Session: Inhibitors of Bacterial and Fungal Efflux Pumps                               Location:                                           Exhibit Hall                              Session Date:                                           Monday, 9/27/99                              Session Time:                                           3:00 pm - 4:30 pm
                               Inhibitors of Efflux Pumps in Pseudomonas aeruginosa Potentiate the Activity of                              the Fluoroquinolone Antibacterial Levofloxacin 
                               T.E. Renau1, R. Leger1, E.M. Flamme1, J. Sangalang1, M.W. She1, R. Yen1,                              C.L. Ford1, K.M. Mathias1, S. Chamberland1, S.J. Hecker1, V.J. Lee1, T.                              Ohta2, K. Nakayama2                              1Microcide Pharmaceuticals, Inc.: Mountain View, CA; 2Daiichi Pharmaceutical                              Co. Ltd.: Tokyo, Japan
                               P. aeruginosa is an opportunistic pathogen characterized by intrinsic resistance to a wide                              variety of antimicrobial agents, a property that has been attributed in part to the activity of                              several efflux systems. We embarked on a program to identify broad-spectrum efflux                              pump inhibitors in P. aeruginosa in order to potentiate the activity of the fluoroquinolone                              antibacterial agent levofloxacin. To identify potential inhibitors, we screened against                              specifically engineered strains of P. aeruginosa that over-expressed each of the known                              pumps. Follow-up studies were implemented to confirm that the inhibitors were indeed                              blocking the efflux pumps. One of the compounds identified from this effort was                              MC-207,110, a low molecular weight dipeptide amide. The compound had minimal                              intrinsic antibacterial activity (MIC = 256 µg/mL) but potentiated the activity of                              levofloxacin 8-fold at 10 µg/mL. The overall in vitro biological profile and structural                              simplicity of MC-207,110 led to its choice as the lead compound in our program. We                              began an extensive medicinal chemistry effort to optimize the biological and                              physicochemical properties of this lead. Herein we describe a portion of our work in this                              area and disclose the first known class of broad-spectrum efflux pump inhibitors in                              P. aeruginosa. |