Harnessing Β-Lactam Antibiotics for Illumination of the Activity of Penicillin-Binding Proteins
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The Activity of Mecillinam Vs Enterobacteriaceae Resistant to 3Rd Generation Cephalosporins in Bristol, UK
The activity of mecillinam vs Enterobacteriaceae resistant to 3rd generation cephalosporins in Bristol, UK Welsh Antimicrobial Study Group Grŵp Astudio Wrthfiotegau Cymru G Weston1, KE Bowker1, A Noel1, AP MacGowan1, M Wootton2, TR Walsh2, RA Howe2 (1) BCARE, North Bristol NHS Trust, Bristol BS10 5NB (2) Welsh Antimicrobial Study Group, NPHS Wales, University Hospital of Wales, CF14 4XW Introduction Results Results Results Figure 1: Population Distributions of Mecillinam MICs for E. Figure 2: Population Distributions of MICs for ESBL- Resistance in coliforms to 3rd generation 127 isolates were identified by screening of which 123 were confirmed as resistant to CTX or coli (n=72), NON-E. coli Enterobacteriaceae (n=47) and multi- producing E. coli (n=67) against mecillinam or mecillinam + cephalosporins (3GC) is an increasing problem resistant strains (n=39) clavulanate CAZ by BSAC criteria. The majority of 3GC- both in hospitals and the community. Oral options MR Non-E. coli E. coli Mecalone Mec+Clav resistant strains were E. coli 60.2%, followed by for the treatment of these organisms is often 35 50 Enterobacter spp. 16.2%, Klebsiella spp. 12.2%, limited due to resistance to multiple antimicrobial 45 and others (Citrobacter spp., Morganella spp., 30 classes. Mecillinam, an amidinopenicillin that is 40 Pantoea spp., Serratia spp.) 11.4%. 25 available in Europe as the oral pro-drug 35 All isolates were susceptible to meropenem with s 20 30 e s pivmecillinam, is stable to many beta-lactamases. t e a t l a mecillinam the next most active agent with more l o 25 o s We aimed to establish the activity of mecillinam i s i 15 % than 95% of isolates susceptible (table). -
Mecillinam (FL 1060), a 6,3-Amidinopenicillanic Acid Derivative: Bactericidal Action and Synergy in Vitro L
ANTUCROBIAL AGENTS AND CHEzOTHrAPY, Sept. 1975, p. 271-276 Vol. 8, No. 3 Copyright 0 1975 American Society for Microbiology Printed in U.S.A. Mecillinam (FL 1060), a 6,3-Amidinopenicillanic Acid Derivative: Bactericidal Action and Synergy In Vitro L. TYBRING* AND N. H. MELCHIOR Bacteriological Research Department, Leo Pharmaceutical Products, DK-2750 Ballerup, Denmark Received for publication 26 December 1974 A newly described 6d-amidinopenicillanic acid derivative, mecillinam (for- merly called FL 1060), showed a high in vitro activity against Enterobacteriac- eae. The effect on Escherichia coli was bactericidal and was due to lysis of the cells. The longer the culture grew under the influence of mecillinam or the lower the inoculum, the greater the bactericidal effect. The morphology of the cells changed towards large spheric forms (2 to 5 ,m) under the influence of mecillinam. Consequently a great discrepancy between the optical density and the viable count was seen. The morphologically abnormal cells could be protected against lysis in vitro by addition of ionized compounds such as sodium chloride. Abnormal cells were more sensitive to ampicillin than normal cells. As expected synergy could be demonstrated between mecillinam and ampicillin. This was marked under experimental conditions where the abnormal cells were protected against lysis. In a previous paper from this laboratory a new the liquid media was measured by the cryostatic group of penicillanic acid derivatives, 6,- method using a Knauer type M osmometer, and the amidinopenicillanic acids, with unusual in specific conductivity was measured as millisiemens at vitro antibacterial properties was described (4). 36 C using a conductivity meter, Radiometer type One member of CDM 2c. -
AMEG Categorisation of Antibiotics
12 December 2019 EMA/CVMP/CHMP/682198/2017 Committee for Medicinal Products for Veterinary use (CVMP) Committee for Medicinal Products for Human Use (CHMP) Categorisation of antibiotics in the European Union Answer to the request from the European Commission for updating the scientific advice on the impact on public health and animal health of the use of antibiotics in animals Agreed by the Antimicrobial Advice ad hoc Expert Group (AMEG) 29 October 2018 Adopted by the CVMP for release for consultation 24 January 2019 Adopted by the CHMP for release for consultation 31 January 2019 Start of public consultation 5 February 2019 End of consultation (deadline for comments) 30 April 2019 Agreed by the Antimicrobial Advice ad hoc Expert Group (AMEG) 19 November 2019 Adopted by the CVMP 5 December 2019 Adopted by the CHMP 12 December 2019 Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2020. Reproduction is authorised provided the source is acknowledged. Categorisation of antibiotics in the European Union Table of Contents 1. Summary assessment and recommendations .......................................... 3 2. Introduction ............................................................................................ 7 2.1. Background ........................................................................................................ -
