WO2011010190A1 - Antibacterial composition comprising fluoroquinlone such as norfloxacin together with tripmethoprim - Google Patents

Antibacterial composition comprising fluoroquinlone such as norfloxacin together with tripmethoprim Download PDF

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Publication number
WO2011010190A1
WO2011010190A1 PCT/IB2009/054349 IB2009054349W WO2011010190A1 WO 2011010190 A1 WO2011010190 A1 WO 2011010190A1 IB 2009054349 W IB2009054349 W IB 2009054349W WO 2011010190 A1 WO2011010190 A1 WO 2011010190A1
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acid
antibacterial composition
ingredients
antibacterial
composition
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PCT/IB2009/054349
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French (fr)
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Anatolii Albertovich Kuzmin
Oleksandr Mykolajovych Borovko
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Anatolii Albertovich Kuzmin
Oleksandr Mykolajovych Borovko
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Publication of WO2011010190A1 publication Critical patent/WO2011010190A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/4353—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems
    • A61K31/436—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems the heterocyclic ring system containing a six-membered ring having oxygen as a ring hetero atom, e.g. rapamycin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/4353—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems
    • A61K31/437—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems the heterocyclic ring system containing a five-membered ring having nitrogen as a ring hetero atom, e.g. indolizine, beta-carboline
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/4709—Non-condensed quinolines and containing further heterocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
    • A61K31/5375—1,4-Oxazines, e.g. morpholine
    • A61K31/5383—1,4-Oxazines, e.g. morpholine ortho- or peri-condensed with heterocyclic ring systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/12—Carboxylic acids; Salts or anhydrides thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
    • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/08—Solutions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/04—Antibacterial agents

Definitions

  • the present invention relates to veterinary medicine. More particularly, it relates to drugs useful for preventing and treating infectious diseases such as salmonellosis, col- ibacillosis, pasteurellosis, and other diseases.
  • Antibiotics sulfanilamides and nitrofurans
  • Antibiotics are well known as useful in veterinary medicine to treat gastrointestinal diseases.
  • the use of antibiotics for a long time results in the appearance of new strains of microorganisms which are resistant to these drugs this requiring increases in doses and a permanent renewal of means of control of infectious disease pathogens.
  • a long-term use of antibiotics has an appreciable unfavorable impact on the organism of subjects being treated.
  • antibacterial compositions are widely used which compositions comprise sulfanilamides and trimethoprim and the synergy of the above ingredients was considered to be an advantage thereof for a long period of time.
  • trimethoprim possibly, decelerates the evolution of resistance to sulfanilamides. Increase in susceptibility to sulfanilamides can also be explained, however, by decrease in a selective pressure due to reduction in their use. In most clinical cases, a sulfanilamide component of such compositions is of no value due to a high resistance of microflora to sulfanilamides. Furthermore, just the sulfanilamide component poses the risk of severe undesirable reactions and drug interactions. In view of the foregoing, what is needed is the development of new antibacterial compositions comprising trimethoprim.
  • trimethoprim along with fluoroquinolone (fluoroquinolones) is of interest for creating new and effective antibacterial compositions.
  • First-generation fluoroquinolones showed a low activity against Gram-positive bacteria.
  • microorganisms developed resistance to fluoroquinolones.
  • Further researches resulted in the synthesis of second- generation, third-generation and forth-generation fluoroquinolones and in the development of new drug compositions. Even at low levels, the present days' fluoroquinolones exhibit high bacterial activity against Gram-positive bacteria and Gram- negative bacteria as well as against mycoplasmas.
  • antibacterial composition disclosed in a Chinese patent application No. 101043568 which antibacterial composition comprises at least one fluoroquinolone or at least one pharmaceutically acceptable salt thereof, trimethoprim, additives, and water.
  • antibacterial composition disclosed comprises dexamethasone sodium phosphate, and the combination of the latter, trimethoprim and ofloxacin shows a synergistic activity improving a treatment effect of the antibacterial composition.
  • the antibacterial composition disclosed is administered with the aids of injections.
