DOCSLIB.ORG

WO 2018/206466 Al 15 November 2018 (15.11.2018) W ! P O PCT

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
WO 2018/206466 Al 15 November 2018 (15.11.2018) W ! P O PCT (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 WO 2018/206466 Al 15 November 2018 (15.11.2018) W ! P O PCT (51) International Patent Classification: HR, HU, ID, IL, IN, IR, IS, JO, JP, KE, KG, KH, KN, KP, A61K 31/403 (2006.01) A61K 31/424 (2006.01) KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, A61K 45/06 (2006.01) A61K 31/43 (2006.01) MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, A61P 31/06 (2006.01) A61K 31/454 (2006.01) OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, A61P 31/08 (2006.01) A61K 31/496 (2006.01) SC, SD, SE, SG, SK, SL, SM, ST, SV, SY,TH, TJ, TM, TN, A61K 31/133 (2006.01) TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (21) International Application Number: (84) Designated States (unless otherwise indicated, for every PCT/EP2018/061615 kind of regional protection available): ARIPO (BW, GH, GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, TZ, (22) International Filing Date: UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, 04 May 2018 (04.05.2018) TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, (25) Filing Language: English EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, SM, (26) Publication Langi English TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW, (30) Priority Data: KM, ML, MR, NE, SN, TD, TG). 17382255.2 08 May 2017 (08.05.2017) EP Declarations under Rule 4.17: (71) Applicants: GLAXOSMITHKLINE INTELLECTUAL — as to applicant's entitlement to apply for and be granted a PROPERTY DEVELOPMENT LIMITED [GB/GB]; patent (Rule 4.1 7(H)) 980 Great West Road, Brentford Middlesex TW8 9GS — as to the applicant's entitlement to claim the priority of the (GB). THE UNIVERSITY OF BRITISH COLUMBIA earlier application (Rule 4.17(Hi)) [CA/CA]; #103-6190 Agronomy Road, Vancouver, British Columbia V6T 1Z3 (CA). Published: — with international search report (Art. 21(3)) (72) Inventors: BARROS AGUIRRE, David; GlaxoSmithK- line, Severo Ochoa 2 Parque Tecnologico de Madrid, Tres Cantos, 28760 Madrid (ES). BATES, Robert H.; GlaxoSmithKline, Severo Ochoa 2 Parque Tecnologico de Madrid, Tres Cantos, 28760 Madrid (ES). GONZALEZ DEL RIO, Ruben; GlaxoSmithKline, Severo Ochoa 2 Par que Tecnologico de Madrid, Tres Cantos, 28760 Madrid (ES). MENDOZA LOSANA, Alfonso; GlaxoSmithKline, Severo Ochoa 2 Parque Tecnologico de Madrid, Tres Can tos, 28760 Madrid (ES). RAMON GARCIA, Santiago; Andador Luis Puntes 10, 4°B, 50008 Zaragoza (ES). (74) Agent: AHERN, Jenna Marie; GlaxoSmithKline, Global Patents (CN925. 1), 980 Great West Road, Brentford M id dlesex TW8 9GS (GB). (81) Designated States (unless otherwise indicated, for every kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, (54) Title: SANFETRINEM OR A SALT OR ESTER THEREOF FOR USE IN TREATING MYCOBACTERIAL INFECTION (57) Abstract: The present invention relates to formula (I) or a pharmaceutically ac ceptable salt or ester prodrug thereof for use in the treatment of a mycobacterial infec tion or disease resulting from a mycobacterial infection, such as tuberculosis. o (I) 00 o o SANFETRINEM OR A SALT OR ESTER THEREOF FOR USE IN TREATING MYCOBACTERIAL INFECTION The work leading to this invention has received funding from the People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme (FP7/2007-2013) under REA grant agreement no. 291799. Field of the Invention The present invention relates to sanfetrinem, or a pharmaceutically acceptable salt or ester prodrug thereof, and its use in the treatment of a mycobacterial infection or a disease resulting from a mycobacterial infection. More specifically, the present invention relates to the use of sanfetrinem, or a pharmaceutically acceptable salt or ester prodrug thereof, in the treatment of tuberculosis. In particular, the present invention relates to the prodrug, sanfetrinem cilexetil, and its use in the treatment of tuberculosis. Background to the Invention Nearly ten million people are infected with tuberculosis (TB) each year, causing 1.5 million deaths each year, according to a report published by The World Health Organisation in 2014. Despite available treatments for tuberculosis, the global disease burden remains a major problem owing to Mycobacterium tuberculosis, the causative bacterial agent for TB, becoming resistant to many of the treatments. Although TB is caused by bacterial infection, the use of the most prominent class of