78495, 162 Aminoglycosides. See also specific drugs BC-3205, 341, 344 historical perspective, 229–230 BC-7013, 341, 344 indications, 239–241 b-Lactamase. See also specific enzymes mechanism of action, 232 classification novel drugs, 237 class A, 67–71 pharmacodynamics, 238–239 class B, 69–74 pharmacokinetics, 238–239 class C, 69, 74 resistance mechanisms class D, 70, 74–77 aminoglycoside-modifying enzymes evolution of antibiotic resistance, 4 acetyltransferases, 233–235 historical perspective, 67 nucleotidyltransferases, 235 inhibitors phosphotransferases, 235 overview, 37–39 efflux-mediated resistance, 236 structures, 38 molecular epidemiology, 236–237 nomenclature, 67 overview, 17, 233 b-Lactams. See also specific classes and antibiotics ribosomal RNA modifications, 235–236 Enterococcus faecium–resistancemechanisms,
    [Show full text]
  • BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available
    BMJ Open: first published as 10.1136/bmjopen-2018-027935 on 5 May 2019. Downloaded from BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] http://bmjopen.bmj.com/ on September 26, 2021 by guest. Protected copyright. BMJ Open BMJ Open: first published as 10.1136/bmjopen-2018-027935 on 5 May 2019. Downloaded from Treatment of stable chronic obstructive pulmonary disease: a protocol for a systematic review and evidence map Journal: BMJ Open ManuscriptFor ID peerbmjopen-2018-027935 review only Article Type: Protocol Date Submitted by the 15-Nov-2018 Author: Complete List of Authors: Dobler, Claudia; Mayo Clinic, Evidence-Based Practice Center, Robert D.
    [Show full text]
  • Anti-Infective Drug Poster
    Anti-Infective Drugs Created by the Njardarson Group (The University of Arizona): Edon Vitaku, Elizabeth A. Ilardi, Daniel J. Mack, Monica A. Fallon, Erik B. Gerlach, Miyant’e Y. Newton, Angela N. Yazzie, Jón T. Njarðarson Streptozol Spectam Novocain Sulfadiazine M&B Streptomycin Chloromycetin Terramycin Tetracyn Seromycin Tubizid Illosone Furadantin Ethina Vancocin Polymyxin E Viderabin Declomycin Sulfamethizole Blephamide S.O.P. ( Sulfanilamide ) ( Spectinomycin ) ( Procaine ) ( Sulfadiazine ) ( Sulfapyridine ) ( Streptomycin ) ( Chloramphenicol ) ( Oxytetracycline ) ( Tetracycline ) ( Cycloserine ) ( Isoniazid ) ( Erythromycin ) ( Nitrofurantoin ) ( Ethionamide ) ( Vancomycin ) ( Colistin ) ( Vidarabine ) ( Demeclocycline ) ( Sulfamethizole ) ( Prednisolone Acetate & Sulfacetamide ) ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIMYCOBACTERIAL ANTIMYCOBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIMYCOBACTERIAL ANTIBACTERIAL ANTIBACTERIAL ANTIVIRAL ANTIBACTERIAL ANTIBACTERIAL ANTIBACTERIAL Approved 1937 Approved 1937 Approved 1939 Approved 1941 Approved 1942 Approved 1946 Approved 1949 Approved 1950 Approved 1950s Approved 1950s Approved 1952 Approved 1953 Approved 1953 Approved 1956 Approved 1958 Approved 1959 Approved 1960 Approved 1960 Approved 1960s Approved 1961 Coly-Mycin S Caprocin Poly-Pred Aureocarmyl Stoxil Flagyl NegGram Neomycin Flumadine Omnipen Neosporin G.U. Clomocycline Versapen-K Fungizone Vibramycin Myambutol Pathocil Cleocin Gentak Floxapen
    [Show full text]
  • Summary Report on Antimicrobials Dispensed in Public Hospitals
    Summary Report on Antimicrobials Dispensed in Public Hospitals Year 2014 - 2016 Infection Control Branch Centre for Health Protection Department of Health October 2019 (Version as at 08 October 2019) Summary Report on Antimicrobial Dispensed CONTENTS in Public Hospitals (2014 - 2016) Contents Executive Summary i 1 Introduction 1 2 Background 1 2.1 Healthcare system of Hong Kong ......................... 2 3 Data Sources and Methodology 2 3.1 Data sources .................................... 2 3.2 Methodology ................................... 3 3.3 Antimicrobial names ............................... 4 4 Results 5 4.1 Overall annual dispensed quantities and percentage changes in all HA services . 5 4.1.1 Five most dispensed antimicrobial groups in all HA services . 5 4.1.2 Ten most dispensed antimicrobials in all HA services . 6 4.2 Overall annual dispensed quantities and percentage changes in HA non-inpatient service ....................................... 8 4.2.1 Five most dispensed antimicrobial groups in HA non-inpatient service . 10 4.2.2 Ten most dispensed antimicrobials in HA non-inpatient service . 10 4.2.3 Antimicrobial dispensed in HA non-inpatient service, stratified by service type ................................ 11 4.3 Overall annual dispensed quantities and percentage changes in HA inpatient service ....................................... 12 4.3.1 Five most dispensed antimicrobial groups in HA inpatient service . 13 4.3.2 Ten most dispensed antimicrobials in HA inpatient service . 14 4.3.3 Ten most dispensed antimicrobials in HA inpatient service, stratified by specialty ................................. 15 4.4 Overall annual dispensed quantities and percentage change of locally-important broad-spectrum antimicrobials in all HA services . 16 4.4.1 Locally-important broad-spectrum antimicrobial dispensed in HA inpatient service, stratified by specialty .