  • the disadvantages of the above antibacterial composition include an injection form of drug administration because, if treating a large number of animals, injections are troublesome and laborious. Moreover, treatment with the aids of injections of said antibacterial composition must be performed by a skilled veterinary medicine staff. Disclosure of Invention
  • an object of the present invention is to provide an antibacterial composition which, due to its ingredients and the combination ratio thereof, will exhibit a high therapeutic efficacy in the treatment of infectious diseases, whose use will ensure a simple treatment of subjects being treated, as well as will be advantageous economically and safe because of reducing the probability of side effects of composition ingredients.
  • the present invention provides an antibacterial composition that comprises at least one fluoroquinolone or at least one pharmaceutically acceptable salt thereof, trimethoprim, additives, and water, the antibacterial composition being characterized in that it additionally comprises at least one organic acid with such combination ratio of the ingredients as follows (in % w/w):
  • Such ingredients and their combination ratio of the antibacterial composition ensure improvement in a treatment and prevention efficacy and the broadening of an antibacterial action of the drug.
  • Said quantities of the ingredients of the antibacterial composition in accordance with the present invention are sufficient enough to provide a therapeutically effective influence in the condition being treated as well as to provide a preventive influence to prevent a possible disease in poultry and mammals.
  • said combination ratio of the ingredients is an optimum one in terms of the safety of the intake of this antibacterial composition and makes it possible to avoid possible side effects occurring in the treatment with the aids of the antibacterial composition in accordance with the present invention.
  • Therapeutically effective quantities of the antibacterial composition ingredients will vary depending on a specific state being treated, a physical condition of subjects being treated, a severity of the state to be treated/prevented, a treatment duration, a nature of a concurrent therapy, a specific compound or composition used, a defined pharmaceutically acceptable additive used and the like factors.
  • an organic acid in the antibacterial composition makes it possible to ensure the complete dissolution of hardly soluble ingredients of the antibacterial composition of the invention - fluoroquinolones and trimethoprim this in turn making it possible to ensure a high therapeutic efficacy of the antibacterial composition of the invention and a convenient soluble dosage form for oral administration.
  • this new group of chemotherapeutic drugs of the fluoroquinolone group makes it possible to administer the antibacterial composition once a day this simplifying significantly the treatment of subjects being treated, for example, poultry, as well as allows to ensure a high economic expediency of employing the antibacterial composition in accordance with the present invention in veterinary medicine.
  • fluoroquinolone or a pharmaceutically acceptable salt thereof is selected from the group including: norfloxacin, lomefloxacin, enrofloxacin, ofloxacin, pe- floxacin, ciprofloxacin, levofloxacin, sparfloxacin, gatifloxacin, moxifloxacin, trovafloxacin, fleroxacin, tosufloxacin, danofloxacin, gemifloxacin, sitafloxacin, cli- nafloxacin.
  • Fluoroquinolones are characterized by a broad spectrum of antibacterial activities including against staphylococcuses, a high bactericidal activity, and an excellent pharmacokinetics allowing their use for treating infectious diseases of various localization. Fluoroquinolones which have been introduced in practice since the mid-1990s (the third and forth generations) are characterized by a higher activity against Gram-positive bacteria (first of all, against pneumococcuses), intracellular pathogens, anaerobes (the forth generation), as well as by even more optimized pharmacokinetics. The presence, among drugs, of dosage forms for intravenous administration and ingestion in combination with a high bioavailability makes it possible to carry out sequential therapy which is substantially cheaper than parenteral therapy with a clinical efficacy being comparative.
  • fluoroquinolones Unlike non-fluorinated quinolones, fluoroquinolones have a large distribution volume, create high concentrations in organs and tissues, and penetrate into cells. The degree of metabolism depends on physicochemical properties of the drug: pefloxacin is biotransformed most actively; lomefloxacin, ofloxacin, levofloxacin are bio- transformed least actively. Between 3% to 4% and 15% to 28% of the dose ad- ministered are excreted in feces. A half-life of different fluoroquinolones varies between 3 to 4 hours (norfloxacin) and 12 to 14 hours (pefloxacin, moxifloxacin) and even 18 to 20 hours (sparfloxacin).