antibiotics, the β-lactams, has been largely ignored. Despite the fact that the dozens of approved β- lactam drugs make up an estimated two thirds of the global antibiotic market, their evaluation against TB was limited by early failures in clinical trials and assumptions that the lypophilic mycobacterial cell wall was impermeable to such highly polar molecules. Sanfetrinem cilexetil is an experimental antibiotic from the 1990s linked with infections caused by a variety of bacterial species but not including mycobacteria. Owing to the ever-growing emergence of multi-drug resistant strains of Mycobacterium tuberculosis and continued high incidence of TB, there exists an urgent need to provide further drug compounds for the treatment of TB. Summary of the Invention In a first aspect of the present invention, there is provided , having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof for use in the treatment of a disease resulting from a mycobacterial infection. In a second aspect of the present invention, there is provided , having the name ( 1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof for use in the treatment of a mycobacterial infection. In a third aspect of the present invention, there is provided , having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof for use in the treatment of tuberculosis. In a fourth aspect of the present invention, there is provided a method for the treatment of a disease resulting from a mycobacterial infection in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of , having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof. In a fifth aspect of the present invention, there is provided a method for the treatment of a mycobacterial infection in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof. In a sixth aspect of the present invention, there is provided a method for the treatment of tuberculosis in a patient in need thereof, comprising administering a therapeutically effective amount of having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof. In a seventh aspect of the present invention, there is provided use of , having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof in the manufacture of a medicament for use in the treatment of tuberculosis, a mycobacterial infection or a disease resulting from a mycobacterial infection. In an eighth aspect of the present invention, there is provided a pharmaceutical composition comprising (a) , having the name ( 1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof; and (b) a pharmaceutically acceptable excipient, for use in the treatment of tuberculosis, a mycobacterial infection or a disease resulting from a mycobacterial infection. In a ninth aspect of the present invention, there is provided a combination of (a) having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof; and (b) a further other anti tuberculosis agent, for use in the treatment of a mycobacterial infection, a disease resulting from a mycobacterial infection, or tuberculosis. In a tenth aspect of the present invention, there is provided a combination of (a) having the name (1S,5S,8aS,8bR)-1-((R)-1-hydroxyethyl)-5- methoxy-2-oxo-1 ,2,5,6,7,8,8a,8b-octahydroazeto[2,1-a]isoindole-4-carboxylic acid, or a pharmaceutically acceptable salt or ester prodrug thereof; and (b) a β-lactamase inhibitor.
Load more

Recommended publications
  • WO 2015/179249 Al 26 November 2015 (26.11.2015) P O P C T
    (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 WO 2015/179249 Al 26 November 2015 (26.11.2015) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every C12N 15/11 (2006.01) A61K 38/08 (2006.01) kind of national protection available): AE, AG, AL, AM, C12N 15/00 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, (21) Number: International Application DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, PCT/US2015/031213 HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, (22) International Filing Date: KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, 15 May 2015 (15.05.2015) MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, (25) Filing Language: English SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, (26) Publication Language: English TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 62/000,43 1 19 May 2014 (19.05.2014) US kind of regional protection available): ARIPO (BW, GH, 62/129,746 6 March 2015 (06.03.2015) US GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, (72) Inventors; and TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, (71) Applicants : GELLER, Bruce, L.
