Antibiotics Currently in Clinical Development
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The Role of Nanobiosensors in Therapeutic Drug Monitoring
Journal of Personalized Medicine Review Personalized Medicine for Antibiotics: The Role of Nanobiosensors in Therapeutic Drug Monitoring Vivian Garzón 1, Rosa-Helena Bustos 2 and Daniel G. Pinacho 2,* 1 PhD Biosciences Program, Universidad de La Sabana, Chía 140013, Colombia; [email protected] 2 Therapeutical Evidence Group, Clinical Pharmacology, Universidad de La Sabana, Chía 140013, Colombia; [email protected] * Correspondence: [email protected]; Tel.: +57-1-8615555 (ext. 23309) Received: 21 August 2020; Accepted: 7 September 2020; Published: 25 September 2020 Abstract: Due to the high bacterial resistance to antibiotics (AB), it has become necessary to adjust the dose aimed at personalized medicine by means of therapeutic drug monitoring (TDM). TDM is a fundamental tool for measuring the concentration of drugs that have a limited or highly toxic dose in different body fluids, such as blood, plasma, serum, and urine, among others. Using different techniques that allow for the pharmacokinetic (PK) and pharmacodynamic (PD) analysis of the drug, TDM can reduce the risks inherent in treatment. Among these techniques, nanotechnology focused on biosensors, which are relevant due to their versatility, sensitivity, specificity, and low cost. They provide results in real time, using an element for biological recognition coupled to a signal transducer. This review describes recent advances in the quantification of AB using biosensors with a focus on TDM as a fundamental aspect of personalized medicine. Keywords: biosensors; therapeutic drug monitoring (TDM), antibiotic; personalized medicine 1. Introduction The discovery of antibiotics (AB) ushered in a new era of progress in controlling bacterial infections in human health, agriculture, and livestock [1] However, the use of AB has been challenged due to the appearance of multi-resistant bacteria (MDR), which have increased significantly in recent years due to AB mismanagement and have become a global public health problem [2]. -
Overcoming Fluoroquinolone Resistance: Mechanistic Basis of Non- Quinolone Antibacterials Targeting Type Ii Topoisomerases
OVERCOMING FLUOROQUINOLONE RESISTANCE: MECHANISTIC BASIS OF NON- QUINOLONE ANTIBACTERIALS TARGETING TYPE II TOPOISOMERASES By Elizabeth Grace Gibson Dissertation Submitted to the Faculty of the Graduate School of Vanderbilt University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY in Pharmacology May 10, 2019 Nashville, Tennessee Approved: Neil Osheroff, Ph.D. Joey Barnett, Ph.D. Wendell S. Akers, Pharm.D., Ph.D. Sean Davies, Ph.D. Benjamin Spiller, Ph.D. Timothy R. Sterling, M.D. DEDICATION To all my family and church family who have supported and encouraged me over all my years in school. To Him who I put all my trust. Commit your way to the Lord, trust also in Him and He shall bring it to pass. Psalm 37:5 ii ACKNOWLEDGEMENTS I want to first thank my Ph.D. advisor, Dr. Neil Osheroff, for allowing me to work in his laboratory. Thank you for all your support and encouragement and just being an overall great mentor. You really know how to bring us up when we need it or give us an ego check when we get a little high and mighty when things are going well. I appreciate your supportiveness to careers outside academia. I also appreciate that you always have our best interest at heart. To Dr. Joe Deweese, my first research mentor and the one who instilled the love of topoisomerase research. Without your guidance I would not be where I am today. Thank you for introducing me to Neil and his laboratory and helping with the transition from research in your lab to his. -
Gonorrhea, Chlamydia, and Syphilis