  • fluoroquinolone or a pharmaceutically acceptable salt thereof in the antibacterial composition in an amount of between 0.1 % w/w and 40 % w/w ensures the most optimum and balanced influence for this allows the antibacterial composition to be dosed according to the amount of water or feed consumed by the subject being treated.
  • trimethoprim which is a concurrent inhibitor of dihydrofolate reductase and inhibits one of the stages of the synthesis of nucleic acids, namely, the formation of tetrahydrofolic acid from di- hydrofolic acid.
  • Trimethoprim exhibits a marked antibacterial activity against many gram-positive microbes and gram-negative microbes.
  • trimethoprim in the antibacterial composition in an amount of between 0.1 % w/w and 30 % w/w ensures the most optimum and balanced influence for this allows the antibacterial composition of the invention to be dosed depending on the amount of water or feed consumed by the subject being treated.
  • the antibacterial composition in accordance with the present invention comprises at least one organic acid which is selected from the group including: formic acid; acetic acid; valeric acid; caproic acid; heptanoic acid; malic acid; tartaric acid; lactic acid; oxalic acid; succinic acid; propionic acid; citric acid; malonic acid; and glutaric acid.
  • organic acid selected from the group including: formic acid; acetic acid; valeric acid; caproic acid; heptanoic acid; malic acid; tartaric acid; lactic acid; oxalic acid; succinic acid; propionic acid; citric acid; malonic acid; and glutaric acid.
  • an organic acid in the antibacterial composition of the invention in an amount of between 0.1 % w/w and 90 % w/w makes it possible to ensure the complete dissolution of hardly soluble ingredients of the antibacterial composition - fluoroquinolones and trimethoprim this in turn making it possible to ensure a high therapeutic efficacy of the antibacterial composition in the treatment of infectious diseases in subjects influenced by the antibacterial composition of the invention.
  • the antibacterial composition in accordance with the present invention comprises at least one additive that belongs to a functional group of stabilizers, preservatives, antioxidants.
  • the inclusion of additives makes it possible to ensure the production of a selected dosage form of the antibacterial composition, its safe storage, and its subsequent use in veterinary medicine.
  • the antibacterial composition in accordance with the present invention it is possible to treat poultry and decorative birds, mammals, in particular, cattle, small cattle, pigs, horses for infectious diseases induced by Gram-positive bacteria and Gram-negative bacteria, in particular, by: Salmonella spp., Enterobacter spp., Klebsiella spp., Proteus spp., Shigella spp., Citrobacter spp., M. morgami.
  • Vibrio spp. Haemophilus spp., Neisseria spp., Pseudomonas spp., Listeria spp., Pasteurella spp., Legionella spp., Staphylococcus spp., E. coli, Serratia spp., St. epidermidis, St. aureus, S. piogenes, Providencia spp.
  • Embodiments of the antibacterial composition in accordance with the present invention will be illustrated below using the following examples.
  • Said combination ratio of the ingredients of the antibacterial composition is the minimum one and, in this case, the use of a large enough amount of the drug is required. Even with such combination ratio of the ingredients, the antibacterial composition exhibits a sufficient therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients. If a combination ratio of the ingredients is less than the indicated combination ratio, it is not possible to attain the required therapeutic efficacy.
  • Said combination ratio of the ingredients of the antibacterial composition is one of the most preferred and, with such combination ratio of the ingredients, the antibacterial composition of the invention exhibits a therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients.
  • Said combination ratio of norfloxacin is the maximum one since norfloxacin is hardly soluble at a level of more than 40%.
  • the antibacterial composition of the invention exhibits a therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients.
  • Said combination ratio of enrofloxacin is the maximum one since enrofloxacin is hardly soluble at a level of more than 40%.
  • the antibacterial composition of the invention exhibits a therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients.
  • a minimal bactericidal concentration of the antibacterial composition in accordance with the present invention and a blank (a 10% norfloxacin solution) was determined by the broth microdilution method.
