In vitro evaluation of CBR-2092, a novel rifamycin-quinolone hybrid antibiotic: microbiology profiling studies with staphylococci and streptococci

Antimicrob Agents Chemother. 2008 Jul;52(7):2324-34. doi: 10.1128/AAC.01651-07. Epub 2008 Apr 28.

Abstract

We present data from antimicrobial assays performed in vitro that pertain to the potential clinical utility of a novel rifamycin-quinolone hybrid antibiotic, CBR-2092, for the treatment of infections mediated by gram-positive cocci. The MIC(90)s for CBR-2092 against 300 clinical isolates of staphylococci and streptococci ranged from 0.008 to 0.5 mug/ml. Against Staphylococcus aureus, CBR-2092 exhibited prolonged postantibiotic effects (PAEs) and sub-MIC effects (SMEs), with values of 3.2, 6.5, and >8.5 h determined for the PAE (3x MIC), SME (0.12x MIC), and PAE-SME (3x MIC/0.12x MIC) periods, respectively. Studies of genetically defined mutants of S. aureus indicate that CBR-2092 is not a substrate for the NorA or MepA efflux pumps. In minimal bactericidal concentration and time-kill studies, CBR-2092 exhibited bactericidal activity against staphylococci that was retained against rifampin- or intermediate quinolone-resistant strains, with apparent paradoxical cidal characteristics against rifampin-resistant strains. In spontaneous resistance studies, CBR-2092 exhibited activity consistent with balanced contributions from its composite pharmacophores, with a mutant prevention concentration of 0.12 mug/ml and a resistance frequency of <10(-12) determined at 1 mug/ml in agar for S. aureus. Similarly, CBR-2092 suppressed the emergence of preexisting rifamycin resistance in time-kill studies undertaken at a high cell density. In studies of the intracellular killing of S. aureus, CBR-2092 exhibited prolonged bactericidal activity that was superior to the activities of moxifloxacin, rifampin, and a cocktail of moxifloxacin and rifampin. Overall, CBR-2092 exhibited promising activity in a range of antimicrobial assays performed in vitro that pertain to properties relevant to the effective treatment of serious infections mediated by gram-positive cocci.

MeSH terms

  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Drug Resistance, Bacterial / genetics
  • Humans
  • In Vitro Techniques
  • Microbial Sensitivity Tests
  • Mutation
  • Phenotype
  • Quinolones / chemistry
  • Quinolones / pharmacology*
  • Rifamycins / chemistry
  • Rifamycins / pharmacology*
  • Staphylococcus / drug effects*
  • Staphylococcus / genetics
  • Staphylococcus / isolation & purification
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics
  • Staphylococcus aureus / isolation & purification
  • Staphylococcus epidermidis / drug effects
  • Staphylococcus epidermidis / genetics
  • Staphylococcus epidermidis / isolation & purification
  • Streptococcus / drug effects*
  • Streptococcus / genetics
  • Streptococcus / isolation & purification

Substances

  • Anti-Bacterial Agents
  • CBR 2092
  • Quinolones
  • Rifamycins