Macrocyclic Antibiotics Research Articles

Antimicrobial activity of fidaxomicin against Clostridium difficile clinical isolates in Aichi area in Japan.

We evaluated the susceptibility of 100 Japanese Clostridium difficile isolates to fidaxomicin, a new macrocyclic antibiotic. The minimum inhibitory concentration (MIC) range of fidaxomicin was 0.03-0.5μg/mL, with a MIC for inhibition of 50% (MIC50) of 0.12μg/mL, and for inhibition of 90% (MIC90) of 0.25μg/mL. We also evaluated the susceptibilities of the same 100 C.difficile isolates to vancomycin, metronidazole, moxifloxacin, clindamycin, meropenem, and ampicillin. Of all the antibiotics tested, fidaxomicin showed the most potent antimicrobial activity against this group of C.difficile isolates. MIC levels against C.difficile isolates, including those producing binary toxin, did not substantially differ from those previously reported in Europe, North America and Taiwan.

Engineering of the LysR family transcriptional regulator FkbR1 and its target gene to improve ascomycin production.

Ascomycin (FK520), a macrocyclic polyketide natural antibiotic, displays high anti-fungal and immunosuppressive activity. In this study, the LysR family transcriptional regulator FkbR1 was characterized, and its role in ascomycin biosynthesis was explored by gene deletion, complementation, and overexpression. Inactivation of fkbR1 led to 67.5% reduction of ascomycin production, which was restored by complementation of fkbR1. Overexpression of fkbR1 resulted in a 33.5% increase in ascomycin production compared with the parent strain FS35. These findings indicated that FkbR1 was a positive regulator for ascomycin production. Quantitative RT-PCR analysis revealed that the expressions of fkbE, fkbF, fkbS, and fkbU were downregulated in the fkbR1 deletion strain and upregulated in the fkbR1 overexpression strain. Electrophoretic mobility shift assays (EMSAs) in vitro and chromatin immunoprecipitation (ChIP)-qPCR assays in vivo indicated that FkbR1 bound to the intergenic region of fkbR1-fkbE. To investigate the roles of the target genes fkbE and fkbF in ascomycin production, the deletion and overexpressions of fkbE and fkbF were implemented, respectively. Overexpression of fkbE resulted in a 45.6% increase in ascomycin production, but little change was observed in fkbF overexpression strain. To further enhance ascomycin production, the fkbR1 and fkbE combinatorial overexpression strain OfkbRE was constructed with the ascomycin yield increased by 69.9% to 536.7mg/L compared with that of the parent strain. Our research provided a helpful strategy to increase ascomycin production via engineering FkbR1 and its target gene.

Cost-effectiveness analysis on the use of fidaxomicin and vancomycin to treat Clostridium difficile infection in France

Background: Fidaxomicin is a macrocyclic antibiotic with proven efficacy against Clostridium difficile infection (CDI) in adults. It was licensed in France in 2012, but, due to higher acquisition costs compared with existing treatments, healthcare providers require information on its cost/benefit profile.Objective: To compare healthcare costs and health outcomes of fidaxomicin and vancomycin, as reference treatment for CDI.Methods: A Markov model was used to simulate the treatment pathway, over 1 year, of adult patients with CDI receiving fidaxomicin or vancomycin. Several patient sub-groups (severe CDI; recurrent CDI; concomitant antibiotics; cancer; renal failure; elderly) were evaluated. Cost-effectiveness was analyzed based on cure and recurrence rates derived from published randomized clinical trials comparing fidaxomicin and vancomycin, and costs calculated from the payer perspective using French hospitalization data and drug cost databases. Model outputs included costs in euros (reference year 2014) and health outcomes (recurrence; sustained cure rates). Alternative scenario and sensitivity analyses were performed using data from other clinical trials in CDI, including one conducted in real-life clinical practice in France.Results: Drug acquisition costs were €1,692 higher in fidaxomicin-treated patients, but this was offset by the lower hospitalization costs with fidaxomicin, which were reduced by €1,722. The reduction in the cost of hospitalization was driven by the significantly lower number of recurrences in fidaxomicin-treated patients, offsetting the acquisition cost of fidaxomicin in all sub-groups except recurrent CDI and concomitant antibiotics.Conclusion: This study demonstrated that, despite higher acquisition costs, the lower recurrence rate with fidaxomicin resulted in cost savings or low incremental costs compared with vancomycin.