    [Show full text]
  • Resolution of Antibiotic Mixtures in Serum Samples by High-Voltage Electrophoresis
    J Clin Pathol: first published as 10.1136/jcp.28.6.435 on 1 June 1975. Downloaded from J. clin. Path., 1975, 28, 435-442 Resolution of antibiotic mixtures in serum samples by high-voltage electrophoresis D. S. REEVES AND H. A. HOLT From the Department of Medical Microbiology, Division ofPathology, Southmead Hospital, Bristol BSJO SNB SYNOPSIS The use of high-voltage electrophoresis and bioautography for the separation mixtures of antibiotics received in clinical serum samples is described. The electrophoretic characteristics of 39 antibiotics are given as is the accuracy of the method for quantitating three antibiotics. In screening 189 consecutive serum samples submitted for routine antibiotic assay, undisclosed anti- biotics were revealed by the technique in 35. The treatment of infection by administering more Methods than one antibiotic simultaneously to patients in hospital is common practice. Increasingly labora- MATERIALS tories are being asked to assay sera from such The sources of the antibiotics used are shown in patients, and although it is frequently possible to table I. They were prepared for electrophoresis as measure at least one element in a mixture by the use solutions in distilled water or pooled human serum. of a selectively resistant organism or by inactivating Samples from patients examined for their anti- a component, such procedures are not always biotic content were those which had been received available. A further problem is that, in our ex- for assay, mostly of gentamicin, in controlling http://jcp.bmj.com/ perience, sera for assay sometimes contain anti- therapy. They were stored at -20°C for examination biotics ofwhich the laboratoryis not made aware and in batches.
    [Show full text]
  • Using Saccharomyces Cerevisiae for the Biosynthesis of Tetracycline Antibiotics
    Using Saccharomyces cerevisiae for the Biosynthesis of Tetracycline Antibiotics Ehud Herbst Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Graduate School of Arts and Sciences COLUMBIA UNIVERSITY 2019 © 2019 Ehud Herbst All rights reserved ABSTRACT Using Saccharomyces cerevisiae for the biosynthesis of tetracycline antibiotics Ehud Herbst Developing treatments for antibiotic resistant bacterial infections is among the most urgent public health challenges worldwide. Tetracyclines are one of the most important classes of antibiotics, but like other antibiotics classes, have fallen prey to antibiotic resistance. Key small changes in the tetracycline structure can lead to major and distinct pharmaceutically essential improvements. Thus, the development of new synthetic capabilities has repeatedly been the enabling tool for powerful new tetracyclines that combatted tetracycline-resistance. Traditionally, tetracycline antibiotics were accessed through bacterial natural products or semisynthetic analogs derived from these products or their intermediates. More recently, total synthesis provided an additional route as well. Importantly however, key promising antibiotic candidates remained inaccessible through existing synthetic approaches. Heterologous biosynthesis is tackling the production of medicinally important and structurally intriguing natural products and their unnatural analogs in tractable hosts such as Saccharomyces cerevisiae. Recently, the heterologous biosynthesis of several tetracyclines was achieved in Streptomyces lividans through the expression of their respective biosynthetic pathways. In addition, the heterologous biosynthesis of fungal anhydrotetracyclines was shown in S. cerevisiae. This dissertation describes the use of Saccharomyces cerevisiae towards the biosynthesis of target tetracyclines that have promising prospects as antibiotics based on the established structure- activity relationship of tetracyclines but have been previously synthetically inaccessible.