2019 GONORRHEA, CHLAMYDIA, AND SYPHILIS AND CHLAMYDIA, GONORRHEA, Dedication TAG would like to thank the National Coalition of STD Directors for funding and input on the report. THE PIPELINE REPORT Pipeline for Gonorrhea, Chlamydia, and Syphilis By Jeremiah Johnson Introduction The current toolbox for addressing gonorrhea, chlamydia, and syphilis is inadequate. At a time where all three epidemics are dramatically expanding in locations all around the globe, including record-breaking rates of new infections in the United States, stakeholders must make do with old tools, inadequate systems for addressing sexual health, and a sparse research pipeline of new treatment, prevention, and diagnostic options. Lack of investment in sexual health research has left the field with inadequate prevention options, and limited access to infrastructure for testing and treatment have allowed sexually transmitted infections (STIs) to flourish. The consequences of this underinvestment are large: according to the World Health Organization (WHO), in 2012 there were an estimated 357 million new infections (roughly 1 million per day) of the four curable STIs: gonorrhea, chlamydia, syphilis, and trichomoniasis.1 In the United States, the three reportable STIs that are the focus of this report—gonorrhea, chlamydia, and syphilis—are growing at record paces. In 2017, a total of 30,644 cases of primary and secondary (P&S) syphilis—the most infectious stages of the disease—were reported in the United States. Since reaching a historic low in 2000 and 2001, the rate of P&S syphilis has increased almost every year, increasing 10.5% during 2016–2017. Also in 2017, 555,608 cases of gonorrhea were reported to the U.S. -
Activity of the Investigational Fluoroquinolone Finafloxacin and Seven Other PD Dr
Contact information: CORRESPONDING AUTHOR Activity of the Investigational Fluoroquinolone Finafloxacin and Seven Other PD Dr. Reiner Schaumann 49 th ICAAC Institute for Medical Microbiology and Epidemiology of Infectious Diseases San Francisco 2009 Antimicrobial Agents Against 83 Obligately Anaerobic Bacteria. University of Leipzig Liebigstr. 24 1 1 2 1 2 1 D-04103 Leipzig R. SCHAUMANN , G. H. GENZEL , W. STUBBINGS , C. S. STINGU , H. LABISCHINSKI , A. C. RODLOFF Germany E - 1973 Phone +49 341 97 15 200 1Inst. f. Med. Microbiology and Epidemiology of Infectious Diseases, Univ. of Leipzig, Leipzig, Germany; 2MerLion Pharmaceuticals GmbH, Berlin, Germany. Fax +49 341 97 15 209 E-Mail: [email protected] AbstractAbstract MethodsMethods ResultsResults andand DiscussionDiscussion Background: Finafloxacin (FIN) is a novel Bacterial Strains The Figures 2 and 3 show the scatter fluoroquinolone belonging to a 8-cyano subclass 83 obligately anaerobes including reference strains were taken from the histograms of MIC values obtained for FIN culture collection from the Institute for Medical Microbiology and and exhibits enhanced activity at slightly acidic and the seven other antimicrobial agents pH. FIN exhibited superior activity to comparator Epidemiology of Infectious Diseases, University of Leipzig, Germany. The fluoroquinolones in a wide range of rodent strains were collected from clinical specimens at the Institute and from against 83 obligately anaerobic bacteria infection models. With the present study the national and international studies and obtained in part from other included in this study. activity of FIN against 83 recently isolated strains laboratories. The following strains were used: Bacteroides fragils group of obligately anaerobic bacteria including (n=62): B. -
Paper I and II)
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1335 Constraints on up-regulation of drug efflux in the evolution of ciprofloxacin resistance LISA PRASKI ALZRIGAT ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 ISBN 978-91-554-9923-5 UPPSALA urn:nbn:se:uu:diva-320580 2017 Dissertation presented at Uppsala University to be publicly examined in B22, BMC, Husargatan 3, Uppsala, Friday, 9 June 2017 at 09:00 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in English. Faculty examiner: Professor Fernando Baquero (Departamento de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain). Abstract Praski Alzrigat, L. 2017. Constraints on up-regulation of drug efflux in the evolution of ciprofloxacin resistance. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1335. 48 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-554-9923-5. The crucial role of antibiotics in modern medicine, in curing infections and enabling advanced medical procedures, is being threatened by the increasing frequency of resistant bacteria. Better understanding of the forces selecting resistance mutations could help develop strategies to optimize the use of antibiotics and slow the spread of resistance. Resistance to ciprofloxacin, a clinically important antibiotic, almost always involves target mutations in DNA gyrase and Topoisomerase IV. Because ciprofloxacin is a substrate of the AcrAB-TolC efflux pump, mutations causing pump up-regulation are also common. Studying the role of efflux pump-regulatory mutations in the development of ciprofloxacin resistance, we found a strong bias against gene-inactivating mutations in marR and acrR in clinical isolates. -
