WO2018154091A1 - Association of n-acetylcysteine and colistin for use in bacterial infections - Google Patents
Association of n-acetylcysteine and colistin for use in bacterial infections Download PDFInfo
- Publication number
- WO2018154091A1 WO2018154091A1 PCT/EP2018/054611 EP2018054611W WO2018154091A1 WO 2018154091 A1 WO2018154091 A1 WO 2018154091A1 EP 2018054611 W EP2018054611 W EP 2018054611W WO 2018154091 A1 WO2018154091 A1 WO 2018154091A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- colistin
- nac
- maltophilia
- association according
- synergistic pharmacological
- Prior art date
Links
- 108010078777 Colistin Proteins 0.000 title claims abstract description 163
- 229960003346 colistin Drugs 0.000 title claims abstract description 157
- XDJYMJULXQKGMM-UHFFFAOYSA-N polymyxin E1 Natural products CCC(C)CCCCC(=O)NC(CCN)C(=O)NC(C(C)O)C(=O)NC(CCN)C(=O)NC1CCNC(=O)C(C(C)O)NC(=O)C(CCN)NC(=O)C(CCN)NC(=O)C(CC(C)C)NC(=O)C(CC(C)C)NC(=O)C(CCN)NC1=O XDJYMJULXQKGMM-UHFFFAOYSA-N 0.000 title claims abstract description 157
- KNIWPHSUTGNZST-UHFFFAOYSA-N polymyxin E2 Natural products CC(C)CCCCC(=O)NC(CCN)C(=O)NC(C(C)O)C(=O)NC(CCN)C(=O)NC1CCNC(=O)C(C(C)O)NC(=O)C(CCN)NC(=O)C(CCN)NC(=O)C(CC(C)C)NC(=O)C(CC(C)C)NC(=O)C(CCN)NC1=O KNIWPHSUTGNZST-UHFFFAOYSA-N 0.000 title claims abstract description 157
- JORAUNFTUVJTNG-BSTBCYLQSA-N n-[(2s)-4-amino-1-[[(2s,3r)-1-[[(2s)-4-amino-1-oxo-1-[[(3s,6s,9s,12s,15r,18s,21s)-6,9,18-tris(2-aminoethyl)-3-[(1r)-1-hydroxyethyl]-12,15-bis(2-methylpropyl)-2,5,8,11,14,17,20-heptaoxo-1,4,7,10,13,16,19-heptazacyclotricos-21-yl]amino]butan-2-yl]amino]-3-h Chemical compound CC(C)CCCCC(=O)N[C@@H](CCN)C(=O)N[C@H]([C@@H](C)O)CN[C@@H](CCN)C(=O)N[C@H]1CCNC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](CC(C)C)NC(=O)[C@H](CCN)NC1=O.CCC(C)CCCCC(=O)N[C@@H](CCN)C(=O)N[C@H]([C@@H](C)O)CN[C@@H](CCN)C(=O)N[C@H]1CCNC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](CC(C)C)NC(=O)[C@H](CCN)NC1=O JORAUNFTUVJTNG-BSTBCYLQSA-N 0.000 title claims abstract description 153
- 208000035143 Bacterial infection Diseases 0.000 title claims abstract description 33
- 208000022362 bacterial infectious disease Diseases 0.000 title claims abstract description 33
- PWKSKIMOESPYIA-BYPYZUCNSA-N L-N-acetyl-Cysteine Chemical compound CC(=O)N[C@@H](CS)C(O)=O PWKSKIMOESPYIA-BYPYZUCNSA-N 0.000 title claims description 122
- 229960004308 acetylcysteine Drugs 0.000 title claims description 15
- 241000122973 Stenotrophomonas maltophilia Species 0.000 claims abstract description 52
- 241000588626 Acinetobacter baumannii Species 0.000 claims abstract description 49
- 230000002195 synergetic effect Effects 0.000 claims abstract description 32
- 244000052769 pathogen Species 0.000 claims abstract description 30
- 238000011282 treatment Methods 0.000 claims abstract description 28
- 230000000144 pharmacologic effect Effects 0.000 claims abstract description 27
- 208000018569 Respiratory Tract disease Diseases 0.000 claims abstract description 16
- 201000009267 bronchiectasis Diseases 0.000 claims abstract description 11
- 230000001684 chronic effect Effects 0.000 claims abstract description 10
- 208000006545 Chronic Obstructive Pulmonary Disease Diseases 0.000 claims abstract description 9
- 201000003883 Cystic fibrosis Diseases 0.000 claims description 27
- 208000015181 infectious disease Diseases 0.000 claims description 19
- 230000003115 biocidal effect Effects 0.000 claims description 9
- 239000002552 dosage form Substances 0.000 claims description 6
- 238000001727 in vivo Methods 0.000 claims description 4
- 238000011269 treatment regimen Methods 0.000 claims description 4
- 206010061598 Immunodeficiency Diseases 0.000 claims description 2
- 230000032770 biofilm formation Effects 0.000 claims 1
- 101000618525 Homo sapiens Membrane transport protein XK Proteins 0.000 description 107
- 101001109463 Homo sapiens NACHT, LRR and PYD domains-containing protein 1 Proteins 0.000 description 107
- 230000000694 effects Effects 0.000 description 20
- 239000008194 pharmaceutical composition Substances 0.000 description 15
- 230000000844 anti-bacterial effect Effects 0.000 description 12
- 241000894006 Bacteria Species 0.000 description 11
- 230000001717 pathogenic effect Effects 0.000 description 11
- 244000000058 gram-negative pathogen Species 0.000 description 10
- 206010035664 Pneumonia Diseases 0.000 description 9
- 239000003795 chemical substances by application Substances 0.000 description 9
- 230000003214 anti-biofilm Effects 0.000 description 8
- 229960004531 colistimethate sodium Drugs 0.000 description 7
- IQWHCHZFYPIVRV-VLLYEMIKSA-I colistin A sodium methanesulfonate Chemical compound [Na+].[Na+].[Na+].[Na+].[Na+].CC[C@@H](C)CCCCC(=O)N[C@@H](CCNCS([O-])(=O)=O)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CCNCS([O-])(=O)=O)C(=O)N[C@H]1CCNC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCNCS([O-])(=O)=O)NC(=O)[C@H](CCNCS([O-])(=O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](CC(C)C)NC(=O)[C@H](CCNCS([O-])(=O)=O)NC1=O IQWHCHZFYPIVRV-VLLYEMIKSA-I 0.000 description 7
- 108700028201 colistinmethanesulfonic acid Proteins 0.000 description 7
- 230000002401 inhibitory effect Effects 0.000 description 7
- 238000010611 checkerboard assay Methods 0.000 description 6
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 6
- 229940079593 drug Drugs 0.000 description 6
- 239000003814 drug Substances 0.000 description 6
- 238000000034 method Methods 0.000 description 6
- 239000000203 mixture Substances 0.000 description 6
- 239000000546 pharmaceutical excipient Substances 0.000 description 6
- 210000004027 cell Anatomy 0.000 description 5
- 201000010099 disease Diseases 0.000 description 5
- 208000031729 Bacteremia Diseases 0.000 description 4
- 208000009470 Ventilator-Associated Pneumonia Diseases 0.000 description 4
- 238000003556 assay Methods 0.000 description 4
- 229960001127 colistin sulfate Drugs 0.000 description 4
- 238000002474 experimental method Methods 0.000 description 4