    [Show full text]
  • Failure of Initial Antiretroviral Treatment Regimens
    An update of Current Research January, 1999 The Forum for Collaborative HIV Research, (FCHR) situated within the Center for Health Policy Research (CHPR) at The George Washington University School of Public Health & Health Services, is an independent public-private partnership composed of representatives from multiple interests in the HIV clinical research arena. The FCHR primarily facilitates ongoing discussion and collaboration between appropriate stakeholders on the development and implementation of new clinical studies in HIV and on the transfer of the results of research into clinical practice. The main purpose of the FCHR is to enhance collaboration between interested groups in order to address the critical unanswered questions regarding the optimal medical management of HIV disease. By encouraging coordination among public and private HIV/AIDS clinical research efforts, the FCHR hopes to integrate these efforts into HIV/AIDS medical care settings. Therefore, studies performed by these various research entities, separately or in cooperation, can begin faster; duplication of efforts can be reduced; patient enrollment and retention can be further facilitated; and costs of getting answers to the critical questions can be shared. At present,the FCHR is staffed by three persons and consists of over one hundred members, representing all facets of the field. These include pharmaceutical companies; public and private third-party payors; health care delivery system groups; government agencies; clinical research centers; and patient advocacy groups. The Director of the FCHR is David Barr. For further information about the Forum for Collaborative HIV Research and its projects, please call William Gist at 202-530-2334 or visit our website at: www.gwumc.edu/chpr and click on HIV Research.
    [Show full text]
  • Oxazolidinones for TB
    Oxazolidinones for TB: Current Status and Future Prospects 12th International Workshop on Clinical Pharmacology of Tuberculosis Drugs London, UK 10 September 2019 Lawrence Geiter, PhD Disclosures • Currently contract consultant with LegoChem Biosciences, Inc., Daejeon, Korea (LCB01-0371/delpazolid) • Previously employed with Otsuka Pharmaceutical Development and Commercialization, Inc. (delamanid, OPC-167832, LAM assay) What are Oxazolidinones • A family of antimicrobials mostly targeting an early step in protein synthesis • Cycloserine technically oxazolidinone but 2-oxazolidinone different MOA and chemical properties • New generation oxazolidinones bind to both 50S subunit and 30S subunit • Linezolid (Zyvox) and Tedizolid (Sivestro) approved for drug resistant skin infections and community acquired pneumonia Cycloserine • Activity against TB demonstrated in non- clinical and clinical studies • Mitochondrial toxicity >21 days limits use in TB treatment Linezolid Developing Oxazolidinones for TB Compound Generic Brand Sponsor Development Status TB Code- Activity/Trials PNU-100766 Linezolid Zyvox Pfizer Multiple regimen Yes/Yes TR-201 Tedizolid Sivextro Merck Pre-clinical efficacy Yes/No PNU-100480 Sutezolid Pfizer Multiple regimen studies Sequella Yes/Yes (PanACEA) TB Alliance LCB01-0371 Delpazolid LegoChem Bio EBA trial recruitment completed Yes/Yes TBI-223 - Global Alliance SAD trial launched Yes/Yes AZD5847 Posizolid AstraZenica Completed EBA Yes/No RX-1741 Radezolid Melinta IND for vaginal infections ?/No RBX-7644 Ranbezolid Rabbaxy None found ?/No MRX-4/MRX-1 Contezolid MicuRx Skin infections Yes/No U-100592 Eperezolid ? No clinical trials ?/No PK of Oxazolidinones in Development for TB Steady State PK Parameters Parameter Linezolid 600 Delpazolid 800 mg QD2 mg QD3 Cmax (mg/L) 17.8 8.9 Cmin (mg/L) 2.43 0.1 Tmax (h) 0.87 0.5 T1/2 (h) 3.54 1.7 AUC0-24 (µg*h/mL) 84.5 20.1 1 MIC90 (µg/mL) 0.25 0.5 References 1.