Antibacterial Efficacy of Eravacycline in Vivo Against Gram-Positive And
crossmark Antibacterial Efficacy of Eravacycline In Vivo against Gram-Positive and Gram-Negative Organisms Marguerite L. Monogue,a Abrar K. Thabit,a,b Yukihiro Hamada,a,c David P. Nicolaua,d Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut, USAa; Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabiab; Aichi Medical University Hospital School of Medicine, Aichi, Japanc; Division of Infectious Diseases, Hartford Hospital, Hartford, Connecticut, USAd Members of the tetracycline class are frequently classified as bacteriostatic. However, recent findings have demonstrated an im- > proved antibacterial killing profile, often achieving 3 log10 bacterial count reduction, when such antibiotics have been given for periods longer than 24 h. We aimed to study this effect with eravacycline, a novel fluorocycline, given in an immunocompetent murine thigh infection model over 72 h against two methicillin-resistant Staphylococcus aureus (MRSA) isolates (eravacycline to 0.25 g/ml). A humanized Downloaded from 0.125 ؍ and 0.25 g/ml) and three Enterobacteriaceae isolates (eravacycline MICs 0.03 ؍ MICs eravacycline regimen, 2.5 mg/kg of body weight given intravenously (i.v.) every 12 h (q12h), demonstrated progressively en- hanced activity over the 72-h study period. A cumulative dose response in which bacterial density was reduced by more than 3 log10 CFU at 72 h was noted over the study period in the two Gram-positive isolates, and eravacycline performed similarly to comparator antibiotics (tigecycline, linezolid, and vancomycin). A cumulative dose response with eravacycline and comparators (tigecycline and meropenem) over the study period was also observed in the Gram-negative isolates, although more variability in bacterial killing was observed for all antibacterial agents. -
Against Helicobacter Pylori in Vitro and in Vivo Merlion Pharmaceuticals Pte Ltd, Washington DC 2008 05-01 the Capricorn, 1 2 1 1 3 3 1 Science Park 2, A
Contact information: 48th ICAAC / 46th IDSA, WILL STUBBINGS Antimicrobial Activity of Finafloxacin (FIN) against Helicobacter pylori In Vitro and In Vivo MerLion Pharmaceuticals Pte Ltd, Washington DC 2008 05-01 The Capricorn, 1 2 1 1 3 3 1 Science Park 2, A. BUISSONNIÈRE , H-O. WERLING B. BERGEY , P. LEHOURS , W. STUBBINGS , H. LABISCHINSKI , F. MEGRAUD . Singapore 117528 F1-2038 Phone +65 6829 5600 1INSERM U853, Bordeaux, France, 2Bayer HealthCare AG, Elberfeld, Germany, 3MerLion Pharmaceuticals Pte Ltd, Singapore. [email protected] RevisedRevised abstractabstract MethodsMethods ResultsResults andand DiscussionDiscussion Introduction: FIN is a novel fluoroquinolone (FQ) belonging to a new 8- Minimum inhibitory concentration (MIC) determination Murine model of H. felis infection cyano subclass. FIN exhibits optimal efficacy at slightly acidic pH (5.0 - 6.0), Finafloxacin Levofloxacin Clearance % under which other FQs lose activity. FIN is intended for therapeutic use MICs were determined for FIN and LVX against H. pylori strains (n= 55) that were MIC MIC MIC MIC W 8801, X 7328, 17-8299, H. felis was passaged in mice to achieve a persistent infection that pH 50 90 50 90 X 2752, X 9181, Y 1304 against bacterial infections associated with an acidic environment such as H. obtained from patients gastroscoped in the Southwest of France. MICs were 100 [mg/L] [mg/L] [mg/L] [mg/L] 34-6601 exhibited a similar response to therapy as H. pylori in humans. Triple pylori eradication. The antibacterial activity of FIN, was determined against performed by agar dilution at 3 different pHs: 7.3, 6.3 and 5.3. An inoculum FIN FQ RES and susceptible strains at acidic pH, and against H. -
200 and 800 Mg) in Healthy Volunteers Receiving a Single Oral Dose