Determination of the enantiomeric purity of albuterol on sorbents modified by macrocyclic antibiotics

The separation of albuterol enantiomers on sorbents with macrocyclic glycopeptide antibiotics immobilized on the silica surface was investigated. Commercial columns—Nautilus-E (BioKhimMak, Russia) with eremomycin as a chiral selector and ChirobioticTAG (Astec, United States) with teicoplanin aglycone as a chiral selector—were used for enantioseparation. Levalbuterol is the (R)-enantiomer of albuterol. We managed to separate albuterol enantiomers on both columns in a polar organic mode, but selectivity was higher on the ChirobioticTAG column (R s = 1.7). The maximum resolution of enantiomer peaks (1.7) was observed in methanol–acetonitrile–triethylamine–acetic acid (90: 10: 0.05: 0.05) as the mobile phase. The detection limit of the compound calculated by a signal–background ratio of 3: 1 was 0.00002 mg/mL, which corresponds to 0.1% of (S)-enantiomer with respect to the total amount. The results made it possible to determine the enantiomeric purity of the active pharmaceutical substances of levalbuterol.

Research progress of bonded chiral stationary phases

Chiral separation is important in biological medicine and other fields. High performance liquid chromatography (HPLC) is widely used in chiral separation and analysis for its economic, rapid and efficient characteristics. Chiral stationary phase (CSP) is the key to achieve chiral resolution in HPLC. Meanwhile, the key to preparing effective CSP is the screening of chiral selector. In recent years, a lot of CSPs with different chiral selectors had been prepared. Silica gel immobilized CSP is especially attached great attention because of its high solvent tolerance and stability. In this paper, the new type of CSPs prepared by using chiral single molecules, polysaccharides, cyclodextrins, macrocyclic antibiotics, crown ethers, calixarenes and alkaloids as chiral selectors are summarized, and the development prospect of immobilized CSPs are also discussed.

Separation of β-blocker and amino acid enantiomers on a mixed chiral sorbent modified with macrocyclic antibiotics eremomycin and vancomycin

A mixed chiral sorbent based on silica with immobilized macrocyclic antibiotics eremomycin and vancomycin was synthesized. A possibility of the separation of enantiomers of β-blockers (metoprolol, pindolol, alprenolol, oxprenolol, labetalol, and atenolol) and amino acids (tryptophan, phenylalanine, DOPA, methionine, and acetyl glutamic acid) on this chiral sorbent by HPLC was studied. The influence of the composition of the mobile phase (pH of buffer solution, its concentration, content of organic modifier, and its nature) on the retention times of β-blocker and amino acid enantiomers, selectivity, and resolution of peaks was studied. It was shown that the mixed chiral sorbent has enantioselectivity to both classes of compounds, while silica modified with vancomycin has no ability to the separation of enantiomers of non-derivatized amino acids, and silica modified with eremomycin has no ability to the separation of β-blocker enantiomers. High values of resolution for amino acids (max Rs > 4) and β-blockers (max Rs > 1) were obtained.

Micrococcin P1, a naturally occurring macrocyclic peptide inhibiting hepatitis C virus entry in a pan-genotypic manner

