Spero Therapeutics, Cambridge, Massachusetts, USA
Spero Therapeutics, Cambridge, Massachusetts, USA.
Antimicrob Agents Chemother. 2020 Jul 22;64(8). doi: 10.1128/AAC.02240-19.
The continued evolution of bacterial resistance to the β-lactam class of antibiotics has necessitated countermeasures to ensure continued effectiveness in the treatment of infections caused by bacterial pathogens. One relatively successful approach has been the development of new β-lactam analogs with advantages over prior compounds in this class. The carbapenems are an example of such β-lactam analogs possessing improved stability against β-lactamase enzymes and, therefore, a wider spectrum of activity. However, all carbapenems currently marketed for adult patients are intravenous agents, and there is an unmet need for an oral agent to treat patients that otherwise do not require hospitalization. Tebipenem pivoxil hydrobromide (tebipenem-PI-HBr or SPR994) is an orally available prodrug of tebipenem, a carbapenem with activity versus multidrug-resistant (MDR) Gram-negative pathogens, including quinolone-resistant and extended-spectrum-β-lactamase-producing Tebipenem-PI-HBr is currently in development for the treatment of complicated urinary tract infections (cUTI). Microbiological data are presented here that demonstrate equivalency of tebipenem with intravenous carbapenems such as meropenem and support its use in infections in which the potency and spectrum of a carbapenem are desired. The results from standard microbiology assays as well as efficacy in several mouse infection models suggest that tebipenem-PI-HBr could be a valuable oral agent available to physicians for the treatment of infections, particularly those caused by antibiotic-resistant Gram-negative pathogens.
细菌对β-内酰胺类抗生素的耐药性不断进化,这使得我们有必要采取措施确保该类抗生素在治疗细菌病原体引起的感染方面仍然有效。一种相对成功的方法是开发具有优于该类中先前化合物优势的新型β-内酰胺类似物。碳青霉烯类就是此类β-内酰胺类似物的一个例子,它们对β-内酰胺酶具有更好的稳定性,因此具有更广泛的活性谱。然而,目前市场上供成人患者使用的所有碳青霉烯类药物均为静脉制剂,对于那些不需要住院治疗的患者,仍需要一种口服制剂来治疗。替比培南匹伏酯氢溴酸盐(替比培南-PI-HBr 或 SPR994)是替比培南的口服前药,替比培南是一种对多种耐药(MDR)革兰氏阴性病原体具有活性的碳青霉烯类药物,包括对喹诺酮类药物耐药和产生扩展谱β-内酰胺酶的病原体。替比培南-PI-HBr 目前正在开发用于治疗复杂性尿路感染(cUTI)。本文提供了微生物学数据,证明了替比培南与静脉用碳青霉烯类药物(如美罗培南)等效,并支持在需要碳青霉烯类药物的效力和谱时将其用于感染。标准微生物学检测结果以及在几种小鼠感染模型中的疗效表明,替比培南-PI-HBr 可能成为一种有价值的口服药物,供医生用于治疗感染,特别是由抗生素耐药的革兰氏阴性病原体引起的感染。