- 238000000338 in vitro Methods 0.000 description 4
- 230000002147 killing effect Effects 0.000 description 4
- 230000000813 microbial effect Effects 0.000 description 4
- ZESIAEVDVPWEKB-ORCFLVBFSA-N n-[(2s)-4-amino-1-[[(2s,3r)-1-[[(2s)-4-amino-1-oxo-1-[[(3s,6s,9s,12s,15r,18s,21s)-6,9,18-tris(2-aminoethyl)-3-[(1r)-1-hydroxyethyl]-12,15-bis(2-methylpropyl)-2,5,8,11,14,17,20-heptaoxo-1,4,7,10,13,16,19-heptazacyclotricos-21-yl]amino]butan-2-yl]amino]-3-h Chemical compound OS(O)(=O)=O.OS(O)(=O)=O.CC(C)CCCCC(=O)N[C@@H](CCN)C(=O)N[C@H]([C@@H](C)O)CN[C@@H](CCN)C(=O)N[C@H]1CCNC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](CC(C)C)NC(=O)[C@H](CCN)NC1=O.CCC(C)CCCCC(=O)N[C@@H](CCN)C(=O)N[C@H]([C@@H](C)O)CN[C@@H](CCN)C(=O)N[C@H]1CCNC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](CC(C)C)NC(=O)[C@H](CCN)NC1=O ZESIAEVDVPWEKB-ORCFLVBFSA-N 0.000 description 4
- 238000012360 testing method Methods 0.000 description 4
- 208000019206 urinary tract infection Diseases 0.000 description 4
- WSFSSNUMVMOOMR-UHFFFAOYSA-N Formaldehyde Chemical compound O=C WSFSSNUMVMOOMR-UHFFFAOYSA-N 0.000 description 3
- 206010048038 Wound infection Diseases 0.000 description 3
- 239000003242 anti bacterial agent Substances 0.000 description 3
- 230000000845 anti-microbial effect Effects 0.000 description 3
- 230000005713 exacerbation Effects 0.000 description 3
- 238000009472 formulation Methods 0.000 description 3
- RWSXRVCMGQZWBV-WDSKDSINSA-N glutathione Chemical compound OC(=O)[C@@H](N)CCC(=O)N[C@@H](CS)C(=O)NCC(O)=O RWSXRVCMGQZWBV-WDSKDSINSA-N 0.000 description 3
- 230000036457 multidrug resistance Effects 0.000 description 3
- 239000000651 prodrug Substances 0.000 description 3
- 229940002612 prodrug Drugs 0.000 description 3
- 230000009467 reduction Effects 0.000 description 3
- 229960005404 sulfamethoxazole Drugs 0.000 description 3
- 208000024891 symptom Diseases 0.000 description 3
- 230000001225 therapeutic effect Effects 0.000 description 3
- 238000010610 time kill assay Methods 0.000 description 3
- 238000011200 topical administration Methods 0.000 description 3
- RPABDKTXMKOGKI-OYTUFZPASA-N 6-methyl-n-[2-[(2s,5s,8s,11s,14s,17s,20s,23s)-8,11,14,20-tetrakis(2-aminoethyl)-5-[(1r)-1-hydroxyethyl]-17,23-bis(2-methylpropyl)-3,6,9,12,15,18,21,24-octaoxo-1,4,7,10,13,16,19,22-octazacyclotetracos-2-yl]ethyl]octanamide Chemical compound CCC(C)CCCCC(=O)NCC[C@@H]1NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CCN)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H]([C@@H](C)O)NC1=O RPABDKTXMKOGKI-OYTUFZPASA-N 0.000 description 2
- RZVAJINKPMORJF-UHFFFAOYSA-N Acetaminophen Chemical compound CC(=O)NC1=CC=C(O)C=C1 RZVAJINKPMORJF-UHFFFAOYSA-N 0.000 description 2
- 206010006458 Bronchitis chronic Diseases 0.000 description 2
- 206010014561 Emphysema Diseases 0.000 description 2
- XUJNEKJLAYXESH-REOHCLBHSA-N L-Cysteine Chemical compound SC[C@H](N)C(O)=O XUJNEKJLAYXESH-REOHCLBHSA-N 0.000 description 2
- 208000019693 Lung disease Diseases 0.000 description 2
- 201000009906 Meningitis Diseases 0.000 description 2
- 239000004480 active ingredient Substances 0.000 description 2
- 229940088710 antibiotic agent Drugs 0.000 description 2
- 238000009635 antibiotic susceptibility testing Methods 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 206010006451 bronchitis Diseases 0.000 description 2
- 239000000872 buffer Substances 0.000 description 2
- 208000007451 chronic bronchitis Diseases 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 238000001514 detection method Methods 0.000 description 2
- 230000008029 eradication Effects 0.000 description 2
- 239000003172 expectorant agent Substances 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 210000000987 immune system Anatomy 0.000 description 2
- 238000007918 intramuscular administration Methods 0.000 description 2
- 238000001990 intravenous administration Methods 0.000 description 2
- 210000004072 lung Anatomy 0.000 description 2
- 230000000116 mitigating effect Effects 0.000 description 2
- 210000005099 mouse brain capillary cell Anatomy 0.000 description 2
- 210000000214 mouth Anatomy 0.000 description 2
- 229940066491 mucolytics Drugs 0.000 description 2
- 239000000843 powder Substances 0.000 description 2
- 239000002243 precursor Substances 0.000 description 2
- 230000000241 respiratory effect Effects 0.000 description 2
- 210000002345 respiratory system Anatomy 0.000 description 2
- 150000003839 salts Chemical class 0.000 description 2
- 210000002966 serum Anatomy 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 239000000725 suspension Substances 0.000 description 2
- 230000009044 synergistic interaction Effects 0.000 description 2
- 238000002560 therapeutic procedure Methods 0.000 description 2
- 241000193830 Bacillus <bacterium> Species 0.000 description 1
- 101100459439 Caenorhabditis elegans nac-2 gene Proteins 0.000 description 1
- 208000014085 Chronic respiratory disease Diseases 0.000 description 1
- 206010011409 Cross infection Diseases 0.000 description 1
- 108010069514 Cyclic Peptides Proteins 0.000 description 1
- 102000001189 Cyclic Peptides Human genes 0.000 description 1
- 206010059866 Drug resistance Diseases 0.000 description 1
- 241000588697 Enterobacter cloacae Species 0.000 description 1
- 241000305071 Enterobacterales Species 0.000 description 1
- 206010016654 Fibrosis Diseases 0.000 description 1
- 108010024636 Glutathione Proteins 0.000 description 1
- 208000008745 Healthcare-Associated Pneumonia Diseases 0.000 description 1
- 241000588747 Klebsiella pneumoniae Species 0.000 description 1
- 235000013878 L-cysteine Nutrition 0.000 description 1
- 239000004201 L-cysteine Substances 0.000 description 1
- 241000124008 Mammalia Species 0.000 description 1
- IABBAGAOMDWOCW-UHFFFAOYSA-N Nicametate citrate Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O.CCN(CC)CCOC(=O)C1=CC=CN=C1 IABBAGAOMDWOCW-UHFFFAOYSA-N 0.000 description 1
- 241000589517 Pseudomonas aeruginosa Species 0.000 description 1
