MBX-500, a hybrid antibiotic with in vitro and in vivo efficacy against toxigenic Clostridium difficile

Antimicrob Agents Chemother. 2012 Sep;56(9):4786-92. doi: 10.1128/AAC.00508-12. Epub 2012 Jun 25.

Abstract

Clostridium difficile infection (CDI) causes moderate to severe disease, resulting in diarrhea and pseudomembranous colitis. CDI is difficult to treat due to production of inflammation-inducing toxins, resistance development, and high probability of recurrence. Only two antibiotics are approved for the treatment of CDI, and the pipeline for therapeutic agents contains few new drugs. MBX-500 is a hybrid antibacterial, composed of an anilinouracil DNA polymerase inhibitor linked to a fluoroquinolone DNA gyrase/topoisomerase inhibitor, with potential as a new therapeutic for CDI treatment. Since MBX-500 inhibits three bacterial targets, it has been previously shown to be minimally susceptible to resistance development. In the present study, the in vitro and in vivo efficacies of MBX-500 were explored against the Gram-positive anaerobe, C. difficile. MBX-500 displayed potency across nearly 50 isolates, including those of the fluoroquinolone-resistant, toxin-overproducing NAP1/027 ribotype, performing as well as comparator antibiotics vancomycin and metronidazole. Furthermore, MBX-500 was a narrow-spectrum agent, displaying poor activity against many other gut anaerobes. MBX-500 was active in acute and recurrent infections in a toxigenic hamster model of CDI, exhibiting full protection against acute infections and prevention of recurrence in 70% of the animals. Hamsters treated with MBX-500 displayed significantly greater weight gain than did those treated with vancomycin. Finally, MBX-500 was efficacious in a murine model of CDI, again demonstrating a fully protective effect and permitting near-normal weight gain in the treated animals. These selective anti-CDI features support the further development of MBX 500 for the treatment of CDI.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Anti-Bacterial Agents / chemical synthesis
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / antagonists & inhibitors*
  • Bacterial Proteins / metabolism
  • Clostridioides difficile / drug effects*
  • Clostridioides difficile / enzymology
  • Clostridioides difficile / isolation & purification
  • Clostridioides difficile / pathogenicity
  • Cricetinae
  • DNA Gyrase / metabolism
  • DNA Topoisomerases, Type I / metabolism
  • DNA-Directed DNA Polymerase / metabolism
  • Enterocolitis, Pseudomembranous / drug therapy*
  • Enterocolitis, Pseudomembranous / microbiology
  • Enterocolitis, Pseudomembranous / mortality
  • Enzyme Inhibitors / chemical synthesis
  • Enzyme Inhibitors / pharmacology*
  • Metronidazole / pharmacology
  • Mice
  • Nucleic Acid Synthesis Inhibitors
  • Species Specificity
  • Survival Rate
  • Topoisomerase II Inhibitors
  • Vancomycin / pharmacology
  • Weight Gain / drug effects

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Enzyme Inhibitors
  • Nucleic Acid Synthesis Inhibitors
  • Topoisomerase II Inhibitors
  • Metronidazole
  • Vancomycin
  • DNA-Directed DNA Polymerase
  • DNA Topoisomerases, Type I
  • DNA Gyrase