Hepatitis C virus (HCV) is considered a major public health concern worldwide. Despite recent advances in curing chronic hepatitis C, unmet medical needs still remain, especially due to the high economic burden of therapies. Accordingly, our study aimed to identify affordable novel HCV inhibitors by screening of natural product compound libraries. We identified micrococcin P1, a macrocyclic peptide antibiotic, inhibiting HCV entry in a pan-genotypic manner with an EC50 range of 0.1–0.5 μM. Micrococcin P1 interfered with HCV entry at an attachment step. Furthermore, micrococcin P1 efficiently inhibited HCV spread by blocking cell-free infection as well as cell-to-cell transmission, without affecting the secretion of infectious virions. Interestingly, the putative molecular target of micrococcin P1 is glycoprotein E2 (IIe-630-Thr), as revealed by selection for viral drug resistance. In addition, micrococcin P1 inhibited sofosbuvir-resistant HCV strains and showed synergy in combination with selected HCV drugs, suggesting an alternative treatment paradigm for patients. In conclusion, we identified micrococcin P1 as specifically inhibiting entry of all HCV genotypes and demonstrated that micrococcin P1 potentially could add value to therapies in combination with current HCV interventions.

HPLC Enantioseparation of Phenylcarbamic Acid Derivatives by Using Macrocyclic Chiral Stationary Phases

Abstract The HPLC by using chiral stationary phases based on macrocyclic antibiotics, dimethylphenyl carbamate cyklofructan 7 and β-cyclodextrin in terms of polar-organic separation mode (mobile phase methanol/acetonitrile/acetic acid/triethylamine) were used for enantioseparation of alkoxy derivatives of phenylcarbamic acid. The effect of the analyte structures on the efficiency of enantioseparation was investigated. The most suitable stationary phase was teicoplanin aglycone, where the separations of the enantiomers were obtained (the resolution value from 0.65 to 2.90, depending on the structure of the analyte). Significant effect on the resolution of the enantiomers has position of alkoxy substituent in the hydrophobic part of the molecule. The enantiorecognition was achieved for 3-alkoxysubstituted derivatives.

Synthesis and antimicrobial activity against Pseudomonas aeruginosa of macrocyclic β-hairpin peptidomimetic antibiotics containing N-methylated amino acids

Antimicrobial resistance among Gram-negative bacteria is a growing problem, fueled by the paucity of new antibiotics that target these microorganisms. One novel family of macrocyclic β-hairpin-shaped peptidomimetics was recently shown to act specifically against Pseudomonas spp. by a novel mechanism of action, targeting the outer membrane protein LptD, which mediates lipopolysaccharide transport to the cell surface during outer membrane biogenesis. Here we explore the mode of binding of one of these β-hairpin peptidomimetics to LptD in Pseudomonas aeruginosa, by examining the effects on antimicrobial activity following N-methylation of individual peptide bonds. An N-methyl scan of the cyclic peptide revealed that residues on both sides of the β-hairpin structure at a non-hydrogen bonding position likely mediate hydrogen-bonding interactions with the target LptD. Structural analyses by NMR spectroscopy further reinforce the conclusion that the folded β-hairpin structure of the peptidomimetic is critical for binding to the target LptD. Finally, new NMe analogues with potent activity have been identified, which opens new avenues for optimization in this family of antimicrobial peptides.

Enantiomeric resolution of multiple chiral centres racemates by capillary electrophoresis.

Enantiomeric resolution of multichiral centre racemates is an important area as some multichiral centre racemates are of great medicinal importance. However, enantioseparation of such types of racemates is a challenging task. Amongst many analytical techniques, capillary electrophoresis is a powerful technique and may be used to resolve such racemates. Only few papers are available describing enantiomeric resolution of such racemates. Therefore, efforts have been made to describe the enantiomeric resolution of multichiral centre racemates by capillary electrophoresis. This article discusses the importance of multichiral racemates, the need for capillary electrophoresis in enantiomeric resolution and chiral resolution of multichiral centre racemates using various chiral selectors. Further, attempts have been made to discuss the future challenges and prospects of enantiomeric resolution of multichiral racemates. The various chiral selectors used for the purpose are chiral crown ether, cyclodextrins, polysaccharides, macrocyclic glycopeptide antibiotics and ligand exchange.