- DWAQJAXMDSEUJJ-UHFFFAOYSA-M Sodium bisulfite Chemical compound [Na+].OS([O-])=O DWAQJAXMDSEUJJ-UHFFFAOYSA-M 0.000 description 1
- 241000191967 Staphylococcus aureus Species 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 230000000996 additive effect Effects 0.000 description 1
- 239000000443 aerosol Substances 0.000 description 1
- 150000001413 amino acids Chemical class 0.000 description 1
- 230000003110 anti-inflammatory effect Effects 0.000 description 1
- 239000000729 antidote Substances 0.000 description 1
- 229960005475 antiinfective agent Drugs 0.000 description 1
- 239000004599 antimicrobial Substances 0.000 description 1
- 239000003963 antioxidant agent Substances 0.000 description 1
- 230000003078 antioxidant effect Effects 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 230000003190 augmentative effect Effects 0.000 description 1
- 230000001580 bacterial effect Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 239000002775 capsule Substances 0.000 description 1
- YZBQHRLRFGPBSL-RXMQYKEDSA-N carbapenem Chemical compound C1C=CN2C(=O)C[C@H]21 YZBQHRLRFGPBSL-RXMQYKEDSA-N 0.000 description 1
- 229940041011 carbapenems Drugs 0.000 description 1
- FPPNZSSZRUTDAP-UWFZAAFLSA-N carbenicillin Chemical compound N([C@H]1[C@H]2SC([C@@H](N2C1=O)C(O)=O)(C)C)C(=O)C(C(O)=O)C1=CC=CC=C1 FPPNZSSZRUTDAP-UWFZAAFLSA-N 0.000 description 1
- 229960003669 carbenicillin Drugs 0.000 description 1
- 239000000969 carrier Substances 0.000 description 1
- 150000001793 charged compounds Chemical class 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 230000001332 colony forming effect Effects 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 230000001010 compromised effect Effects 0.000 description 1
- 238000005202 decontamination Methods 0.000 description 1
- 230000003588 decontaminative effect Effects 0.000 description 1
- 230000001066 destructive effect Effects 0.000 description 1
- 235000014113 dietary fatty acids Nutrition 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 231100000673 dose–response relationship Toxicity 0.000 description 1
- 229930195729 fatty acid Natural products 0.000 description 1
- 239000000194 fatty acid Substances 0.000 description 1
- 150000004665 fatty acids Chemical class 0.000 description 1
- 230000004761 fibrosis Effects 0.000 description 1
- 230000037406 food intake Effects 0.000 description 1
- 239000000499 gel Substances 0.000 description 1
- 229960003180 glutathione Drugs 0.000 description 1
- 239000008187 granular material Substances 0.000 description 1
- 230000009931 harmful effect Effects 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 238000011534 incubation Methods 0.000 description 1
- 230000005764 inhibitory process Effects 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 238000007913 intrathecal administration Methods 0.000 description 1
- 238000007914 intraventricular administration Methods 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- LRPCLTPZMUIPFK-UHFFFAOYSA-N methane;sulfuric acid Chemical compound C.OS(O)(=O)=O LRPCLTPZMUIPFK-UHFFFAOYSA-N 0.000 description 1
- 210000002200 mouth mucosa Anatomy 0.000 description 1
- 210000003097 mucus Anatomy 0.000 description 1
- 238000002663 nebulization Methods 0.000 description 1
- 230000001937 non-anti-biotic effect Effects 0.000 description 1
- 239000007800 oxidant agent Substances 0.000 description 1
- 230000001590 oxidative effect Effects 0.000 description 1
- 229960005489 paracetamol Drugs 0.000 description 1
- 238000007911 parenteral administration Methods 0.000 description 1
- 239000002245 particle Substances 0.000 description 1
- 239000006187 pill Substances 0.000 description 1
- 239000003755 preservative agent Substances 0.000 description 1
- 230000002335 preservative effect Effects 0.000 description 1
- 150000003141 primary amines Chemical class 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000002685 pulmonary effect Effects 0.000 description 1
- 150000003254 radicals Chemical class 0.000 description 1
- 230000010076 replication Effects 0.000 description 1
- 238000012552 review Methods 0.000 description 1
- 230000000630 rising effect Effects 0.000 description 1
- 206010040872 skin infection Diseases 0.000 description 1
- 210000000813 small intestine Anatomy 0.000 description 1
- 235000010267 sodium hydrogen sulphite Nutrition 0.000 description 1
- 229910001415 sodium ion Inorganic materials 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 238000000527 sonication Methods 0.000 description 1
- 241000894007 species Species 0.000 description 1
- 230000003068 static effect Effects 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 238000007920 subcutaneous administration Methods 0.000 description 1
- -1 sulfomethyl group Chemical group 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 239000006188 syrup Substances 0.000 description 1
- 235000020357 syrup Nutrition 0.000 description 1
- 239000003826 tablet Substances 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
- A61K38/12—Cyclic peptides, e.g. bacitracins; Polymyxins; Gramicidins S, C; Tyrocidins A, B or C
-
- 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
- A61K31/16—Amides, e.g. hydroxamic acids
- A61K31/164—Amides, e.g. hydroxamic acids of a carboxylic acid with an aminoalcohol, e.g. ceramides
-
- 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
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
- A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
- A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
-
- 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
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Definitions
- the present invention relates to a synergistic pharmacological association of N- acetylcysteine (hereinafter NAC) and colistin for use in the treatment of bacterial infections caused by one or more pathogens selected from Stenotrophomonas maltophilia (S. maltophilia) and Acinetobacter baumannii (A. baumannii) strains.