Diabetes Starting Earlier
Original Article Activity of Mecillinam and Clavulanic Acid on ESBL Producing and Non- ESBL Producing Escherichia Coli Isolated From UTI Cases Khandaker Shadia1, Abdullah Akhtar Ahmed1, Lovely Barai2, Fahmida Rahman1, Nusrat Tahmina3 and J. Ashraful Haq1 1Department of Microbiology, Ibrahim Medical College; 2Department of Microbiology, BIRDEM General Hospital; 3Department of Microbiology, Primeasia University Abstract Mecillinam is one of the very few oral antibacterial agents used against extended spectrum β- lactamase (ESBL) producing Escherichia coli (E. coli) causing urinary tract infection (UTI)). It is reported that, resistance to mecillinam can be reversed to some extent by adding beta lactamase inhibitor like clavulanic acid. The present study was aimed to determine in-vitro activity of mecillinam and mecillinam-clavulanic acid combination on the susceptibility of ESBL producing and non-ESBL producing E. coli. Total 124 E. coli (78 ESBL positive and 46 ESBL negative) isolates from urine samples of patients with UTI were included in the study. Organisms were isolated from patients attending BIRDEM General Hospital from July 2012 to December 2012. ESBL production was tested by double disc synergy test. Minimum inhibitory concentration (MIC) of mecillinam and clavulanic acid against E. coli was determined by agar dilution method. Of the total E. coli isolates, 62.9% was ESBL positive and 37.1% was negative for ESBL. Out of ESBL positive isolates, 75.6% was sensitive to mecillinam while ESBL negative isolates showed the sensitivity as 67.4%. The sensitivity to mecillinam of ESBL positive and negative isolates increased to 85.9% and 86.9% respectively by addition of clavulanic acid with mecillinam. -
Dose Amoxicillin/Clavulanate
1 Clinical trial of the treatment of acute sinusitis with standard-dose vs. high- dose amoxicillin/clavulanate Principal Investigator: Paul Sorum, MD, PhD, Professor of Internal Medicine and Pediatrics Co-Investigators: Andrea Matho, MD, 2nd year Med-Ped resident (the four 2nd-year residents will be responsible for the timely follow-up of enrolled patients) Mary Mulqueen, MD, 2nd year Med-Ped resident Aaron Quidort, MD, 2nd year Med-Ped resident Miyuki Tanino, MD, 2nd year Med-Ped resident Sujata Kane, PA-C (who will be enrolling the most patients) Christine McGovern, MS, PA-C (who will work with the residents to assure the smooth enrollment and complete follow-up of patients) Joseph Wayne, MD, MPH, Associate Professor of Internal Medicine and Pediatrics Gina Garrison, Pharm D, Associate Professor of Pharmacy Practice, Albany College of Pharmacy and Health Sciences (who will prepare the medications) Sub-Investigators The other attending physicians at the AMC Internal Medicine and Pediatrics office (who will be enrolling patients): Rahim Dhanani, MD Elizabeth Higgins, MD Hamish Kerr, MD Deborah Light, MD Jennifer Lindstrom, MD Tricia Pelnik-Fecko, MD Ivelisse Verrico, MD Kathleen Zabinski-Kramer, MD The other Medicine-Pediatrics residents (who will be enrolling patients and making follow-up telephone calls) Brady Bowen, DO Melanie Ecung Deyss, MD Laura El-Hage, MD Sara Khalil, MD Preetha Kurian, MD Daniel Lavelle, MD Manpreet Mann, MD Lyndsay Molinari, MD Uwa Otabor, MD Samuel Park, MD Britta Sundquist, MD Lisa Thaler, DO 2 Others Nursing staff (who will provide the patients with documents relating to the study) Medical students for research experience or work-study (who will help the residents to follow-up telephone calls and who will, if possible, enter data into the Excel data base) (to be set up) Statistical consultant: Michael Mulvihill, DPH, Einstein Medical Center, NYC A. -
Consideration of Antibacterial Medicines As Part Of
Consideration of antibacterial medicines as part of the revisions to 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) Section 6.2 Antibacterials including Access, Watch and Reserve Lists of antibiotics This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programs, and medicine formularies for use in primary, secondary and tertiary care. This document does not replace the full report of the WHO Expert Committee on Selection and Use of Essential Medicines (see The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization; 2019 (WHO Technical Report Series, No. 1021). Licence: CC BY-NC-SA 3.0 IGO: https://apps.who.int/iris/bitstream/handle/10665/330668/9789241210300-eng.pdf?ua=1) and Corrigenda (March 2020) – TRS1021 (https://www.who.int/medicines/publications/essentialmedicines/TRS1021_corrigenda_March2020. pdf?ua=1). Executive summary of the report: https://apps.who.int/iris/bitstream/handle/10665/325773/WHO- MVP-EMP-IAU-2019.05-eng.pdf?ua=1. -