  • the antibacterial composition in accordance with the present invention surpasses significantly the blank in terms of antibacterial activities this indicating synergy.
  • Antimicrobial activities of the antibacterial composition in accordance with the present invention as compared with other antibiotics were studied using the disk diffusion method. As test cultures, E. coli O78 strain i Salmonella typhimurium were used. [Table 3]
  • the antibacterial composition in accordance with the present invention surpasses significantly other antibiotics, in particular, enrofloxacin which is a fluoroquinolone, in terms of a zone of inhibition of microorganisms used.
  • Treatment with the aids of the antibacterial composition in accordance with the present invention is as follows:
  • the antibacterial composition in accordance with the present invention may be employed for the treatment of infectious diseases in poultry and mammals of any age, for example, for the treatment of salmonellosis.
  • the antibacterial composition in accordance with the present invention is added to drinking water or feed with an optimum concentration of 1 : 1000 once a day for 5 days.
  • the duration of treatment may, however, vary depending on a condition of the subjects being treated with the antibacterial composition.
  • a drug containing 10% of enrofloxacin was used as a blank.
  • broilers of not more than 3 weeks of age were employed.
  • the existence of colibacillosis signs such as general depression, lack of appetite, profuse diarrhea and a sharp thirst, signs of respiratory distress was the criterion of animal selection for this experiment. The diagnosis was confirmed by bacteriological studies.
  • the antibacterial composition of the invention and the blank were given water at a dose of 1 mL per 1 L of drinking water for 5 days.
  • Clinical determination of efficacy included the registration of mortality, the number of non-recovered subjects, which have been treated, and the number of recovered subjects.
  • the present invention provides an antibacterial composition that, due to its ingredients and the combination ratio thereof, exhibits a high therapeutic efficacy in the treatment of infectious diseases. Moreover, the use of the antibacterial composition in accordance with the present invention ensures a simple treatment of subjects being treated and is advantageous economically and safe because of reducing the probability of side effects of composition ingredients.

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Abstract

The present invention relates to veterinary medicine. More particularly, it relates to drugs useful for preventing and treating infectious diseases such as, for example, salmonellosis, colibacillosis, pasterellosis, and other diseases. Thus, the present invention provides an antibacterial composition which, due to its ingredients and the combination ratio thereof, exhibits a high therapeutic efficacy in the treatment of infectious diseases. Moreover, the use of the antibacterial composition in accordance with the present invention ensures a simple treatment of subjects being treated and is advantageous economically and safe because of reducing the probability of side effects of composition ingredients.

Description

Description
ANTIBACTERIAL COMPOSITION COMPRISING FLUOROQUINOLONE SUCH AS NORFLOXACIN TOGETHER WITH TRIMETHOPRIM
Technical Field
The present invention relates to veterinary medicine. More particularly, it relates to drugs useful for preventing and treating infectious diseases such as salmonellosis, col- ibacillosis, pasteurellosis, and other diseases.
Background Art
Antibiotics, sulfanilamides and nitrofurans, are well known as useful in veterinary medicine to treat gastrointestinal diseases. However the use of antibiotics for a long time results in the appearance of new strains of microorganisms which are resistant to these drugs this requiring increases in doses and a permanent renewal of means of control of infectious disease pathogens. Moreover, a long-term use of antibiotics has an appreciable unfavorable impact on the organism of subjects being treated. In the veterinary medicine practice, antibacterial compositions are widely used which compositions comprise sulfanilamides and trimethoprim and the synergy of the above ingredients was considered to be an advantage thereof for a long period of time.
Recently, studies show that synergy in such compositions is mainly a laboratory phenomenon and is of no essential value for a clinical efficacy of such drugs [Brumfitt W., Hamilton-Miller J.M.T. Limitations of and indications for the use of co- trimoxazole. J. Chemother., 1994, 6, 3-11]. Trimethoprim, possibly, decelerates the evolution of resistance to sulfanilamides. Increase in susceptibility to sulfanilamides can also be explained, however, by decrease in a selective pressure due to reduction in their use. In most clinical cases, a sulfanilamide component of such compositions is of no value due to a high resistance of microflora to sulfanilamides. Furthermore, just the sulfanilamide component poses the risk of severe undesirable reactions and drug interactions. In view of the foregoing, what is needed is the development of new antibacterial compositions comprising trimethoprim.