- NAC N- acetylcysteine
- colistin for use in the treatment of bacterial infections caused by one or more pathogens selected from Stenotrophomonas maltophilia (S. maltophilia) and Acinetobacter baumannii (A. baumannii) strains.
- NAC N- acetylcysteine
- colistin for use in the treatment of bacterial infections caused by one or more pathogens selected from Stenotrophomonas maltophilia (S. maltophilia) and Acinetobacter baumannii (A
- Colistin also termed polymixin E, a polymixin antibiotic produced by certain strains of Bacillus polymixa, consists of a cationic cyclic heptapeptide with a tripeptide side chain acylated at the N terminus by a fatty acid through an a-amide linkage (Reviews of Anti-Infective Agents CID 2005; 40: 1033-41).
- colistin sulfate which is administered orally for bowel decontamination and topically as a powder for the treatment of bacterial skin infections
- CMS colistimethate sodium
- colistin methanesulfate pentasodium colistimethanesulfate
- colistin sulfonyl methate parenteral (intravenous, intramuscular, aerosolized and intrathecal/intraventricular) therapy.
- Colistin can be therefore administered as a prodrug in form of colistimethate sodium, which is readily idrolized to form sulfomethylated derivatives, as well as colistin sulfate, the active form of the drug.
- Colistin has recently gained a crucial role for the treatment of various types of infections (e.g. pneumonia, bacteremia, urinary tract infections) caused by Gram- negative pathogens expressing a multidrug resistance phenotype (e.g. non-fermenting Gram-negative pathogens, and carbapenem-resistant enterobacteria).
- infections e.g. pneumonia, bacteremia, urinary tract infections
- Gram- negative pathogens e.g. non-fermenting Gram-negative pathogens, and carbapenem-resistant enterobacteria.
- Pseudomonas aeruginosa P. aeruginosa
- other multidrug resistant non-fermenting Gram-negative pathogens e.g. Acinetobacter baumannii, Stenotrophomonas maltophilia
- Colistin represents a last-resort agent for the treatment of infections caused by multidrug resistant A. baumannii.
- great concerns arise from the rising trend of resistance to colistin in A. baumannii, which often results in pan-drug resistance phenotypes (PDR), with no available treatment option left.
- PDR pan-drug resistance phenotypes
- Colistimethate sodium is a combination of the negatively charged molecular ion colistin sulphomethate with positive sodium ions.
- Colistimethate sodium can be produced by a sulfomethylation reaction of colistin with formaldehyde followed by sodium bisulfite, which leads to the addition of a sulfomethyl group to the primary amines of colistin (Antimicrob. Agents Chemother. April 2003 vol. 47 no. 4 1364-1370).
- Colistimethate sodium is commercially available under various brand names by different manufacturers throughout the world, for example as PromixinTM (Profile Pharma Limited).
- the term "colistin” includes colistin and its pharmaceutically acceptable salts and/or prodrugs such as colistin sulfate, colistimethate sodium, colistin methane sulphate and colimycin or colomycin, all intended to refer to the bactericidal cyclopeptide antibiotic colystin or precursors thereof such as the prodrug colimycin which is converted to the active drug colistin.
- the term "colistin” refers to colistin sulfate (in accordance with the international guidelines for antimicrobial susceptibility testing provided by the Clinical and Laboratory Standards Institute - CLSI and the European Committee on Antimicrobial Susceptibility Testing - EUCAST).
- NAC is the acetylated precursor of both the amino acid L-cysteine and reduced glutathione (GSH).
- GSH reduced glutathione
- NAC can be typically considered a non-antibiotic drug, to which antibacterial and antibiofilm properties have been associated in some cases.
- Parry and Neu found that NAC had the characteristics to inhibit the growth of both gram-positive and gram-negative bacteria, including Staphylococcus aureus, P. aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae (Journal of Clinical Microbiology, Jan 1977, p.58-61).
- NAC is commercially available under various brand names by different manufacturers throughout the world, for example as FluimucilTM (Zambon Spa).
- S. maltophilia infections are commonly associated with respiratory tract diseases, in particular chronic respiratory tract diseases; for example, S. maltophilia infections can trigger pulmonary exacerbations of chronic obstructive lung disease (COPD), Cystic Fibrosis (CF) and bronchiectasis non CF.
- COPD chronic obstructive lung disease
- CF Cystic Fibrosis
- bronchiectasis non CF bronchiectasis
- S. maltophilia are characterized by a multidrug resistance phenotype and the ability to form biofilms. In virtue of these features, they are responsible for chronic lung colonization in individuals with weakened immune systems or chronic lung disease, particularly CF and bronchiectasis non CF, which may last several months or years and are difficult or impossible to be eradicated by current antibiotic treatment strategies.
- A. baumannii is an important and difficult-to-treat pathogen, which can infect the respiratory tract of patients affected by respiratory tract diseases, including chronic respiratory tract diseases.
- respiratory tract diseases including chronic respiratory tract diseases.
- A. baumannii infections in patients with pneumonia, in particular, in ventilator- associated pneumonia (VAP) represents one of the most dreadful complications that occur in the critical care setting.
- A. baumannii has been also identified in the CF population and in the population with bronchiectasis non CF.
- A. baumannii infections with bacteremia, wound infections, urinary tract infections and meningitis has been also described. It can be noted that there has been a dramatic increase in the number of A. baumannii strains with resistance to multiple antibiotic classes and the multidrug-resistant nature of this pathogen represents a challenge in the treatment and control of nosocomial infections, with relatively limited treatment options.
- nosocomial pneumonia due to multidrug resistant gram-negative bacteria comprising A. baumannii is among the most serious complications that occur in the intensive care unit (ICU) setting. Mortality, morbidity and health care costs are substantially increased by this type of infection.
- ICU intensive care unit
- the present inventors faced the problem of treating a bacterial infection caused by one or more pathogens selected from S. maltophilia and/or A. baumannii. After a long set of tests and experimentations, the present inventors have surprisingly found that the association of NAC and colistin has a synergistic antimicrobial effect against a consistent number of S. maltophilia and/or A. baumannii clinical isolates, even resulting in a bactericidal effect.
- the association of NAC and colistin has also been found to have synergistic anti- biofilm activity in in vitro biofilm models of S. maltophilia and/or A. baumannii.
- the anti-biofilm activity of the association of NAC and colistin against S. maltophilia and/or A. baumannii biofilms envisages a potential use also for both preventing and eradicating colonization by said pathogens, especially in the hospitalized patients affected by diseases including, for example, chronic bronchitis, emphysema, COPD and exacerbations, CF, bronchiectasis non CF, pneumonia, VAP, bacteremia, wound infections, urinary tract infections and meningitis.
