Discovery of 2-Sulfinyl-Diazabicyclooctane Derivatives, Potential Oral β-Lactamase Inhibitors for Infections Caused by Serine β-Lactamase-Producing Enterobacterales

J Med Chem. 2021 Jul 8;64(13):9496-9512. doi: 10.1021/acs.jmedchem.1c00799. Epub 2021 Jun 18.

Abstract

Coadministration of β-lactam and β-lactamase inhibitor (BLI) is one of the well-established therapeutic measures for bacterial infections caused by β-lactam-resistant Gram-negative bacteria, whereas we have only two options for orally active BLI, clavulanic acid and sulbactam. Furthermore, these BLIs are losing their clinical usefulness because of the spread of new β-lactamases, including extended-spectrum β-lactamases (ESBLs) belonging to class A β-lactamases, class C and D β-lactamases, and carbapenemases, which are hardly or not inhibited by these classical BLIs. From the viewpoints of medical cost and burden of healthcare personnel, oral therapy offers many advantages. In our search for novel diazabicyclooctane (DBO) BLIs possessing a thio-functional group at the C2 position, we discovered a 2-sulfinyl-DBO derivative (2), which restores the antibacterial activities of an orally available third-generation cephalosporin, ceftibuten (CTB), against various serine β-lactamase-producing strains including carbapenem-resistant Enterobacteriaceae (CRE). It can be orally absorbed via the ester prodrug modification and exhibits in vivo efficacy in a combination with CTB.

MeSH terms

  • Anti-Bacterial Agents / chemical synthesis
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Azabicyclo Compounds / chemical synthesis
  • Azabicyclo Compounds / chemistry
  • Azabicyclo Compounds / pharmacology*
  • Cyclooctanes / chemical synthesis
  • Cyclooctanes / chemistry
  • Cyclooctanes / pharmacology*
  • Dose-Response Relationship, Drug
  • Drug Discovery
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / enzymology
  • Microbial Sensitivity Tests
  • Molecular Structure
  • Serine / antagonists & inhibitors
  • Serine / metabolism
  • Structure-Activity Relationship
  • beta-Lactamase Inhibitors / chemical synthesis
  • beta-Lactamase Inhibitors / chemistry
  • beta-Lactamase Inhibitors / pharmacology*
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Cyclooctanes
  • beta-Lactamase Inhibitors
  • Serine
  • beta-Lactamases