In this aspect, the use of trimethoprim along with fluoroquinolone (fluoroquinolones) is of interest for creating new and effective antibacterial compositions. First-generation fluoroquinolones showed a low activity against Gram-positive bacteria. Moreover, where fluoroquinolones were used multiple times, microorganisms developed resistance to fluoroquinolones. Further researches resulted in the synthesis of second- generation, third-generation and forth-generation fluoroquinolones and in the development of new drug compositions. Even at low levels, the present days' fluoroquinolones exhibit high bacterial activity against Gram-positive bacteria and Gram- negative bacteria as well as against mycoplasmas.
The most similar to the antibacterial composition in accordance with the present invention is an antibacterial composition disclosed in a Chinese patent application No. 101043568 which antibacterial composition comprises at least one fluoroquinolone or at least one pharmaceutically acceptable salt thereof, trimethoprim, additives, and water. In addition, the antibacterial composition disclosed comprises dexamethasone sodium phosphate, and the combination of the latter, trimethoprim and ofloxacin shows a synergistic activity improving a treatment effect of the antibacterial composition. The antibacterial composition disclosed is administered with the aids of injections.
The disadvantages of the above antibacterial composition include an injection form of drug administration because, if treating a large number of animals, injections are troublesome and laborious. Moreover, treatment with the aids of injections of said antibacterial composition must be performed by a skilled veterinary medicine staff. Disclosure of Invention
Technical Solution
Accordingly, an object of the present invention is to provide an antibacterial composition which, due to its ingredients and the combination ratio thereof, will exhibit a high therapeutic efficacy in the treatment of infectious diseases, whose use will ensure a simple treatment of subjects being treated, as well as will be advantageous economically and safe because of reducing the probability of side effects of composition ingredients.
To achieve this object, the present invention provides an antibacterial composition that comprises at least one fluoroquinolone or at least one pharmaceutically acceptable salt thereof, trimethoprim, additives, and water, the antibacterial composition being characterized in that it additionally comprises at least one organic acid with such combination ratio of the ingredients as follows (in % w/w):
Fluoroquinolone or a pharmaceutically acceptable salt thereof 0.1 to 40
Trimethoprim 0.1 to 30
Organic acid 0.1 to 90
Additives 0.1 to 20
Water Q. S.
Such ingredients and their combination ratio of the antibacterial composition ensure improvement in a treatment and prevention efficacy and the broadening of an antibacterial action of the drug. Said quantities of the ingredients of the antibacterial composition in accordance with the present invention are sufficient enough to provide a therapeutically effective influence in the condition being treated as well as to provide a preventive influence to prevent a possible disease in poultry and mammals. In addition, said combination ratio of the ingredients is an optimum one in terms of the safety of the intake of this antibacterial composition and makes it possible to avoid possible side effects occurring in the treatment with the aids of the antibacterial composition in accordance with the present invention. Therapeutically effective quantities of the antibacterial composition ingredients will vary depending on a specific state being treated, a physical condition of subjects being treated, a severity of the state to be treated/prevented, a treatment duration, a nature of a concurrent therapy, a specific compound or composition used, a defined pharmaceutically acceptable additive used and the like factors.
The inclusion of an organic acid in the antibacterial composition makes it possible to ensure the complete dissolution of hardly soluble ingredients of the antibacterial composition of the invention - fluoroquinolones and trimethoprim this in turn making it possible to ensure a high therapeutic efficacy of the antibacterial composition of the invention and a convenient soluble dosage form for oral administration.
The use of this new group of chemotherapeutic drugs of the fluoroquinolone group makes it possible to administer the antibacterial composition once a day this simplifying significantly the treatment of subjects being treated, for example, poultry, as well as allows to ensure a high economic expediency of employing the antibacterial composition in accordance with the present invention in veterinary medicine.