    [Show full text]
  • Infectious Diseases
    2013 MEDICINES IN DEVELOPMENT REPORT Infectious Diseases A Report on Diseases Caused by Bacteria, Viruses, Fungi and Parasites PRESENTED BY AMERICA’S BIOPHARMACEUTICAL RESEARCH COMPANIES Biopharmaceutical Research Evolves Against Infectious Diseases with Nearly 400 Medicines and Vaccines in Testing Throughout history, infectious diseases hepatitis C that inhibits the enzyme have taken a devastating toll on the lives essential for viral replication. and well-being of people around the • An anti-malarial drug that has shown Medicines in Development world. Caused when pathogens such activity against Plasmodium falci- For Infectious Diseases as bacteria or viruses enter a body and parum malaria which is resistant to multiply, infectious diseases were the current treatments. Application leading cause of death in the United Submitted States until the 1920s. Today, vaccines • A potential new antibiotic to treat methicillin-resistant Staphylococcus Phase III and infectious disease treatments have proven to be effective treatments in aureus (MRSA). Phase II many cases, but infectious diseases still • A novel treatment that works by Phase I pose a very serious threat to patients. blocking the ability of the smallpox Recently, some infectious pathogens, virus to spread to other cells, thus 226 such as pseudomonas bacteria, have preventing it from causing disease. become resistant to available treatments. Infectious diseases may never be fully Diseases once considered conquered, eradicated. However, new knowledge, such as tuberculosis, have reemerged new technologies, and the continuing as a growing health threat. commitment of America’s biopharma- America’s biopharmaceutical research ceutical research companies can help companies are developing 394 medicines meet the continuing—and ever-changing and vaccines to combat the many threats —threat from infectious diseases.
    [Show full text]
  • Ep 2531027 B1
    (19) TZZ ¥_Z _T (11) EP 2 531 027 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: A61K 31/4985 (2006.01) A61K 31/52 (2006.01) 06.05.2015 Bulletin 2015/19 A61K 31/536 (2006.01) A61K 31/513 (2006.01) A61K 38/55 (2006.01) A61P 31/18 (2006.01) (21) Application number: 11737484.3 (86) International application number: (22) Date of filing: 24.01.2011 PCT/US2011/022219 (87) International publication number: WO 2011/094150 (04.08.2011 Gazette 2011/31) (54) Therapeutic combination comprising dolutegravir, abacavir and lamivudine Therapeutische Zusammensetzung enthaltend Dolutegravir, Abacavir und Lamivudine Combinaison thérapeutique comprenant du dolutégravir, de l’abacavir et de la lamivudine (84) Designated Contracting States: (74) Representative: Gladwin, Amanda Rachel AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GlaxoSmithKline GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO Global Patents (CN925.1) PL PT RO RS SE SI SK SM TR 980 Great West Road Designated Extension States: Brentford, Middlesex TW8 9GS (GB) BA ME (56) References cited: (30) Priority: 27.01.2010 US 298589 P WO-A1-2010/011812 WO-A2-2009/148600 US-A1- 2006 084 627 US-A1- 2006 084 627 (43) Date of publication of application: US-A1- 2008 076 738 US-A1- 2009 318 421 12.12.2012 Bulletin 2012/50 US-A1- 2009 318 421 US-B1- 6 544 961 (73) Proprietor: VIIV Healthcare Company • SONG1 et al: "The Effect of Ritonavir-Boosted Research Triangle Park, NC 27709 (US) ProteaseInhibitors on the HIV Integrase Inhibitor, S/GSK1349572,in Healthy Subjects", INTERNET , (72) Inventor: UNDERWOOD, Mark, Richard 15 September 2009 (2009-09-15), XP002697436, Research Triangle Park Retrieved from the Internet: URL:http: North Carolina 27709 (US) //www.natap.org/2009/ICCAC/ICCAC_ 52.htm [retrieved on 2013-05-21] 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.
