Pharmacodynamics of TD-1792, a novel glycopeptide-cephalosporin heterodimer antibiotic used against Gram-positive bacteria, in a neutropenic murine thigh model

Antimicrob Agents Chemother. 2012 Mar;56(3):1578-83. doi: 10.1128/AAC.05382-11. Epub 2011 Dec 12.

Abstract

TD-1792 is a novel glycopeptide-cephalosporin heterodimer investigational antibiotic that displays potent bactericidal effects against clinically relevant Gram-positive organisms in vitro. The present studies evaluated the in vivo pharmacokinetics (PK) and pharmacodynamics (PD) of TD-1792 in the neutropenic murine thigh infection animal model. TD-1792, dosed subcutaneously (SC), produced dose-dependent reduction in the thigh bacterial burden of several organisms, including methicillin-susceptible and -resistant strains of Staphylococcus aureus and Staphylococcus epidermidis (MSSA, MRSA, MSSE, MRSE, respectively), penicillin-susceptible strains of Streptococcus pneumoniae (PSSP), Streptococcus pyogenes, and vancomycin-intermediate-susceptible Staphylococcus aureus (VISA). In single-dose efficacy studies, the 1-log(10) CFU kill effective dose (ED(1-log kill)) estimates for TD-1792 ranged from 0.049 to 2.55 mg/kg of body weight administered SC, and the bacterial burden was reduced by up to 3 log(10) CFU/g from pretreatment values. Against S. aureus ATCC 33591 (MRSA), the total 24-h log(10) stasis dose (ED(stasis)) and ED(1-logkill) doses for TD-1792 were 0.53 and 1.11 mg/kg/24 h, respectively, compared to 23.4 and 54.6 mg/kg/24 h for vancomycin, indicating that TD-1762 is 44- to 49-fold more potent than vancomycin. PK-PD analysis of data from single-dose and dose-fractionation studies for MRSA (ATCC 33591) demonstrated that the total-drug 24-h area under the concentration-time curve-to-MIC ratio (AUC/MIC ratio) was the best predictor of efficacy (r(2) = 0.826) compared to total-drug maximum plasma concentration of drug-to-MIC ratio (Cmax/MIC ratio; r(2) = 0.715) and percent time that the total-drug plasma drug concentration remains above the MIC (%Time>MIC; r(2) = 0.749). The magnitudes of the total-drug AUC/MIC ratios associated with net bacterial stasis, a 1-log(10) CFU reduction from baseline and near maximal effect, were 21.1, 37.2, and 51.8, respectively. PK-PD targets based on such data represent useful inputs for analyses to support dose selection decisions for clinical studies of patients.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / blood
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Area Under Curve
  • Cephalosporins / blood
  • Cephalosporins / chemistry
  • Cephalosporins / pharmacology*
  • Colony Count, Microbial
  • Dimerization
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Glycopeptides / blood
  • Glycopeptides / chemistry
  • Glycopeptides / pharmacology*
  • Humans
  • Injections, Subcutaneous
  • Mice
  • Microbial Sensitivity Tests
  • Neutropenia / drug therapy*
  • Neutropenia / microbiology
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / growth & development
  • Staphylococcus epidermidis / drug effects
  • Staphylococcus epidermidis / growth & development
  • Streptococcal Infections / drug therapy*
  • Streptococcal Infections / microbiology
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / growth & development
  • Streptococcus pyogenes / drug effects
  • Streptococcus pyogenes / growth & development
  • Thigh / microbiology
  • Vancomycin / blood
  • Vancomycin / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Glycopeptides
  • TD 1792
  • Vancomycin