Preferably, fluoroquinolone or a pharmaceutically acceptable salt thereof is selected from the group including: norfloxacin, lomefloxacin, enrofloxacin, ofloxacin, pe- floxacin, ciprofloxacin, levofloxacin, sparfloxacin, gatifloxacin, moxifloxacin, trovafloxacin, fleroxacin, tosufloxacin, danofloxacin, gemifloxacin, sitafloxacin, cli- nafloxacin. Fluoroquinolones are characterized by a broad spectrum of antibacterial activities including against staphylococcuses, a high bactericidal activity, and an excellent pharmacokinetics allowing their use for treating infectious diseases of various localization. Fluoroquinolones which have been introduced in practice since the mid-1990s (the third and forth generations) are characterized by a higher activity against Gram-positive bacteria (first of all, against pneumococcuses), intracellular pathogens, anaerobes (the forth generation), as well as by even more optimized pharmacokinetics. The presence, among drugs, of dosage forms for intravenous administration and ingestion in combination with a high bioavailability makes it possible to carry out sequential therapy which is substantially cheaper than parenteral therapy with a clinical efficacy being comparative.
Unlike non-fluorinated quinolones, fluoroquinolones have a large distribution volume, create high concentrations in organs and tissues, and penetrate into cells. The degree of metabolism depends on physicochemical properties of the drug: pefloxacin is biotransformed most actively; lomefloxacin, ofloxacin, levofloxacin are bio- transformed least actively. Between 3% to 4% and 15% to 28% of the dose ad- ministered are excreted in feces. A half-life of different fluoroquinolones varies between 3 to 4 hours (norfloxacin) and 12 to 14 hours (pefloxacin, moxifloxacin) and even 18 to 20 hours (sparfloxacin).
The inclusion of fluoroquinolone or a pharmaceutically acceptable salt thereof in the antibacterial composition in an amount of between 0.1 % w/w and 40 % w/w ensures the most optimum and balanced influence for this allows the antibacterial composition to be dosed according to the amount of water or feed consumed by the subject being treated.
Advantageously, the use is also made, as one more active ingredient, of trimethoprim which is a concurrent inhibitor of dihydrofolate reductase and inhibits one of the stages of the synthesis of nucleic acids, namely, the formation of tetrahydrofolic acid from di- hydrofolic acid. Trimethoprim exhibits a marked antibacterial activity against many gram-positive microbes and gram-negative microbes. The inclusion of trimethoprim in the antibacterial composition in an amount of between 0.1 % w/w and 30 % w/w ensures the most optimum and balanced influence for this allows the antibacterial composition of the invention to be dosed depending on the amount of water or feed consumed by the subject being treated.
Advantageously, the antibacterial composition in accordance with the present invention comprises at least one organic acid which is selected from the group including: formic acid; acetic acid; valeric acid; caproic acid; heptanoic acid; malic acid; tartaric acid; lactic acid; oxalic acid; succinic acid; propionic acid; citric acid; malonic acid; and glutaric acid. The inclusion of an organic acid in the antibacterial composition of the invention in an amount of between 0.1 % w/w and 90 % w/w makes it possible to ensure the complete dissolution of hardly soluble ingredients of the antibacterial composition - fluoroquinolones and trimethoprim this in turn making it possible to ensure a high therapeutic efficacy of the antibacterial composition in the treatment of infectious diseases in subjects influenced by the antibacterial composition of the invention.
The inclusion of at least one fluoroquinolone or at least one pharmaceutically acceptable salt thereof in the antibacterial composition of the invention along with trimethoprim makes it possible to ensure a synergistic effect of said ingredients of the antibacterial composition. The mechanism of the synergistic effect is in that both ingredients act on various links of the same process, the synthesis of nucleic acids this being a prerequisite for the manifestation of a potential synergy. This ensures a high therapeutic efficacy of the antibacterial composition, broads significantly the spectrum of its action, the duration of its influence and allows the amount of the antibacterial composition required for an effective influence to be reduced this in turn will be advantageous economically and safe because of reducing the probability of side effects of composition ingredients.