Pharmacology Chemotherapy 2011;57:97–107 Received: June 9, 2010 DOI: 10.1159/000321028 Accepted after revision: August 30, 2010 Published online: February 28, 2011 Urinary Pharmacokinetics and Bactericidal Activity of Finafloxacin (200 and 800 mg) in Healthy Volunteers Receiving a Single Oral Dose a b d Florian M.E. Wagenlehner Christine M. Wagenlehner Birgit Blenk d e e c Holger Blenk Sabine Schubert Axel Dalhoff Kurt G. Naber a Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, and b c Department of Anesthesia, Evangelisches Krankenhaus, Giessen , Technical University of Munich, Straubing , d e Department of Microbiology, Nürnberg , and University Hospital Schleswig-Holstein, Campus Kiel, Kiel , Germany Key Words Introduction ؒ Finafloxacin ؒ Urine pharmacokinetics ؒ Pharmacodynamics Urinary bactericidal titers Urinary tract infection (UTI) is one of the most com- mon reasons for medical consultation. Uncomplicated UTI are predominantly caused by Escherichia coli, but Abstract also by Proteus mirabilis and occasionally Klebsiella spp., Background: Finafloxacin is a novel 8-cyano-fluoroquino- other Enterobacteriaceae and Staphylococcus saprophyti- lone under investigation for treatment of urinary tract infec- cus ( ! 5% each) [1–3] . Infections with P. mirabilis are sig- tion. Methods: Urinary concentrations and urinary bacteri- nificantly more common in patients over 50 years, where- cidal titers (UBT) of finafloxacin 200- and 800-mg single dos- as infections with S. saprophyticus are more common in es in 6 healthy volunteers were measured up to 48 h. UBT younger patients. Nosocomial UTI, almost always com- were determined for a reference strain and 9 selected clin- plicated, are caused by a wide range of pathogens, most ical uropathogens at the pH of native, acidified (pH 5.5) frequently E. -
Anew Drug Design Strategy in the Liht of Molecular Hybridization Concept
www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 12 December 2020 | ISSN: 2320-2882 “Drug Design strategy and chemical process maximization in the light of Molecular Hybridization Concept.” Subhasis Basu, Ph D Registration No: VB 1198 of 2018-2019. Department Of Chemistry, Visva-Bharati University A Draft Thesis is submitted for the partial fulfilment of PhD in Chemistry Thesis/Degree proceeding. DECLARATION I Certify that a. The Work contained in this thesis is original and has been done by me under the guidance of my supervisor. b. The work has not been submitted to any other Institute for any degree or diploma. c. I have followed the guidelines provided by the Institute in preparing the thesis. d. I have conformed to the norms and guidelines given in the Ethical Code of Conduct of the Institute. e. Whenever I have used materials (data, theoretical analysis, figures and text) from other sources, I have given due credit to them by citing them in the text of the thesis and giving their details in the references. Further, I have taken permission from the copyright owners of the sources, whenever necessary. IJCRT2012039 International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org 284 www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 12 December 2020 | ISSN: 2320-2882 f. Whenever I have quoted written materials from other sources I have put them under quotation marks and given due credit to the sources by citing them and giving required details in the references. (Subhasis Basu) ACKNOWLEDGEMENT This preface is to extend an appreciation to all those individuals who with their generous co- operation guided us in every aspect to make this design and drawing successful. -
The Study Listed May Include Approved and Non-Approved Uses, Formulations Or Treatment Regimens
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product. Before prescribing any product mentioned in this Register, healthcare professionals should consult prescribing information for the product approved in their country. GSK Medicine: Gepotidacin Study Number: 207625 Title: Meta-analysis to estimate the microbiological treatment effect of nitrofurantoin for determination of the non-inferiority margin in a phase 3 clinical trial of uncomplicated urinary tract infection (uUTI). Rationale: Active-comparator, non-inferiority study designs are generally used in uUTI trials, given the ethical implications of placebo treatment. In order to design, execute, and analyze a non-inferiority trial, an estimate of the treatment effect (M1) of the planned active comparator (nitrofurantoin), must be obtained from historical randomized or open label studies. Once an estimate of M1 (nitrofurantoin treatment effect) is obtained, a non-inferiority margin (M2) or the largest clinically acceptable difference of the test drug compared to the active comparator must be determined. Determination of M1 and M2 is critical to the design, analysis and interpretation of a non-inferiority trial. The rationale for this study was to estimate the treatment effect of an active comparator (nitrofurantoin) in order to determine the non-inferiority margin for a Phase III study, which will demonstrate the efficacy of a new -