- colistin represents one of the last therapeutic options to fight Gram-negative bacteria, the appearance of colistin-resistant Gram-negative pathogens such as S. maltophilia and/or A. baumannii is of great concern.
- the present inventors by concentrating their efforts in identifying an effective treatment able to restore susceptibility of said pathogens to the colistin treatment, have unexpectedly found that colistin effectiveness against colistin-resistant Gram- negative pathogens such as, e.g., A. baumannii and S. maltophilia can be surprisingly restored by administering colistin together with NAC.
- colistin-resistant Gram- negative pathogens such as, e.g., A. baumannii and S. maltophilia
- the MIC of all colistin resistant strains tested lowered at or below the susceptibility breackpoint in the presence of NAC 8 mg/ml.
- Figure 1 Time kill curves. NAC alone (1.6 and 8 mg/ml), colistin alone (2 and 8 ⁇ g/ml and combination NAC + colistin (1.6 mg/ml + 2 ⁇ g/ml, 1.6 mg/ml + 8 ⁇ g/ml, 8 mg/ml + 2 ⁇ g/ml, 8 mg/ml + 8 ⁇ g/ml).
- Figure 2 Time kill curves of S. maltophilia isolates with sub MIC concentrations of N-acetylcysteine (NAC 1.6, 3.2 and 8 mg/ml) and colistin (COL 2, 8 ⁇ g/ml) alone and in combination.
- -x- Control; — O- Colistin 2 ⁇ g/ml; ⁇ Colistin 8 ⁇ g/ml;— : NAC 1.6 mg/ml; "" (dotted line) NAC 3.2 mg/ml; (dashed line) NAC 8 mg/ml; - ⁇ - : NAC 1.6 mg/ml + Colistin 2 ⁇ g/ml; - ⁇ - : NAC 1.6 mg/ml + Colistin 8 ⁇ g/ml; " # " (dotted line) NAC 3.2 mg/ml + Colistin 2 ⁇ g/ml; (dotted line) NAC 3.2 mg/ml +
- FIG. 3 Antibiofilm activity of NAC, colistin and colistin/NAC combinations (sub- MIC concentrations) tested on a Cystic Fibrosis isolate of S. maltophilia. Biofilms were grown on Calgary Device (MBEC assay) for 48 hrs and challenged for 24 hours with NAC alone, Colistin alone at two different concentration: 2 ⁇ g/ml and 8 ⁇ g/ml and the combination of the two (NAC 8 mg/ml + Colistin 2 ⁇ g/ml and 8 ⁇ g/ml).
- pathogens selected from S. maltophilia and A. baumannii strains
- a bacterial infection associated with a respiratory tract disease particularly a chronic respiratory tract disease such as e.g., CF, bronchiectasis non CF and COPD.
- a bacterial infection is caused by a pathogen selected from S. maltophilia and A. baumannii strains, either expressing a colistin susceptible or resistant phenotype; especially, a pathogen selected from S. maltophilia and A. baumannii strains, expressing a colistin resistant phenotype.
- a bacterial infection caused by S. maltophilia strain can be detected, for example, in patients suffering from respiratory tract diseases, particularly chronic respiratory tract diseases such as, for example, in patients suffering from COPD, CF or bronchiectasis non CF, especially when these patients have weakened immune systems.
- a bacterial infection caused by A. baumannii strain can be detected, for example, in patients suffering from pneumonia, VAP, bacteremia; wound infections, urinary tract infections, CF and bronchiectasis non CF, especially when these patients are hospitalized patients.
- patients suffering of a bacterial infection caused by a pathogen selected from S. maltophilia and A. baumannii strains as described above are immunocompromised and/or hospitalized patients.
- a bacterial infection caused by a pathogen selected from S. maltophilia and A. baumannii strains according to the present invention may be a biofilm-associated infection.
- the terms “synergistic” and “synergistically” as applied to the effect of NAC and colistin used in association refer to a greater antibacterial effect obtained when the above- identified bacteria are treated by either NAC or colistin alone.
- the effect of NAC and colistin used in association is greater than the simple addition of the effects of each agent administered alone, i.e. there is an effect which surpasses expectations based on additive effects.
- NAC neuropeptide-susceptible S. maltophilia and colistin-susceptible A. baumannii strains, wherein NAC is able to prevent in vivo emergence of colistin resistance, during colistin treatment regimens.
- NAC and colistin of the pharmacological association according to the present invention may be administered in either order, separately or concurrently, with overlapping or non-overlapping periods of administration, via the same or different modes of administration.
- NAC and colistin can be concurrently administered in a single dosage form or alternatively NAC and colistin can be administered in separate dosage forms in either order, concomitantly or sequentially, with overlapping or non-overlapping periods of administration, via the same of different modes of administration.
- the concurrent or separate administration of the pharmacological association of NAC and colistin has the effect of in inhibiting or suppressing the growth and/or killing a strain of a pathogen selected from S. maltophilia and A. baumannii strains, said effect being unexpectedly and surprisingly greater than what is seen when bacteria are contacted by either NAC or colistin alone.
- the present inventors noticed that with an increase in the use of colistin to treat infections caused by multidrug resistant Gram-negative pathogens, resistance to colistin has been increasingly reported.
- the present inventors strongly perceived the great need of an effective treatment against colistin-resistant Gram-negative pathogens such as, e.g., A. baumannii and S. maltophilia, able to restore susceptibility of said pathogens to the antibiotic treatment, or to prevent in vivo emergence of colistin resistance during colistin treatment regimens.
- colistin-resistant Gram-negative pathogens such as, e.g., A. baumannii and S. maltophilia
- colistin effectiveness against colistin-resistant Gram-negative pathogens such as, e.g., A. baumannii and S. maltophilia can be surprisingly restored by the administration of the association of NAC with colistin.
- colistin susceptibility can be restored by NAC concentrations possibly achievable by topical administration.
- the MIC of all colistin resistant strains tested lowered at or below the susceptibility breakpoint in the presence of NAC 8 mg/ml.
- the association of NAC and colistin may be administered to the patient in the form of one or more pharmaceutical formulations.
- the pharmaceutical formulations of the present invention comprise NAC and/or colistin together with a carrier suitable for pharmaceutical use, consisting of one or more excipients.
- the pharmaceutical formulations of the invention may comprise both NAC and colistin together with a carrier suitable for pharmaceutical use, consisting of one or more excipients, i.e. pharmaceutical formulations for concurrent administration of both NAC and colistin; or the pharmaceutical formulations of the invention may comprise NAC together with a carrier suitable for pharmaceutical use, consisting of one or more excipients; or the pharmaceutical formulations of the invention may comprise colistin together with a carrier suitable for pharmaceutical use, consisting of one or more excipients, i.e. separate pharmaceutical formulations for sequential or concomitant administration of NAC and colistin.