Advantageously, the antibacterial composition in accordance with the present invention comprises at least one additive that belongs to a functional group of stabilizers, preservatives, antioxidants. The inclusion of additives makes it possible to ensure the production of a selected dosage form of the antibacterial composition, its safe storage, and its subsequent use in veterinary medicine.
With the aids of the antibacterial composition in accordance with the present invention, it is possible to treat poultry and decorative birds, mammals, in particular, cattle, small cattle, pigs, horses for infectious diseases induced by Gram-positive bacteria and Gram-negative bacteria, in particular, by: Salmonella spp., Enterobacter spp., Klebsiella spp., Proteus spp., Shigella spp., Citrobacter spp., M. morgami. Vibrio spp., Haemophilus spp., Neisseria spp., Pseudomonas spp., Listeria spp., Pasteurella spp., Legionella spp., Staphylococcus spp., E. coli, Serratia spp., St. epidermidis, St. aureus, S. piogenes, Providencia spp. Embodiments of the antibacterial composition in accordance with the present invention will be illustrated below using the following examples.
Industrial Applicability
Example 1
An antibacterial composition with such combination ratio of the ingredients as follows (in % w/w):
Norfloxacin 0.1
Trimethoprim 0.1
Acetic acid 0.1
Benzyl alcohol 0.1
Water Q. S.
Said combination ratio of the ingredients of the antibacterial composition is the minimum one and, in this case, the use of a large enough amount of the drug is required. Even with such combination ratio of the ingredients, the antibacterial composition exhibits a sufficient therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients. If a combination ratio of the ingredients is less than the indicated combination ratio, it is not possible to attain the required therapeutic efficacy.
Example 2
An antibacterial composition with such combination ratio of the ingredients as follows (in % w/w):
Norfloxacin 10
Trimethoprim 5
Acetic acid 10 Benzyl alcohol 1
Water Q. S.
Said combination ratio of the ingredients of the antibacterial composition is one of the most preferred and, with such combination ratio of the ingredients, the antibacterial composition of the invention exhibits a therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients.
Example 3
An antibacterial composition with such combination ratio of the ingredients as follows (in % w/w):
Norfloxacin 40
Trimethoprim 5
Acetic acid 40
Benzyl alcohol 0.1
Water Q. S.
Said combination ratio of norfloxacin is the maximum one since norfloxacin is hardly soluble at a level of more than 40%. With such combination ratio of the ingredients, the antibacterial composition of the invention exhibits a therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients.
Example 4
An antibacterial composition with such combination ratio of the ingredients as follows (in % w/w):
Enrofloxacin 40
Trimethoprim 5
Acetic acid 40
Benzyl alcohol 0.1
Water Q. S.
Said combination ratio of enrofloxacin is the maximum one since enrofloxacin is hardly soluble at a level of more than 40%. With such combination ratio of the ingredients, the antibacterial composition of the invention exhibits a therapeutic efficacy in the treatment of infectious diseases as well as is simple to use and safe because of reducing the probability of side effects of composition ingredients.
A minimal inhibiting concentration of the antibacterial composition in accordance with the present invention and a blank (a 10% norfloxacin solution) was determined by the broth microdilution method. [Table 1]
[Table ]
Table 1. Minimal inhibiting concentration of the antibacterial composition in accordance with the present invention and a blank, μg/mL (n=5)
Figure imgf000008_0001
A minimal bactericidal concentration of the antibacterial composition in accordance with the present invention and a blank (a 10% norfloxacin solution) was determined by the broth microdilution method.
[Table 2]
[Table ]
Table 2. Minimal bactericidal concentration of the antibacterial composition in accordance with the present invention and a blank, μg/mL (n=5)
Figure imgf000008_0002
As can be seen from Tables 1 and 2 above, the antibacterial composition in accordance with the present invention surpasses significantly the blank in terms of antibacterial activities this indicating synergy.