In Vitro Activity of Eravacycline and Comparator Antimicrobials Against
In Vitro Activity of Eravacycline and comparator antimicrobials *Presenting Author: against 143 recent strains of Bacteroides species Diane M. Citron 1209 [email protected] Diane M. Citron, Kerin L. Tyrrell, and Ellie J. C. Goldstein R. M. Alden Research Laboratory, Culver City, CA 90230 Introduction Results Discussion Eravacycline (ERV) is a novel, fully-synthetic fluorocycline antibiotic in Resistance to tetracycline has become common among Bacteroides species and Table 1. In vitro activity (µg/ml) of eravacycline and comparators development for the treatment of serious infections, including those caused by the MIC90 for all of the strains was >32 µg/ml. Eravacycline was four- to eight- multidrug-resistant (MDR) pathogens. ERV recently completed phase 3 clinical against Bacteroides species. All results for the quality control fold more active than tigecycline against these strains with MIC at 1–4 µg/ml. strains were within acceptable CLSI ranges (4). 90 development for the treatment of complicated intra-abdominal infections (cIAI) Eravacycline was active against several strains that showed resistance to and is in phase 3 clinical development for complicated urinary tract infections piperacillin-tazobactam and meropenem. (cUTI), including pyelonephritis. Organism (no.) / Agent Range MIC MIC 50 90 Resistance to clindamycin was also common and all of these strains were ERV has potent activity against a broad range of Gram-positive, Gram- B. caccae (10) Eravacycline 0.25–4 0.5 2 susceptible to eravacycline. negative and anaerobic pathogens. Like other tetracyclines, ERV inhibits protein Tigecycline 0.25–16 4 16 Metronidazole resistance was not encountered in this group of isolates, although, synthesis by binding to the 30S ribosomal subunit. -
Lactamase-Producing Carbapenem-Resistant Enterobacteriaceae (CRE) to Eravacycline
The Journal of Antibiotics (2016) 69, 600–604 & 2016 Japan Antibiotics Research Association All rights reserved 0021-8820/16 www.nature.com/ja ORIGINAL ARTICLE In vitro susceptibility of β-lactamase-producing carbapenem-resistant Enterobacteriaceae (CRE) to eravacycline Yunliang Zhang, Xiaoyan Lin and Karen Bush Eravacycline is a novel, fully synthetic fluorocycline antibiotic of the tetracycline class being developed for the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Eravacycline has activity against many key Gram-negative pathogens, including Enterobacteriaceae resistant to carbapenems, cephalosporins, fluoroquinolones and β-lactam/β-lactamase inhibitor combinations, including strains that are multidrug-resistant. Carbapenem-resistant Enterobacteriaceae (CRE) isolates from 2010 to 2013 (n = 110) were characterized for carbapenemase genes by PCR and sequencing. MICs for eravacycline, tetracycline, tigecycline, amikacin, imipenem, ceftazidime, cefotaxime and levofloxacin were determined in broth microdilution assays. All isolates produced at least one carbapenemase, most frequently KPC-3. Nine isolates produced both a KPC serine carbapenemase and a metallo-β-lactamase, NDM-1 (n = 1) or VIM-1 (n = 8). The 110 isolates were highly resistant to all the β-lactams tested and to levofloxacin, and had MIC50/MIC90 values in the intermediate − 1 − 1 range for tetracycline and amikacin. MIC50/MIC90 values for eravacycline were 1/2 μgml compared with 2/2 μgml for tigecycline. Eravacycline MICs were often twofold lower than for tigecycline, with 64% of the eravacycline MICs o2 μgml− 1 as compared with o4% of tigecycline MICs. Overall, eravacycline demonstrated the lowest cumulative MICs against this panel of recent CRE and may have the potential to treat infections caused by CRE.