WO 2010/025328 Al
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date 4 March 2010 (04.03.2010) WO 2010/025328 Al (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/00 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, (21) International Application Number: CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, PCT/US2009/055306 DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, 28 August 2009 (28.08.2009) KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (25) Filing Language: English NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (26) Publication Language: English SE, SG, SK, SL, SM, ST, SV, SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: 61/092,497 28 August 2008 (28.08.2008) US (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, (71) Applicant (for all designated States except US): FOR¬ GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, EST LABORATORIES HOLDINGS LIMITED [IE/ ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, —]; 18 Parliament Street, Milner House, Hamilton, TM), European (AT, BE, BG, CH, CY, CZ, DE, DK, EE, Bermuda HM12 (BM). -
Enzymatic Synthesis of Peptidoglycan in Methicillin-Resistant Staphylococcus Aureus and Its Inhibition by Beta-Lactams
Enzymatic Synthesis of Peptidoglycan in Methicillin-Resistant Staphylococcus Aureus and Its Inhibition by Beta-lactams The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Srisuknimit, Veerasak. 2019. Enzymatic Synthesis of Peptidoglycan in Methicillin-Resistant Staphylococcus Aureus and Its Inhibition by Beta-lactams. Doctoral dissertation, Harvard University, Graduate School of Arts & Sciences. Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:42029540 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use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
Lactam Antibiotics Against Escherichia Coli Resides in Different Penic
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Apr. 1995, p. 812–818 Vol. 39, No. 4 0066-4804/95/$04.0010 Copyright q 1995, American Society for Microbiology Target for Bacteriostatic and Bactericidal Activities of b-Lactam Antibiotics against Escherichia coli Resides in Different Penicillin-Binding Proteins† GIUSEPPE SATTA,1 GIUSEPPE CORNAGLIA,2 ANNARITA MAZZARIOL,2 GRAZIA GOLINI,2 2 2 SEBASTIANO VALISENA, AND ROBERTA FONTANA * Istituto di Microbiologia, Universita` Cattolica del Sacro Cuore, I-00168 Rome,1 and Istituto di Microbiologia, Universita` degli Studi di Verona, I-37134 Verona,2 Italy Received 9 August 1994/Returned for modification 14 November 1994/Accepted 23 January 1995 The relationship between cell-killing kinetics and penicillin-binding protein (PBP) saturation has been evaluated in the permeability mutant Escherichia coli DC2 in which the antimicrobial activity of b-lactams has been described as being directly related to the extent of saturation of the PBP target(s). Saturation of a single PBP by cefsulodin (PBP 1s), mecillinam (PBP 2), and aztreonam (PBP 3) resulted in a slow rate of killing (2.5-, 1.5-, and 0.8-log-unit decreases in the number of CFU per milliliter, respectively, in 6 h). Saturation of two of the three essential PBPs resulted in a marked increase in the rate of killing, which reached the maximum value when PBPs 1s and 2 were simultaneously saturated by a combination of cefsulodin and mecillinam (4.7-log- unit decrease in the number of CFU per milliliter in 6 h). Inactivation of all three essential PBPs by the combination of cefsulodin, mecillinam, and aztreonam further increased the killing kinetics (5.5-log-unit decrease in the number of CFU per milliliter), and this was not significantly changed upon additional saturation of the nonessential PBPs 5 and 6 by cefoxitin. -
Treatment of Drug-Resistant Tuberculosis an Official ATS/CDC/ERS/IDSA Clinical Practice Guideline Payam Nahid, Sundari R
AMERICAN THORACIC SOCIETY DOCUMENTS Treatment of Drug-Resistant Tuberculosis An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline Payam Nahid, Sundari R. Mase, Giovanni Battista Migliori, Giovanni Sotgiu, Graham H. Bothamley, Jan L. Brozek, Adithya Cattamanchi, J. Peter Cegielski, Lisa Chen, Charles L. Daley, Tracy L. Dalton, Raquel Duarte, Federica Fregonese, C. Robert Horsburgh, Jr., Faiz Ahmad Khan, Fayez Kheir, Zhiyi Lan, Alfred Lardizabal, Michael Lauzardo, Joan M. Mangan, Suzanne M. Marks, Lindsay McKenna, Dick Menzies, Carole D. Mitnick, Diana M. Nilsen, Farah Parvez, Charles A. Peloquin, Ann Raftery, H. Simon Schaaf, Neha S. Shah, Jeffrey R. Starke, John W. Wilson, Jonathan M. Wortham, Terence Chorba, and Barbara Seaworth; on behalf of the American Thoracic Society, U.S. Centers for Disease Control and Prevention, European Respiratory Society, and Infectious Diseases Society of America THIS OFFICIAL CLINICAL PRACTICE GUIDELINE WAS APPROVED