- the term "excipient” comprises any inert substance added to a pharmaceutical composition to further facilitate administration of an active ingredient.
- carrier comprises any substance suitable as a vehicle for delivering NAC and/or colistin to a suitable in vivo or in vitro site.
- compositions comprising NAC and/or colistin that are suitable to be administered to a subject.
- Acceptable methods for preparing the pharmaceutical formulations according to the invention are well known to a person skilled in the art.
- the terms “individual” “subject” and “patient” are used interchangeably to refer to a member of mammalian specie, preferably a human, which is afflicted with a particular disease, disorder or condition.
- antibacterial means reducing the harmful effects of bacteria by inhibiting, suppressing the growth and/or killing them.
- antibacterial agents includes NAC and colistin.
- bacteria means having a destructive killing action upon bacteria.
- bacterial infection refers to any situation in which the presence of a microbial population(s) is damaging to a host mammal.
- an individual is “suffering" from a microbial infection when excessive numbers of a microbial population are present in or on an individual's body, or when the effects of the presence of a microbial population(s) is damaging the cells or other tissue of an individual.
- bacterial infection refers to an infection caused by a strain of bacteria for which the use of a synergistic pharmacological association of NAC and colistin disclosed herein is appropriate.
- the terms “treat”, “treating” and “treatment” refer to a diminution, a decrease, a limitation, or a mitigation of the degree, intensity, extent of a bacterial infection or its related disease conditions and symptoms caused by a strain of S. maltophilia and/or A. baumanii, that is achieved by a reduction, inhibition or suppression of growth, replication, and/or propagation, or death or destruction of said bacteria, on or in the subject.
- the term "pharmacological association” refers to either a fixed combination of NAC and colistin in one unit dosage form, a non-fixed combination or a kit of parts for the combined administration where NAC and colistin, as defined above, may be administered simultaneously, independently at the same time or separately within time intervals that allow the combination partners to show a synergistic effect.
- compositions of the present invention including oral, parenteral (subcutaneous, intramuscular or intravenous) and inhalation route.
- oral or “orally” refer to the introduction into the body by mouth whereby absorption occurs in one or more of the following areas of the body: the mouth, stomach, small intestine, and the small blood vessels of the oral mucosa.
- Non-limiting examples of pharmaceutical formulations according to the present invention for oral administration include, for example, tablets, coated tablets, granulates, pills, capsules, liquids, gels, syrups, suspensions, and the like, for oral ingestion by an individual.
- Suitable carriers for oral administration are well known in the art.
- compositions according to the invention may be formulated for example in aqueous solutions such as in physiologically compatible buffers or physiological salt buffer.
- Formulations for injection may be presented in unit dosage forms, for example, in ampoules, or in multi-dose containers with, optionally, an added preservative.
- compositions according to the invention may be formulated in solutions, suspensions and dry powder and delivered by using conventional means, so that optimal quantities of a suitable range of particle sizes are provided to the patient.
- the pharmaceutical formulations according to the invention may be preferably administered to the respiratory tract.
- the present invention also provides aerosol pharmaceutical formulations comprising NAC and/or colistin.
- compositions of the present invention may be manufactured in conventional manners, following processes well known in the art.
- the amount of NAC and colistin for use according to the present invention may vary depending on the administration route, the selected kind of composition, the individual characteristics of the patient, the duration of the treatment and the nature of concurrent therapies.
- the synergistic effective amount of the pharmacological association of NAC and colistin can produce a diminution, a decrease, a limitation, or a mitigation of the degree, intensity, extent of a bacterial infection or its related symptoms caused by a strain of A. baumannii and/or S. maltophilia.
- the amount of NAC and colistin sufficient to have a synergistic effect on a bacterial infection caused by a strain of A. baumannii and/or S. maltophilia may vary, for example, in view of the physical characteristics of the patient, the severity of the subject's symptoms, the form of the infection, the identity of the bacteria, the formulations and the means used for administering the drug. The specific dose for a given subject is usually set by the judgement of the attending physician.
- an effective amount of colistin may be between about 0.075 million units and 12 million units (i.e. between about 6mg and 960 mg), preferably between about 0.5 million units and 12 million units (i.e. between about 40 mg and 960 mg); the effective amount of NAC may vary between 100 and 5800 mg, preferably between 100 and 4600 mg, to be administered in a single dose or in more repeated doses.
- a dose may be administered all at once or slowly over a period of time, such as with an i.v. or by inhalation administration.
- dose unit dose
- dose dosage
- effective dose refers to physically discrete units that contain a predetermined quantity of active ingredient calculated to produce a desired therapeutic effect.
- a single dose is thus a predetermined quantity of colistin or NAC that is administered to a patient.
- compositions, route of administration, and dosage can be chosen by the individual physician in view of the patient's condition. Treatment should be continued for as long as required to receive the benefit of the invention.
- a determination of a synergistic interaction between NAC and colistin may be based on the results obtained from the assays described here below.
- ⁇ FIC total fractional inhibitory concentration
- the MIC of NAC was 32 mg/ml for two isolates, and > 32 mg/ml for the remaining ones. Synergism between colistin and NAC was observed in checkerboard assays with all tested isolates. In particular, a restoration of colistin susceptibility (i.e. MIC ⁇ 2 ⁇ g/ml) was observed with 100% and 52% of tested strains in the presence of NAC 4 mg/ml and NAC 2 mg/ml, respectively.
- time-kill assays were also performed according to CLSI guidelines with two selected strains (i.e. Z165 and Z167, Col R ).
- biofilm eradication test on the two isolates was also carried out as follows: biofilms were grown in the NUNC TSP lid system (MB EC assay), for seven days in daily refreshed CAMHB (static conditions). Preformed biofilms were then exposed to two colistin concentrations (i.e. 2 and 8 ⁇ g/ml), and three NAC concentrations (i.e. 1.6, 3.2 and 8 mg/ml), alone and in combination, for 24 hours. After exposure, biofilms were disrupted by sonication and mean viable cell count per peg (log CFU/peg) was determined (detection limit 1.3 log CFU/peg). Data were obtained in at least two independent experiments, with at least six replicates per condition per experiment.
- Results showed a remarkable antibiofilm synergistic activity of combinations including colistin 8 ⁇ g/ml (i.e. representing 0.25 x and 0.06 x MIC for Z165 and Z167, respectively), with a marked reduction of viable biofilm cells also observed in the presence of the lower NAC concentration tested (i.e. 1.6 mg/ml).
- colistin 2 and 8 ⁇ g/ml, representing concentrations achievable in serum and epithelial lining fluid - ELF, respectively
- NAC 1.6 and 8 mg/ml, likely achievable in ELF by topical administration
- Colistin MICs ranged from 0.5 ⁇ g/ml to 128 ⁇ g/ml (MIC50, 16 ⁇ g/ml; MIC90, 64 ⁇ g/ml).
