In vitro and in vivo activity of carbamate-linked dual-action antibacterial Ro 24-4383.

Ro 24-4383 contains desacetylcefotaxime linked by a carbamate bond at the 3' position to ciprofloxacin. Ro 24-4383 was active against 99% of the 363 gram-positive and gram-negative aerobes tested in vitro, while the comparative agents cefotaxime and ciprofloxacin were active against 77 and 97%, respectively. The activities (ED50: mg/kg s.c.) of Ro 24-4383, cefotaxime and ciprofloxacin in systemic murine infections were: Escherichia coli 257, 1.4, less than 0.5, less than 0.2; Klebsiella pneumoniae A, 11, 30, 0.7; Enterobacter cloacae 5699, 3.2, 35, less than 0.2; Citrobacter freundii BS16, 3, 41, less than 0.5; Serratia marcescens SM, 35, greater than 100, 1.6; Pseudomonas aeruginosa 5712, 67, 100, 10; P. aeruginosa 8780, 33, 193, 3; Staphylococcus aureus Smith (oxacillin-susceptible), 12, 3.7, 1; S. aureus 753 (oxacillin-resistant), 28, greater than 100, 2; Streptococcus pneumoniae 6301, 10, 15, greater than 50, and S. pyogenes 4, 3.3, 1.6, 54. Ro 24-4383, although inactive against the S.-pneumoniae-induced pneumonia following one administration of the agent, was highly active (ED50 = 1.5) when three treatments were given following infection. Ro 24-4383 was active against the K.-pneumoniae-induced pneumonia (ED50 = 37), as well as the meningitis induced by S. pneumoniae (ED50 = 158) or K. pneumoniae (ED50 = 100). The protective effect of Ro 24-4383 was demonstrated when administered 8 h before infection with E. coli (ED50 = 37) and 4 h before infection with S. pyogenes (ED50 = 199).

In vivo evaluation of a dual-action antibacterial, Ro 23-9424, compared to cefotaxime and fleroxacin.

The dual-action antibacterial R 23-9424 (desacetylcefotaxime linked to the quinolone fleroxacin) is a new antibacterial agent with excellent in vitro activity. It was evaluated for in vivo efficacy in comparison with the cephalosporin cefotaxime and the quinolone component, fleroxacin. Ro 23-9424 demonstrated significant activity against all strains tested in systemic infections, including those strains resistant in vivo to cefotaxime (Staphylococcus aureus 753, Serratia marcescens SM and Pseudomonas aeruginosa 8780) and fleroxacin (Streptococcus pneumoniae 6301 and Streptococcus pyogenes. In prophylactic studies, Ro 23-9424 compared favorably with fleroxacin against Escherichia coli and with cefotaxime against S. pyogenes, but Ro 23-9424 was considerably more active than cefotaxime against E. coli and more active than fleroxacin against S. pyogenes. In a murine pneumonia model, Ro 23-9424 was equivalent in activity to cefotaxime against S. pneumoniae and more active than cefotaxime against Klebsiella pneumoniae. Fleroxacin was inactive against S. pneumoniae and about 20-fold more active than Ro 23-9424 against K. pneumoniae. In a murine meningitis infection caused by S. pneumoniae, Ro 23-9424 was 3 times as active as cefotaxime, while fleroxacin was inactive. When meningitis was induced by K. pneumoniae, Ro 23-9424 was as active as the quinolone, while cefotaxime was inactive. In a neutropenic (immunocompromised) model, Ro 23-9424 was more active than cefotaxime against P. aeruginosa and 5-fold less active than fleroxacin. In the control normal (immunocompetent) mouse infection, Ro 23-9424 was 3-fold more active than cefotaxime, but 10-fold less active than fleroxacin.

Enteral, oral, and rectal absorption of ceftriaxone using glyceride enhancers.

In vivo models in rodents and primates were used to investigate ways of overcoming the poor oral and rectal absorption of ceftriaxone. The sodium salt of ceftriaxone at 20 mg/kg was formulated in C8-C10 chain length, mono- and diglyceride extracts of coconut oil (Capmul) and administered intraduodenally to adult rats. Peak plasma levels of 17-52 micrograms/ml and bioavailability averaging 38% were attained. Significant plasma levels (42-45 micrograms/ml) were also demonstrated in squirrel monkeys with doses of 20 mg/kg ceftriaxone formulated in Capmul and given by the enteral route. Enteric-coated capsules containing this formulation were also orally administered to squirrel monkeys and gave high plasma levels (10-31 micrograms/ml) between 1 and 6 h following dosing. In rectal absorption studies, ceftriaxone formulated in Capmul as a suspension gave peak blood levels of 62-84 micrograms/ml (average bioavailability 42%) in the rabbit. In the baboon, rectal administration of ceftriaxone formulated with Capmul in a Witepsol H15 suppository gave Cmax levels ranging from 9 to 48 micrograms/ml, depending on the dose of the antibiotic and the drug/enhancer ratio.

In vitro activity of Ro 19-5247 (T-2525) and interpretive criteria for disk diffusion susceptibility testing.

The activity of Ro 19-5247 (the active metabolite of the oral cephalosporin Ro 19-5248 [T-2588]) was compared with that of five orally active agents against a total of 331 bacterial strains. Ro 19-5247 was more active in vitro than amoxicillin, amoxicillin-clavulanate, cefaclor, cefuroxime, and cephalexin against members of the family Enterobacteriaceae. Amoxicillin-clavulanate and amoxicillin overall were more active than the other four agents against staphylococci. Ro 19-5247, amoxicillin-clavulanate, amoxicillin, and cefuroxime were equally active against nonenterococcal streptococci and more active than cefaclor and cephalexin. All six agents showed little or no activity against nonfermentative gram-negative bacteria. Against Streptococcus (Enterococcus) faecalis, only amoxicillin and amoxicillin-clavulanate were active. The interpretive criteria for in vitro susceptibility testing with 10- and 30-micrograms Ro 19-5247 disks were established by regression analysis to correlate the inhibitory zone sizes and MICs for the bacterial isolates. The suggested tentative zone size breakpoints for the 10-micrograms disk are as follows: susceptible, greater than or equal to 22 mm (MIC, less than or equal to 2 micrograms/ml); moderately susceptible, 20 to 21 mm (MIC, 4 micrograms/ml); and resistant, less than or equal to 19 mm (MIC, greater than or equal to 8 micrograms/ml).

Antibacterial activity of 2',3'-dideoxyadenosine in vivo and in vitro.

2',3'-Dideoxyadenosine (DDA) was shown not only to possess antibacterial activity in vitro against a variety of Enterobacteriaceae, but also to be effective in vivo, DDA was active in experimental mouse infections by the oral route against 5 Salmonella strains, 2 of 3 Arizona strains, 5 of 7 Citrobacter strains, 3 of 8 Klebsiella strains, 3 of 5 Escherichia strains, 1 of 3 Shigella strains, and 3 of 15 Serratia strains at concentrations generally well below the toxic level. Closely related compounds, with the exception of 2',3'-dideoxyinosine, were found to be inactive in vivo, indicating that a high degree of structural specificity was required for activity. The synthesis of deoxyribonucleic acid was inhibited by DDA in those strains susceptible in vitro to DDA, whereas ribonucleic acid and protein syntheses were not affected. The concentration of DDA which inhibited bacterial deoxyribonucleic acid synthesis by 50% was calculated based on the relative rates of deoxyribonucleic acid synthesis in ;the absence and in the presence of DDA. This value correlated well with the minimal inhibitory concentration determined by the in vitro broth dilution assay but not always with in vivo activity determined by the mouse protection test.