    [Show full text]
  • ( 12 ) United States Patent
    US010426780B2 (12 ) United States Patent (10 ) Patent No. : US 10 ,426 , 780 B2 Underwood (45 ) Date of Patent : Oct . 1 , 2019 ( 54 ) ANTIVIRAL THERAPY 5 ,089 , 500 A 2 / 1992 Daluge 5 ,519 ,021 A 5 / 1996 Young et al. 5 ,641 , 889 A 6 / 1997 Daluge et al . (71 ) Applicant : VIIV HEALTHCARE COMPANY , 5 ,663 , 169 A 9 /1997 Young et al. Wilmington , DE (US ) 5 ,663 , 320 A 9 / 1997 Mansour et al. 5 ,693 ,787 A 12 / 1997 Mansour et al. (72 ) Inventor : Mark Richard Underwood , Research 5 ,696 ,254 A 12 / 1997 Mansour et al. Triangle Park , NC (US ) 5 , 808 , 147 A 9 / 1998 Daluge et al. 5 ,811 , 423 A 9 / 1998 Young et al . 5 , 840 , 990 A 11/ 1998 Daluge et al . ( 73 ) Assignee : ViiV Healthcare Company , 5 , 849 , 911 A 12 / 1998 Fassler et al. Wilmington , DE (US ) 5 , 905 , 082 A 5 / 1999 Roberts et al. 5 , 914 , 332 A 6 / 1999 Sham et al . ( * ) Notice : Subject to any disclaimer , the term of this 5 ,917 ,041 A 6 / 1999 Daluge et al. patent is extended or adjusted under 35 5 ,917 , 042 A 6 / 1999 Daluge et al . 5 ,919 ,941 A 7 / 1999 Daluge et al. U . S . C . 154 (b ) by 0 days. 5 , 922 ,695 A 7 / 1999 Arimilli et al. 5 , 935 , 94 A 8 / 1999 Munger et al . (21 ) Appl. No. : 15 / 366 , 442 5 ,977 ,089 A 11/ 1999 Arimilli et al . 6 ,043 ,230 A 3 / 2000 Arimilli et al . ( 22 ) Filed : Dec .
    [Show full text]
  • Lamivudine in Combination with Zidovudine, Stavudine, Or Didanosine in Patients with HIV-1 Infection
    Lamivudine in combination with zidovudine, stavudine, or didanosine in patients with HIV-1 infection. A randomized, double-blind, placebo-controlled trial Daniel R. Kuritzkes*, Ian Marschner†, Victoria A. Johnson‡, Roland Bassett†, Joseph J. Eron§, Margaret A. FischlII, Robert L. Murphy¶, Kenneth Fife**, Janine Maenza††, Mary E. Rosandich*, Dawn Bell‡‡, Ken Wood§§, Jean-Pierre Sommadossi‡, Carla PettinelliII II and the National Institute of Allergy and Infectious Disease AIDS Clinical Trials Group Protocol 306 Investigators Objective: To study the antiviral activity of lamivudine (3TC) plus zidovudine (ZDV), didanosine (ddI), or stavudine (d4T). Design: Randomized, placebo-controlled, partially double-blinded multicenter study. Setting: Adult AIDS Clinical Trials Units. Patients: Treatment-naive HIV-infected adults with 200–600 × 106 CD4 T lymphocytes/l. Interventions: Patients were openly randomized to a d4T or a ddI limb, then randomized in a blinded manner to receive: d4T (80 mg/day), d4T plus 3TC (300 mg/day), or ZDV (600 mg/day) plus 3TC, with matching placebos; or ddI (400 mg/day), ddI plus 3TC (300 mg/day), or ZDV (600 mg/day) plus 3TC, with matching placebos. After 24 weeks 3TC was added for patients assigned to the monotherapy arms. Main outcome measure: The reduction in plasma HIV-1 RNA level at weeks 24 and 48. From the *University of Colorado Health Sciences Center and Veterans Affairs Medical Center, Denver, Colorado, the †Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts, the
    [Show full text]
  • Newer Anti-TB Drugs and Drug Delivery Systems
    Chapter 86 Newer Anti-TB Drugs and Drug Delivery Systems Alladi Mohan, D Prabath Kumar, J Harikrishna INTRODUCTION TABLE 1 │ Currently used antituberculosis drugs Tuberculosis (TB) has been a leading cause of death since time Essential first-line antituberculosis drugs immemorial and it continues to cause immense human misery even today. As per the currently available Global Tuberculosis Control Isoniazid 1 Rifampicin Report 2012 of the World Health Organization (WHO) in the year Ethambutol 2011, there were 8.7 million incident cases of TB and 1.4 million Pyrazinamide deaths. Effective predictable treatment of TB became available Streptomycin only in the mid-1940s with the introduction of streptomycin. In Second-line parenteral agent (injectable antituberculosis drugs) the late 1970s, TB appeared to be fading away from being a major public health problem at least in the developed countries. The Kanamycin human immunodeficiency virus (HIV) infection and acquired Amikacin Capreomycin immunodeficiency syndrome (AIDS) pandemic in the early 1980s resulted in a global resurgence of TB.2 The recent years have also Fluoroquinolones witnessed the emergence and global presence of multidrug-resistant Ciprofloxacin TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) that are Ofloxacin highly lethal, extremely expensive and complicated to treat have Levofloxacin been causing concern worldwide.3 Moxifloxacin A major paradigm shift in the treatment of TB occurred with Gatifloxacin the introduction of rifampicin, the last landmark drug introduced Oral bacteriostatic second-line antituberculosis drugs 4 for TB treatment. Based on the data from studies conducted in the Ethionamide 1970s, the standard treatment duration of anti-TB treatment could be Prothionamide shortened to 9 months.