    [Show full text]
  • Stembook 2018.Pdf
    The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.
    [Show full text]
  • Antibiotics Act
    MINISTRY OF LEGALLAWS AFFAIRS OF TRINIDAD AND TOBAGO www.legalaffairs.gov.tt ANTIBIOTICS ACT CHAPTER 30:02 Act 18 of 1948 Amended by 190/1950 46/1964 178/1951 55/1964 219/1951 9/1965 123/1952 34/1965 59/1954 47/1965 71/1954 113/1968 147/1954 4 of 1988 76/1955 55/2003 128/1955 12/2005 173/1955 174/1956 213/2005 17/1957 154/2008 48/1957 188/2008 106/1958 88/2009 13/1960 147/2009 20 of 1960 26/2011 31/1961 40/2011 Current Authorised Pages Pages Authorised (inclusive) by L.R.O. 1–2 .. 3–8 .. 9–12 .. 13–16 .. 17–30 .. 31–38 .. UNOFFICIAL VERSION L.R.O. UPDATED TO DECEMBER 31ST 2013 MINISTRY OF LEGAL AFFAIRS LAWS OF TRINIDAD AND TOBAGOwww.legalaffairs.gov.tt 2 Chap. 30:02 Antibiotics Index of Subsidiary Legislation Page Importation of Antibiotics Preparations Order … … … … 12 Approved Pharmaceutical Firms Order … … … … 32 Antibiotics (Conditions for Use) Order (LN 29/1989) … … … 38 Note on the above Orders The amendments to the above Orders are long and frequent, and in view of their very limited use by the general public they will not be updated annually (following the policy adopted with respect to the Approval of New Drugs Notification under the Food and Drugs Act— See page 2 of Ch. 30:01). For amendments to these Orders—See the Current Edition of the Consolidated Index of Acts and Subsidiary Legislation. Note on Adaptation Under paragraph 6 of the Second Schedule to the Law Revision Act (Ch. 3:03) the Commission amended certain references to public officers in this Chapter.
    [Show full text]
  • Common Study Protocol for Observational Database Studies WP5 – Analytic Database Studies
    Arrhythmogenic potential of drugs FP7-HEALTH-241679 http://www.aritmo-project.org/ Common Study Protocol for Observational Database Studies WP5 – Analytic Database Studies V 1.3 Draft Lead beneficiary: EMC Date: 03/01/2010 Nature: Report Dissemination level: D5.2 Report on Common Study Protocol for Observational Database Studies WP5: Conduct of Additional Observational Security: Studies. Author(s): Gianluca Trifiro’ (EMC), Giampiero Version: v1.1– 2/85 Mazzaglia (F-SIMG) Draft TABLE OF CONTENTS DOCUMENT INFOOMATION AND HISTORY ...........................................................................4 DEFINITIONS .................................................... ERRORE. IL SEGNALIBRO NON È DEFINITO. ABBREVIATIONS ......................................................................................................................6 1. BACKGROUND .................................................................................................................7 2. STUDY OBJECTIVES................................ ERRORE. IL SEGNALIBRO NON È DEFINITO. 3. METHODS ..........................................................................................................................8 3.1.STUDY DESIGN ....................................................................................................................8 3.2.DATA SOURCES ..................................................................................................................9 3.2.1. IPCI Database .....................................................................................................9
    [Show full text]
  • Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in European Acute Care Hospitals
    TECHNICAL DOCUMENT Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals Protocol version 5.3 www.ecdc.europa.eu ECDC TECHNICAL DOCUMENT Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals Protocol version 5.3, ECDC PPS 2016–2017 Suggested citation: European Centre for Disease Prevention and Control. Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals – protocol version 5.3. Stockholm: ECDC; 2016. Stockholm, October 2016 ISBN 978-92-9193-993-0 doi 10.2900/374985 TQ-04-16-903-EN-N © European Centre for Disease Prevention and Control, 2016 Reproduction is authorised, provided the source is acknowledged. ii TECHNICAL DOCUMENT PPS of HAIs and antimicrobial use in European acute care hospitals – protocol version 5.3 Contents Abbreviations ............................................................................................................................................... vi Background and changes to the protocol .......................................................................................................... 1 Objectives ..................................................................................................................................................... 3 Inclusion/exclusion criteria .............................................................................................................................. 4 Hospitals .................................................................................................................................................
    [Show full text]