- the MIC of NAC was 16 mg/ml for nine isolates, >32 mg/ml for one isolate, and 32 mg/ml for the remaining ones. Synergism between colistin and NAC was observed in checkerboard assays with all tested isolates.
- Time-kill curves confirmed the synergy observed by checkerboard assays, demonstrating a bactericidal effect of colistin/NAC combinations at sub-MIC concentrations ( Figure 2 A and B).
- the antibiofilm activity of colistin/NAC combinations was investigated using the MBEC assay, the reference procedure for biofilm susceptibility testing (. Mature S. maltophilia (48 -hours old) were challenged for 24 hours with NAC and colistin, either alone or in combination. Viable cell count of challenged biofilms was compared to controls in order to assess the antibiofilm activity of the tested drugs and drugs/combinations.
- NAC 8 mg/ml plus colistin 2 ⁇ g/ml accounted for a reduction of more than 3 log colony forming units (CFU)/peg compared to controls ( Figure 3).
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Animal Behavior & Ethology (AREA)
- Epidemiology (AREA)
- General Chemical & Material Sciences (AREA)
- Organic Chemistry (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Oncology (AREA)
- Communicable Diseases (AREA)
- Engineering & Computer Science (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Gastroenterology & Hepatology (AREA)
- Immunology (AREA)
- Proteomics, Peptides & Aminoacids (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
Abstract
Description
Claims
Priority Applications (10)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2018223985A AU2018223985B2 (en) | 2017-02-27 | 2018-02-26 | Association of n-acetylcysteine and colistin for use in bacterial infections |
EP18707039.6A EP3585372A1 (en) | 2017-02-27 | 2018-02-26 | Association of n-acetylcysteine and colistin for use in bacterial infections |
JP2019545362A JP7241687B2 (en) | 2017-02-27 | 2018-02-26 | Combination of N-acetylcysteine and colistin for use in bacterial infections |
CA3053441A CA3053441A1 (en) | 2017-02-27 | 2018-02-26 | Association of n-acetylcysteine and colistin for use in bacterial infections |
EA201991889A EA201991889A1 (en) | 2017-02-27 | 2018-02-26 | N-ACETYLCYSTEINE ASSOCIATE AND COLISTINE FOR USE IN BACTERIAL INFECTIONS |
BR112019017113A BR112019017113A2 (en) | 2017-02-27 | 2018-02-26 | synergistic pharmacological association of n-acetylcysteine and colistin, and, n-acetylcysteine. |
US16/487,227 US11382948B2 (en) | 2017-02-27 | 2018-02-26 | Association of N-acetylcysteine and colistin for use in bacterial infections |
CN201880012765.3A CN110352053B (en) | 2017-02-27 | 2018-02-26 | Combination of N-acetylcysteine and polymyxin E for bacterial infections |
CONC2019/0009216A CO2019009216A2 (en) | 2017-02-27 | 2019-08-27 | Association of n-acetylcysteine and colistin for use in bacterial infections |
US17/664,232 US20220370549A1 (en) | 2017-02-27 | 2022-05-20 | Association of n-acetylcysteine and colistin for use in bacterial infections |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP17158241.4A EP3366284A1 (en) | 2017-02-27 | 2017-02-27 | Association of n-acetylcysteine and colistin for use in bacterial infections |
EP17158241.4 | 2017-02-27 |
Related Child Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US16/487,227 A-371-Of-International US11382948B2 (en) | 2017-02-27 | 2018-02-26 | Association of N-acetylcysteine and colistin for use in bacterial infections |
US17/664,232 Division US20220370549A1 (en) | 2017-02-27 | 2022-05-20 | Association of n-acetylcysteine and colistin for use in bacterial infections |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2018154091A1 true WO2018154091A1 (en) | 2018-08-30 |
Family
ID=58191354
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2018/054611 WO2018154091A1 (en) | 2017-02-27 | 2018-02-26 | Association of n-acetylcysteine and colistin for use in bacterial infections |
Country Status (10)
Country | Link |
---|---|
US (2) | US11382948B2 (en) |
EP (2) | EP3366284A1 (en) |
JP (1) | JP7241687B2 (en) |
CN (1) | CN110352053B (en) |
AU (1) | AU2018223985B2 (en) |
BR (1) | BR112019017113A2 (en) |
CA (1) | CA3053441A1 (en) |
CO (1) | CO2019009216A2 (en) |
EA (1) | EA201991889A1 (en) |
WO (1) | WO2018154091A1 (en) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
IT202000023665A1 (en) | 2020-10-07 | 2022-04-07 | Brenta S R L | NANOPARTICLES SYSTEM FOR VEHICLE AND ADMINISTRATION OF ACTIVE INGREDIENTS AND RELATED PRODUCTION METHOD, AS WELL AS BIOFILM ERADICATION ACTIVITIES |
EP4282410A1 (en) | 2022-05-27 | 2023-11-29 | Zambon S.p.A. | Association of colistin and n-acetalcysteine in the treatment of bacterial infections by p. aeruginosa in a mature biofilm phase of growth |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1998020836A2 (en) * | 1996-11-15 | 1998-05-22 | Pathogenesis Corporation | Pure biologically active colistin, its components and a colistin formulation for treatment of pulmonary infections |
WO2004022048A1 (en) * | 2002-09-04 | 2004-03-18 | Zambon Group S.P.A. | Fosfomycin and n-acetylcysteine for the treatment of biofilms caused by escheric ia coli and other pathogens of the urinary tract |
WO2012080700A1 (en) * | 2010-12-14 | 2012-06-21 | Novabiotics Limited | A composition comprising an antibiotic and a dispersant or an anti -adhesive agent |
-
2017
- 2017-02-27 EP EP17158241.4A patent/EP3366284A1/en not_active Withdrawn
-
2018
- 2018-02-26 EP EP18707039.6A patent/EP3585372A1/en active Pending
- 2018-02-26 EA EA201991889A patent/EA201991889A1/en unknown
- 2018-02-26 WO PCT/EP2018/054611 patent/WO2018154091A1/en active Application Filing
- 2018-02-26 AU AU2018223985A patent/AU2018223985B2/en active Active
- 2018-02-26 JP JP2019545362A patent/JP7241687B2/en active Active
- 2018-02-26 CN CN201880012765.3A patent/CN110352053B/en active Active
- 2018-02-26 US US16/487,227 patent/US11382948B2/en active Active