BY THE AMERICAN THORACIC SOCIETY, THE EUROPEAN RESPIRATORY SOCIETY, AND THE INFECTIOUS DISEASES SOCIETY OF AMERICA SEPTEMBER 2019, AND WAS CLEARED BY THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION SEPTEMBER 2019 Background: The American Thoracic Society, U.S. Centers for was judged to be very low, because the data came Disease Control and Prevention, European Respiratory Society, and from observational studies with significant loss to follow-up Infectious Diseases Society of America jointly sponsored this new and imbalance in background regimens between comparator practice guideline on the treatment of drug-resistant tuberculosis groups. Good practices in the management of MDR-TB are (DR-TB). The document includes recommendations on the described. On the basis of the evidence review, a clinical strategy treatment of multidrug-resistant TB (MDR-TB) as well as tool for building a treatment regimen for MDR-TB is also isoniazid-resistant but rifampin-susceptible TB. -
Guideline for Prescribing of Pivmecillinam
Hull & East Riding Prescribing Committee Guideline for Prescribing of Pivmecillinam 1. BACKGROUND Pivmecillinam is an antibiotic belonging to the penicillins class of antibacterials. It has significant activity against many Gram-negative bacteria including E coli, klebsiella, enterobacter, and salmonellae. It is not active against Ps aeruginosa or enterococci. 2. INDICATION Pivmecillinam is licensed in adults and children for the treatment of mecillinam sensitive organisms, including urinary tract infections and salmonellosis In Hull and East Yorkshire area pivmecillinam is a RESTRICTED antibiotic. Use should be reserved for the treatment of recurrent/resistant UTI in adults and children > 40kg with a limited number of treatment options AND prescribed by or recommended by a Consultant Microbiologist or Consultant in Infectious Disease 3. DOSE / DURATION Uncomplicated Lower Urinary Tract Infection 400mg STAT followed by 200mg 8hrly (To complete 3 days in WOMEN, 7 days in MEN) Recurrent Lower Urinary Tract Infections Usual dose is 400 mg (TWO tablets) three times daily. Dose and duration as advised by specialist – may be long term In patients with severe renal impairment accumulation can occur. Dose reduction may be advised for long term use. 4. CONTRAINDICATIONS / CAUTIONS Avoid use is patients with hypersensitivity to the drug substance or any of the other ingredients; hypersensitivity to penicillins and/or cephalosporins; oesophageal strictures and/or obstructive changes in the gastrointestinal tract; a predisposition to carnitine deficiency; porphyria; pregnancy. May be used during breast-feeding and no effects on the infant are anticipated. However, as for other penicillins, trace quantities of mecillinam is excreted into breast milk with the possible risk of sensitisation and subsequent allergic reactions in a sensitised infant. -
Mechanisms and Dynamics of Mecillinam Resistance in Escherichia Coli
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1375 Mechanisms and Dynamics of Mecillinam Resistance in Escherichia coli ELISABETH THULIN ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 ISBN 978-91-513-0090-0 UPPSALA urn:nbn:se:uu:diva-330856 2017 Dissertation presented at Uppsala University to be publicly examined in A1:111a, BMC, Husargatan 3, Uppsala, Friday, 24 November 2017 at 09:00 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in English. Faculty examiner: Professor Laura Piddock ( Institute of Microbiology and Infection, University of Birmingham, UK). Abstract Thulin, E. 2017. Mechanisms and Dynamics of Mecillinam Resistance in Escherichia coli. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1375. 69 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0090-0. The introduction of antibiotics in healthcare is one of the most important medical achievements with regard to reducing human morbidity and mortality. However, bacterial pathogens have acquired antibiotic resistance at an increasing rate, and due to a high prevalence of resistance to some antibiotics they can no longer be used therapeutically. The antibiotic mecillinam, which inhibits the penicillin-binding protein PBP2, however, is an exception since mecillinam resistance (MecR) prevalence has remained low. This is particularly interesting since laboratory experiments have shown that bacteria can rapidly acquire MecR mutations by a multitude of different types of mutations. In this thesis, I examined mechanisms and dynamics of mecillinam resistance in clinical and laboratory isolates of Escherichia coli. Only one type of MecR mutations (cysB) was found in the clinical strains, even though laboratory experiments demonstrate that more than 100 genes can confer resistance Fitness assays showed that cysB mutants have higher fitness than most other MecR mutants, which is likely to contribute to their dominance in clinical settings.