Antimicrobial activities of the antibacterial composition in accordance with the present invention as compared with other antibiotics were studied using the disk diffusion method. As test cultures, E. coli O78 strain i Salmonella typhimurium were used. [Table 3]
[Table ]
Table 3. Bacterial culture susceptibility to the antibacterial composition of the invention and to various antibiotics (disk diffusion method)
Figure imgf000009_0001
As can be seen from Table 3, the antibacterial composition in accordance with the present invention surpasses significantly other antibiotics, in particular, enrofloxacin which is a fluoroquinolone, in terms of a zone of inhibition of microorganisms used.
Treatment with the aids of the antibacterial composition in accordance with the present invention is as follows:
The antibacterial composition in accordance with the present invention may be employed for the treatment of infectious diseases in poultry and mammals of any age, for example, for the treatment of salmonellosis. The antibacterial composition in accordance with the present invention is added to drinking water or feed with an optimum concentration of 1 : 1000 once a day for 5 days. The duration of treatment may, however, vary depending on a condition of the subjects being treated with the antibacterial composition.
The study of therapeutic efficacy of the antibacterial composition was carried out on hens.
As a blank, a drug containing 10% of enrofloxacin was used. For this study, broilers of not more than 3 weeks of age were employed. The existence of colibacillosis signs such as general depression, lack of appetite, profuse diarrhea and a sharp thirst, signs of respiratory distress was the criterion of animal selection for this experiment. The diagnosis was confirmed by bacteriological studies.
The antibacterial composition of the invention and the blank were given water at a dose of 1 mL per 1 L of drinking water for 5 days.
Clinical determination of efficacy included the registration of mortality, the number of non-recovered subjects, which have been treated, and the number of recovered subjects.
The results of this study are given in Table 4. Mortality within the blank group was higher (8% versus 3%) than within the group which was given the antibacterial composition in accordance with the present invention.
[Table 4]
[Table ]
Table 4. Results of study of therapeutic efficacy of the antibacterial composition of the invention and a blank on hens
Figure imgf000010_0001
Thus, the present invention provides an antibacterial composition that, due to its ingredients and the combination ratio thereof, exhibits a high therapeutic efficacy in the treatment of infectious diseases. Moreover, the use of the antibacterial composition in accordance with the present invention ensures a simple treatment of subjects being treated and is advantageous economically and safe because of reducing the probability of side effects of composition ingredients.

Claims

Claims
1. An antibacterial composition comprising: at least one fluoroquinolone or at least one pharmaceutically acceptable salt thereof, trimethoprim, additives, and water, characterized in that the antibacterial composition comprises additionally at least one organic acid with such combination ratio of the ingredients as follows (in % w/w):
Fluoroquinolone or a pharmaceutically acceptable salt thereof 0.1 to 40 Trimethoprim 0.1 to 30
Organic acid 0.1 to 90
Additives 0.1 to 20
Water Q. S.
2. The antibacterial composition as claimed in Claim 1 characterized in that fluoroquinolone or a pharmaceutically acceptable salt thereof is selected from the group including: norfloxacin, lomefloxacin, enrofloxacin, ofloxacin, pefloxacin, ciprofloxacin, levofloxacin, sparfloxacin, gatifloxacin, moxifloxacin,
trovafloxacin, fleroxacin, tosufloxacin, danofloxacin, gemifloxacin, sitafloxacin, clinafloxacin.
3. The antibacterial composition as claimed in Claim 1 characterized in that organic acid is selected from the group including: formic acid; acetic acid;
valeric acid; caproic acid; heptanoic acid, malic acid; tartaric acid; lactic acid; oxalic acid; succinic acid; propionic acid; citric acid; malonic acid; and glutaric acid.
4. The antibacterial composition as claimed in Claim 1 characterized in that stabilizers and/or preservatives and/or antioxidants are used as the additives.
5. The antibacterial composition as claimed in Claim 1 characterized in that said antibacterial composition is employed to treat infectious diseases induced by Gram-positive bacteria and Gram-negative bacteria.
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