    [Show full text]
  • Detection, Survival and Infectious Potential of Mycobacterium Tuberculosis in the Environment: a Review of the Evidence and Epidemiological Implications
    REVIEW TUBERCULOSIS Detection, survival and infectious potential of Mycobacterium tuberculosis in the environment: a review of the evidence and epidemiological implications Leonardo Martinez1, Renu Verma1, Julio Croda2,3, C. Robert Horsburgh Jr4,5, Katharine S. Walter1, Nicholas Degner1, Keren Middelkoop6,7, Anastasia Koch8, Sabine Hermans6,9, Digby F. Warner 8,10, Robin Wood6, Frank Cobelens9 and Jason R. Andrews1 Affiliations: 1Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA. 2Oswaldo Cruz Foundation, Campo Grande and Salvador, Brazil. 3School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil. 4Dept of Medicine, Boston University School of Medicine, Boston, MA, USA. 5Dept of Epidemiology, Biostatistics and Global Health, Boston University School of Public Health, Boston, MA, USA. 6The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 7Dept of Medicine, University of Cape Town, Cape Town, South Africa. 8SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, Dept of Pathology and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 9Dept of Global Health, Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands. 10Wellcome Center for Infectious Diseases Research in Africa, Institute of Infectious Diseases
    [Show full text]
  • Antibiotic Use and Abuse: a Threat to Mitochondria and Chloroplasts with Impact on Research, Health, and Environment
    Insights & Perspectives Think again Antibiotic use and abuse: A threat to mitochondria and chloroplasts with impact on research, health, and environment Xu Wang1)†, Dongryeol Ryu1)†, Riekelt H. Houtkooper2)* and Johan Auwerx1)* Recently, several studies have demonstrated that tetracyclines, the antibiotics Introduction most intensively used in livestock and that are also widely applied in biomedical research, interrupt mitochondrial proteostasis and physiology in animals Mitochondria and chloroplasts are ranging from round worms, fruit flies, and mice to human cell lines. Importantly, unique and subcellular organelles that a plant chloroplasts, like their mitochondria, are also under certain conditions have evolved from endosymbiotic - proteobacteria and cyanobacteria-like vulnerable to these and other antibiotics that are leached into our environment. prokaryotes, respectively (Fig. 1A) [1, 2]. Together these endosymbiotic organelles are not only essential for cellular and This endosymbiotic origin also makes organismal homeostasis stricto sensu, but also have an important role to play in theseorganellesvulnerabletoantibiotics. the sustainability of our ecosystem as they maintain the delicate balance Mitochondria and chloroplasts retained between autotrophs and heterotrophs, which fix and utilize energy, respec- multiple copies of their own circular DNA (mtDNA and cpDNA), a vestige of the tively. Therefore, stricter policies on antibiotic usage are absolutely required as bacterial DNA, which encodes for only a their use in research confounds experimental outcomes, and their uncontrolled few polypeptides, tRNAs and rRNAs [1, 3, applications in medicine and agriculture pose a significant threat to a balanced 4]. Furthermore, both mitochondria and ecosystem and the well-being of these endosymbionts that are essential to chloroplasts have bacterial-type ribo- sustain health.
