Affiliation:
1. JMI Laboratories, North Liberty, Iowa, USA
Abstract
ABSTRACT
WCK 5222 consists of cefepime combined with zidebactam, a bicyclo-acyl hydrazide β-lactam enhancer antibiotic with a dual action involving binding to Gram-negative bacterial PBP2 and β-lactamase inhibition. We evaluated the
in vitro
activity of cefepime-zidebactam against 7,876 contemporary (2015) clinical isolates of
Enterobacteriaceae
(
n
= 5,946),
Pseudomonas aeruginosa
(
n
= 1,291), and
Acinetobacter
spp. (
n
= 639) from the United States (
n
= 2,919), Europe (
n
= 3,004), the Asia-Pacific (
n
= 1,370), and Latin America (
n
= 583). The isolates were tested by a reference broth microdilution method for susceptibility against cefepime-zidebactam (1:1 and 2:1 ratios) and comparator agents. Cefepime-zidebactam was the most active compound tested against
Enterobacteriaceae
(MIC
50/90
, ≤0.03/0.12 μg/ml [1:1] and 0.06/0.25 μg/ml [2:1]; 99.9% of isolates were inhibited at ≤4 [1:1] and ≤8 μg/ml [2:1]). Cefepime-zidebactam was active against individual
Enterobacteriaceae
species (MIC
50/90
, ≤0.03 to 0.06/≤0.03 to 0.5 μg/ml [1:1]) and retained potent activity against carbapenem-resistant isolates (MIC
50/90
, 1/4 μg/ml; 99.3% of isolates were inhibited at ≤8 μg/ml [1:1]). Cefepime-zidebactam activity was consistent among geographic regions, and only one isolate showed MIC values of >8 μg/ml (1:1). Cefepime-zidebactam was also very active against
P. aeruginosa
with MIC
50/90
values of 1/4 μg/ml, and 99.5% of isolates were inhibited at ≤8 μg/ml (1:1). The MIC values for cefepime-zidebactam at the 1:1 ratio were generally 2-fold lower than those for cefepime-zidebactam at the 2:1 ratio (MIC
50/90
, 2/8 μg/ml) and zidebactam alone (MIC
50/90
, 4/8 μg/ml). Against
Acinetobacter
spp., cefepime-zidebactam at 1:1 and 2:1 ratios (MIC
50/90
, 16/32 μg/ml for both) was 4-fold more active than cefepime or ceftazidime. Zidebactam exhibited potent
in vitro
antimicrobial activity against some organisms. These results support the clinical development of WCK 5222 for the treatment of Gram-negative bacterial infections, including those caused by multidrug-resistant isolates.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
68 articles.
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