Determination of the enantiomeric purity of Pemetrexed on the macrocyclic glycopeptides bonded phases

The enantioseparation of Pemetrexed on chiral sorbents with macrocyclic glycopeptide antibiotics as chiral selectors was investigated. The pharmacological group of Pemetrexed is antimetabolites with antitumor activity. Pemetrexed is a structural analog of folic acid. IUPAC name of this drug is disodium (2 S )-2-[[4-[2-(2-amino-4-oxo-4,7-dihydro-1 H -pyrrolo[2,3- d ]pyrimidin-5-yl)ethyl]benzoyl]amino]pentanedioate heptahydrate. The mechanism of Pemetrexed antitumor action is based on the inhibition of the synthesis of purine and pyrimidine. Chiral stationary phases with antibiotics of different structures were used. Columns with silica modified antibiotic eremomycin (commercial column Nautilus-E, Bio-Chem-Mac, Russia) and silica with teicoplanin aglycone (ChirobioticTAG, Astec, USA) were applied. The separation of the enantiomers was carried out by the reversed-phase and polar-ion chromatography modes. The mobile phase in the reversed-phase chromatography mode was a mixture of ammonium dihydrogenphosphate solution and organic solvents (methanol, acetonitrile), and in polar-ion mode – organic solvents (methanol, acetonitrile) with additives of acids (acetic acid, formic acid) and bases (triethylamine, diethylamine). The influence of the components’ nature and concentration in the mobile phase, their composition and pH on the separation of Pemetrexed enantiomers was investigated using the silica modified eremomycin and teicoplanin aglycone. The resolution of Pemetrexed enantiomers was 2.8 - 3.3 in the reverse phase mode on the column with eremomycin. In the polar-ion mode chromatography, Pemetrexed eluted with dead volume (capacity factor k ` = 0.1 ÷ 0.3) independently of the additives concentrations in the mobile phase. The enantiomers of Pemetrexed were not separated on the column with teicoplanin aglycone. Teicoplanin aglycone has one amino-group only, whereas eremomycin has three amino-groups. Electrostatic interactions between teicoplanin aglycone and Pemetrexed were less than interactions between eremomycin and Pemetrexed. Eremomycin has more chiral centers than teicoplanin aglycone. In addition, hydrophobic interactions, hydrogen bonds and dipolar interactions with amide and hydroxyl groups of eremomycin provide high enantioselectivity of sorbent with eremomycin. The determination of enantiomeric purity of Pemetrexed drug on the column with eremomycin was conducted. Mobile phase was (55:15:30) MeOH:ACN:NH 4 H 2 PO 4 (50mM, pH = 2.5). The time of analysis was less than 10 minutes. D-isomer was not detected in the drug. The limit of detection of Pemetrexed D-enantiomer was 0.0003 mg/ml (assumed 3:1 signal to noise ratio) which constituted 0.12 % from the total amount drug. Keywords : macrocyclic glucopeptides, chiral selector, enantiomers, enantiomeric purity of the pharmaceutical substances (Russian) DOI: h ttp://dx.doi.org/10.15826/analitika.2016.20.2.002 E.N. Shapovalova, I.A. Fedorova, A.A. Priporova, I.A. Ananieva, O.A. Shpigun M.V.Lomonosov Moscow State University, 1-3 Leninskie gory, Moscow, , 119991, Russian Federation

Affinity Capillary Electrophoresis Applied to Investigation of Valinomycin Complexes with Ammonium and Alkali Metal Ions.

This chapter deals with the application of affinity capillary electrophoresis (ACE) to investigation of noncovalent interactions (complexes) of valinomycin, a macrocyclic dodecadepsipeptide antibiotic ionophore, with ammonium and alkali metal ions (lithium, sodium, potassium, rubidium, and cesium). The strength of these interactions was characterized by the apparent binding (stability, association) constants (K b) of the above valinomycin complexes using the mobility shift assay mode of ACE. The study involved measurements of effective electrophoretic mobility of valinomycin at variable concentrations of ammonium or alkali metal ions in the background electrolyte (BGE). The effective electrophoretic mobilities of valinomycin measured at ambient temperature and variable ionic strength were first corrected to the reference temperature 25 °C and constant ionic strength (10 or 25 mM). Then, from the dependence of the corrected valinomycin effective mobility on the ammonium or alkali metal ion concentration in the BGE, the apparent binding constants of the valinomycin-ammonium or valinomycin-alkali metal ion complexes were determined using a nonlinear regression analysis. Logarithmic form of the binding constants (log K b) were found to be in the range of 1.50-4.63, decreasing in the order Rb(+) > K(+) > Cs(+) > > Na(+) > NH4 (+) ~ Li(+).