    [Show full text]
  • Computational Antibiotics Book
    Andrew V DeLong, Jared C Harris, Brittany S Larcart, Chandler B Massey, Chelsie D Northcutt, Somuayiro N Nwokike, Oscar A Otieno, Harsh M Patel, Mehulkumar P Patel, Pratik Pravin Patel, Eugene I Rowell, Brandon M Rush, Marc-Edwin G Saint-Louis, Amy M Vardeman, Felicia N Woods, Giso Abadi, Thomas J. Manning Computational Antibiotics Valdosta State University is located in South Georgia. Computational Antibiotics Index • Computational Details and Website Access (p. 8) • Acknowledgements (p. 9) • Dedications (p. 11) • Antibiotic Historical Introduction (p. 13) Introduction to Antibiotic groups • Penicillin’s (p. 21) • Carbapenems (p. 22) • Oxazolidines (p. 23) • Rifamycin (p. 24) • Lincosamides (p. 25) • Quinolones (p. 26) • Polypeptides antibiotics (p. 27) • Glycopeptide Antibiotics (p. 28) • Sulfonamides (p. 29) • Lipoglycopeptides (p. 30) • First Generation Cephalosporins (p. 31) • Cephalosporin Third Generation (p. 32) • Fourth-Generation Cephalosporins (p. 33) • Fifth Generation Cephalosporin’s (p. 34) • Tetracycline antibiotics (p. 35) Computational Antibiotics Antibiotics Covered (in alphabetical order) Amikacin (p. 36) Cefempidone (p. 98) Ceftizoxime (p. 159) Amoxicillin (p. 38) Cefepime (p. 100) Ceftobiprole (p. 161) Ampicillin (p. 40) Cefetamet (p. 102) Ceftoxide (p. 163) Arsphenamine (p. 42) Cefetrizole (p. 104) Ceftriaxone (p. 165) Azithromycin (p.44) Cefivitril (p. 106) Cefuracetime (p. 167) Aziocillin (p. 46) Cefixime (p. 108) Cefuroxime (p. 169) Aztreonam (p.48) Cefmatilen ( p. 110) Cefuzonam (p. 171) Bacampicillin (p. 50) Cefmetazole (p. 112) Cefalexin (p. 173) Bacitracin (p. 52) Cefodizime (p. 114) Chloramphenicol (p.175) Balofloxacin (p. 54) Cefonicid (p. 116) Cilastatin (p. 177) Carbenicillin (p. 56) Cefoperazone (p. 118) Ciprofloxacin (p. 179) Cefacetrile (p. 58) Cefoselis (p. 120) Clarithromycin (p. 181) Cefaclor (p.
    [Show full text]
  • Recent Advances in Antiviral Therapy J Clin Pathol: First Published As 10.1136/Jcp.52.2.89 on 1 February 1999
    J Clin Pathol 1999;52:89–94 89 Recent advances in antiviral therapy J Clin Pathol: first published as 10.1136/jcp.52.2.89 on 1 February 1999. Downloaded from Derek Kinchington Abstract indicated that using a combination of drugs In the early 1980s many institutions in might overcome this problem. The only Britain were seriously considering available drugs during the late 1980s were two whether there was a need for specialist other nucleotide reverse transcriptase inhibi- departments of virology. The arrival of tors (NRTI) which also targeted HIV reverse HIV changed that perception and since transcriptase (HIV-RT): 2',3'-dideoxycytidine then virology and antiviral chemotherapy (ddC) and 2',3'-dideoxyinosine (ddI).56 In have become two very active areas of bio- vitro combination studies gave surprising medical research. Cloning and sequencing results: those viruses that became highly resist- have provided tools to identify viral en- ant to ZDV remained sensitive to both ddC zymes and have brought the day of the and ddI.7 Furthermore, neither cross resistance “designer drug” nearer to reality. At the nor interference between the drugs was an other end of the spectrum of drug discov- issue, and subsequent clinical experience ery, huge numbers of compounds for showed that patients benefited when these two screening can now be generated by combi- compounds were used in combination with natorial chemistry. The impetus to find ZDV.8 It was also found by in vitro studies that drugs eVective against HIV has also virus isolated from patients on long term ZDV stimulated research into novel treatments monotherapy had become insensitive to ZDV, for other virus infections including her- but regained sensitivity when these patients pesvirus, respiratory infections, and were switched to ddI monotherapy.
    [Show full text]