- 2018-02-26 BR BR112019017113A patent/BR112019017113A2/en active Search and Examination
- 2018-02-26 CA CA3053441A patent/CA3053441A1/en active Pending
-
2019
- 2019-08-27 CO CONC2019/0009216A patent/CO2019009216A2/en unknown
-
2022
- 2022-05-20 US US17/664,232 patent/US20220370549A1/en active Pending
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1998020836A2 (en) * | 1996-11-15 | 1998-05-22 | Pathogenesis Corporation | Pure biologically active colistin, its components and a colistin formulation for treatment of pulmonary infections |
WO2004022048A1 (en) * | 2002-09-04 | 2004-03-18 | Zambon Group S.P.A. | Fosfomycin and n-acetylcysteine for the treatment of biofilms caused by escheric ia coli and other pathogens of the urinary tract |
WO2012080700A1 (en) * | 2010-12-14 | 2012-06-21 | Novabiotics Limited | A composition comprising an antibiotic and a dispersant or an anti -adhesive agent |
Non-Patent Citations (8)
Title |
---|
ALFREDSSON H ET AL: "N-ACETYLCYSTEINE AND 2-MERCAPTOETHANE SULPHONATE INHIBIT ANTI-PSEUDOMONAS ACTIVITY OF ANTIBIOTICS IN VITRO", EUROPEAN JOURNAL OF RESPIRATORY DISEA, MUNKSGAARD, COPENHAGEN, DK, vol. 70, no. 4, 1 January 1987 (1987-01-01), pages 213 - 217, XP009020456, ISSN: 0106-4339 * |
ANTIMICROB. AGENTS CHEMOTHER., vol. 47, no. 4, April 2003 (2003-04-01), pages 1364 - 1370 |
ANTIMICROB. AGENTS CHEMOTHER., vol. 60, no. 12, December 2016 (2016-12-01), pages 7513 - 7517 |
JOURNAL OF CLINICAL MICROBIOLOGY, January 1977 (1977-01-01), pages 58 - 61 |
JOURNAL OF INFECTION, vol. 3, no. 4, December 1981 (1981-12-01), pages 353 - 359 |
LORENZO DRAGO ET AL: "Activity of N-acetyl-L-cysteine against biofilm of Staphylococcus aureus and Pseudomonas aeruginosa on orthopedic prosthetic materials", INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, vol. 36, no. 1, 14 February 2013 (2013-02-14), IT, pages 39 - 46, XP055381798, ISSN: 0391-3988, DOI: 10.5301/ijao.5000135 * |
REVIEWS OF ANTI-INFECTIVE AGENTS CID, vol. 40, 2005, pages 1033 - 41 |
SUTEP JARURATANASIRIKUL ET AL: "Population pharmacokinetics and pharmacodynamics modeling to optimize dosage regimens of sulbactam in critically ill patients with severe sepsis caused by Acinetobacter baumannii", ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1 December 2016 (2016-12-01), XP055382211, ISSN: 0066-4804, DOI: 10.1128/AAC.01669-16 * |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
IT202000023665A1 (en) | 2020-10-07 | 2022-04-07 | Brenta S R L | NANOPARTICLES SYSTEM FOR VEHICLE AND ADMINISTRATION OF ACTIVE INGREDIENTS AND RELATED PRODUCTION METHOD, AS WELL AS BIOFILM ERADICATION ACTIVITIES |
EP4282410A1 (en) | 2022-05-27 | 2023-11-29 | Zambon S.p.A. | Association of colistin and n-acetalcysteine in the treatment of bacterial infections by p. aeruginosa in a mature biofilm phase of growth |
WO2023227673A1 (en) | 2022-05-27 | 2023-11-30 | Zambon S.P.A. | Antimicrobial association in the treatment of p. aeruginosa biofilm-associated infections |
Also Published As
Publication number | Publication date |
---|---|
CN110352053A (en) | 2019-10-18 |
CN110352053B (en) | 2023-03-28 |
JP7241687B2 (en) | 2023-03-17 |
EP3585372A1 (en) | 2020-01-01 |
EP3366284A1 (en) | 2018-08-29 |
JP2020508318A (en) | 2020-03-19 |
EA201991889A1 (en) | 2020-01-09 |
AU2018223985B2 (en) | 2023-11-23 |
BR112019017113A2 (en) | 2020-04-07 |
CO2019009216A2 (en) | 2020-01-17 |
US20210128678A1 (en) | 2021-05-06 |
CA3053441A1 (en) | 2018-08-30 |
US20220370549A1 (en) | 2022-11-24 |
US11382948B2 (en) | 2022-07-12 |
AU2018223985A1 (en) | 2019-08-29 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20230372362A1 (en) | Methods for treating lung infections and inflammation | |
US20220370549A1 (en) | Association of n-acetylcysteine and colistin for use in bacterial infections | |
US9925206B2 (en) | Compositions and methods for treating bacterial infection | |
WO2019099946A1 (en) | Stable ascorbic acid compositions and methods of using the same | |
Vendrell et al. | Evidence of inhaled tobramycin in non-cystic fibrosis bronchiectasis | |
BR112020026267A2 (en) | LYSINS AND THEIR DERIVATIVES RESENSIBILIZE AGAIN STAPHYLOCOCCUS AUREUS AND GRAM-POSITIVE BACTERIA TO ANTIBIOTICS AGAIN | |
US9526766B2 (en) | Potentiation of antibiotic treatment with a protein-lipid complex | |
EA044449B1 (en) | ASSOCIATE OF N-ACETYL CYSTEINE AND COLISTIN FOR USE IN BACTERIAL INFECTIONS | |
WO2022081594A1 (en) | Antimicrobial combination therapeutics | |
US11918552B2 (en) | N-acetylcysteine for use as antibacterial agent | |
EA043054B1 (en) | N-ACETYLCYSTEINE FOR USE AS ANTIBACTERIAL AGENT | |
US20230364065A1 (en) | Antibiotic combination therapies | |
CN117412756A (en) | Phosphomycin and colistin combination for combating biofilm-associated bacterial infections | |
Fiegel et al. | Cystic fibrosis infection and biofilm busters | |
US20200061103A1 (en) | Inhibition of neurological disease |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 18707039 Country of ref document: EP Kind code of ref document: A1 |
|
ENP | Entry into the national phase |
Ref document number: 3053441 Country of ref document: CA |
|
ENP | Entry into the national phase |
Ref document number: 2019545362 Country of ref document: JP Kind code of ref document: A |
|
REG | Reference to national code |
Ref country code: BR Ref legal event code: B01A Ref document number: 112019017113 Country of ref document: BR |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
ENP | Entry into the national phase |
Ref document number: 2018223985 Country of ref document: AU Date of ref document: 20180226 Kind code of ref document: A |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2018707039 Country of ref document: EP |
|
ENP | Entry into the national phase |
Ref document number: 112019017113 Country of ref document: BR Kind code of ref document: A2 Effective date: 20190816 |