Management of Clostridium difficile in a developing nation

Introduction: Clostridium difficile is the most important definable cause of healthcare acquired diarrhea. Recommended treatments for Clostridium difficile infection (CDI) are metronidazole, oral vancomycin and fidaxomicin (a new narrow spectrum macrocyclic antibiotic). Aim: The aim of this investigation was to review the treatment of CDI in Iran. Method: 1600 medical records and prescriptions were scrutinized for patients complaining of diarrhea, colitis and gastroenteritis. The therapeutic route was investigated in each individual case bearing in mind the medical and medication history as well as other co-morbidities. Results: The selection of antibiotic by many medical practitioners for the treatment of diarrhea, colitis and gastroenteritis were inappropriate and random. In most cases the chosen antibiotic, can itself be associated with initiation or worsening of CDI. Conclusion: The needs for antimicrobial stewardship program to preserve the effectiveness of current available therapies are strongly recommended. This program must focus on the overall reduction of inappropriate antibiotic prescribing and ultimately on enforcing the adherence to the reputable antibacterial guidelines.

Clostridium difficile versus general gastroenteritis: A critical review of a concept

Objective: Clostridium difficile is the most important definable cause of healthcare-acquired diarrhea which is mostly associated with inappropriate use of broad-spectrum antibiotics. Recommended treatments for C. difficile infection (CDI) are metronidazole, oral vancomycin, and fidaxomicin (a new narrow spectrum macrocyclic antibiotic). The aim of this investigation was to review the chosen management of general gastroenteritis against risks associated with inappropriate therapeutic options such as CDI in the largest teaching medical school in Iran. Methods: Two thousand medical records and prescriptions were scrutinized, between March 2012 and July 2013 in Phase 1 and September 2014-January 2015 in Phase 2 for patients complaining of diarrhea, colitis, and gastroenteritis. The therapeutic route was investigated in each individual case bearing in mind the medical and medication history as well as other comorbidities. The selection of antibiotic by many medical practitioners for the treatment of mentioned complaints was inappropriate and random. Results: In most cases, the chosen antibiotic can itself be associated with initiation or worsening of CDI. Although there is no official report on resistance to metronidazole or oral vancomycin at this stage, this unrestricted antibiotic use must be addressed. Conclusions: The needs for antimicrobial stewardship programs to preserve the effectiveness of current available therapies are strongly recommended. This program must focus on the overall reduction of inappropriate antibiotic prescribing and ultimately on enforcing the adherence to the reputable antibacterial guidelines.

Semi-synthetic zwitterionic rifamycins: a promising class of antibiotics; survey of their chemistry and biological activities

Rifamycins are an important group of macrocyclic antibiotics highly active against tuberculosis and various other Gram-positive pathogenic bacteria.

ENANTİYOMERİK REZOLÜSYON İÇİN KULLANILAN KİRAL SABİT FAZLAR

Enantiomer separation has attracted increasing attentions in pharmaceutical industry, due to great differences in pharmacological, toxicological and/or metabolic activities of enantiomeric drugs in living system. Several methods have been succesfully used to achieve chiral separation. To date the chromatographic method is one of the most effective. Numerous kinds of CSPs have been developed for chiral separation these include cyclo-dextrins, polysaccharides, macrocyclic antibiotics, ligand-exchange, Pirkle, crown ethers and protein derivatives. In this rewiev we will inform ligands and macromolecules used as CSP.

Bacillusin A, an Antibacterial Macrodiolide from Bacillus amyloliquefaciens AP183.

Bioassay-guided fractionation of the organic extracts of a Bacillus amyloliquefaciens strain (AP183) led to the discovery of a new macrocyclic polyene antibiotic, bacillusin A (1). Its structure was assigned by interpretation of NMR and MS spectroscopic data as a novel macrodiolide composed of dimeric 4-hydroxy-2-methoxy-6-alkenylbenzoic acid lactones with conjugated pentaene-hexahydroxy polyketide chains. Compound 1 showed potent antibacterial activities against methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium with minimum inhibitory concentrations in a range of 0.6 to 1.2 μg/mL. The biosynthetic significance of this unique class of antibiotic compounds is briefly discussed.

The in situ monitoring of the transformation of moxidectin ethanol solvate to form I in an ethanol–water mixture

Moxidectin is a single-component and semisynthetic macrocyclic lactone antibiotic, which has been widely used in the prevention and treatment of parasites in farm animals.

Fidaxomicin: A novel agent for the treatment of Clostridium difficile infection.

Due to the limitations of existing treatment options for Clostridium difficile infection (CDI), new therapies are needed. To review the available data on fidaxomicin regarding chemistry, mechanisms of action and resistance, in vitro activity, pharmacokinetic and pharmacodynamic properties, efficacy and safety in clinical trials, and place in therapy. A search of PubMed using the terms "fidaxomicin", "OPT-80", "PAR-101", "OP-1118", "difimicin", "tiacumicin" and "lipiarmycin" was performed. All English-language articles from January 1983 to November 2014 were reviewed, as well as bibliographies of all articles. Fidaxomicin is the first macrocyclic lactone antibiotic with activity versus C difficile. It inhibits RNA polymerase, therefore, preventing transcription. Fidaxomicin (and its active metabolite OP-1118) is bactericidal against C difficile and exhibits a prolonged postantibiotic effect (approximately 10 h). Other than for C difficile, fidaxomicin demonstrated only moderate inhibitory activity against Gram-positive bacteria and was a poor inhibitor of normal colonic flora, including anaerobes and enteric Gram-negative bacilli. After oral administration (200 mg two times per day for 10 days), fidaxomicin achieved low serum concentration levels but high fecal concentration levels (mean approximately 1400 μg/g stool). Phase 3 clinical trials involving adults with CDI demonstrated that 200 mg fidaxomicin twice daily for 10 days was noninferior to 125 mg oral vancomycin four times daily for 10 days in regard to clinical response at the end of therapy. Fidaxomicin was, however, reported to be superior to oral vancomycin in reducing recurrent CDI and achieving a sustained clinical response (assessed at day 28) for patients infected with non-BI/NAP1/027 strains. Fidaxomicin was noninferior to oral vancomycin with regard to clinical response at the end of CDI therapy. Fidaxomicin has been demonstated to be as safe as oral vancomycin, but superior to vancomycin in achieving a sustained clinical response for CDI in patients infected with non-BI/NAP1/027 strains. Caution should be exercised in using fidaxomicin monotherapy for treatment of severe complicated CDI because limited data are available. Whether fidaxomicin is cost effective (due to its significantly higher acquisition cost versus oral vancomycin) depends on the acceptable willingness to pay threshold per quality-adjusted life year as a measure of assessing cost effectiveness.

Toxic megacolon associated with Clostridium difficile infection recurrence: a case report complicated by multiple bacterial infections and successfully treated with oral fidaxomicin

Toxic megacolon is a severe complication of Clostridium difficile infection (CDI) with a high percentage of mortality. The mainstay of treatment is currently represented by medical management, while surgical intervention is indicated in patients not improving after 2-3 days of antibiotic therapy. Generally metronidazole and vancomycin are administered as first-line treatment, but recently several cases of refractory C. difficile have made the treatment of this infection more difficult. Fidaxomicin is a narrow-spectrum oral macrocyclic antibiotic with excellent in vitro activity against C. difficile strains. We report the case of a woman admitted with a diagnosis of toxic megacolon complicating a C. difficile colitis not responding to standard antibiotic therapy.