U.S. patent application number 17/090218 was filed with the patent office on 2021-02-25 for respiratory infection treating agent.
This patent application is currently assigned to KYORIN PHARMACEUTICAL CO., LTD.. The applicant listed for this patent is KYORIN PHARMACEUTICAL CO., LTD.. Invention is credited to Hirotaka ANDO, Kota KUME, Yuta TANAKA, Hisao YOSHIDA.
Application Number | 20210052572 17/090218 |
Document ID | / |
Family ID | 1000005199077 |
Filed Date | 2021-02-25 |
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United States Patent
Application |
20210052572 |
Kind Code |
A1 |
KUME; Kota ; et al. |
February 25, 2021 |
RESPIRATORY INFECTION TREATING AGENT
Abstract
[Problem] The present invention pertains to a safer and more
effective respiratory infection treating agent. [Solution] A
respiratory infection treating agent containing, as an active
ingredient,
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquin
oline-3-carboxylic acid or a pharmaceutically acceptable salt
thereof.
Inventors: |
KUME; Kota; (Tokyo, JP)
; YOSHIDA; Hisao; (Tokyo, JP) ; ANDO;
Hirotaka; (Tochigi, JP) ; TANAKA; Yuta;
(Tochigi, JP) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
KYORIN PHARMACEUTICAL CO., LTD. |
Tokyo |
|
JP |
|
|
Assignee: |
KYORIN PHARMACEUTICAL CO.,
LTD.
Tokyo
JP
|
Family ID: |
1000005199077 |
Appl. No.: |
17/090218 |
Filed: |
November 5, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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16189461 |
Nov 13, 2018 |
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17090218 |
|
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15554329 |
Aug 29, 2017 |
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PCT/JP2016/057797 |
Mar 11, 2016 |
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16189461 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61K 31/4709 20130101;
Y02A 50/30 20180101 |
International
Class: |
A61K 31/4709 20060101
A61K031/4709 |
Foreign Application Data
Date |
Code |
Application Number |
Mar 13, 2015 |
JP |
2015-051206 |
Jul 8, 2015 |
JP |
2015-136944 |
Claims
1-13. (canceled)
14. A method of treating a respiratory infection comprising,
administering
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof in an amount
effective to treat the respiratory infection to a subject in need
thereof, wherein the subject is human and wherein
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof is administered
in an amount of 10 mg to 250 mg per day.
15. A method of treating an infection which is one or more
infections selected from the group consisting of pharyngitis,
laryngitis, tonsillitis, acute bronchitis, pneumonia, secondary
infections of chronic respiratory diseases, sinusitis, and
tympanitis, and in which pathogenic bacteria are Streptococcus
pneumoniae, the method comprising, administering
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof in an amount
effective to treat the respiratory infection to a subject in need
thereof, wherein the subject is human and wherein 7-[(3
S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluoro-1-(-
2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof is administered
in an amount of 10 mg to 250 mg per day.
Description
TECHNICAL FIELD
[0001] The present invention relates to a respiratory infection
treating agent.
BACKGROUND ART
[0002] Since the development of norfloxacin, quinolone carboxylic
acid-based antibacterial agents called new quinolone have been
developed worldwide. Currently, many new quinolone-based
antibacterial agents are generally used as an infection treating
agent.
[0003] On the other hand, a quinolone carboxylic acid derivative
represented by a general formula (1) is disclosed by this applicant
(Patent Literature 1).
##STR00001##
[0004] In the formula (1), R.sup.1 is an alkyl group having 1 to 6
carbon atoms of which 1 or 2 or more hydrogen atoms may be
substituted with 1 or 2 or more halogen atoms, a cycloalkyl group
which has 3 to 6 carbon atoms and may be substituted with 1 or 2 or
more halogen atoms, or an aryl or heteroaryl group which may be
substituted with 1 or 2 or more substituents which are the same or
different and are selected from a halogen atom and an amino group;
R.sup.2 is a hydrogen atom, an alkyl group having 1 to 3 carbon
atoms, or a pharmaceutically acceptable cation; R.sup.3 is a
hydrogen atom, a halogen atom, a hydroxyl group, an amino group, or
an alkyl group having 1 to 3 carbon atoms; R.sup.4 is a hydrogen
atom or a halogen atom; R.sup.5 is a fluorine atom; R.sup.6 is a
hydrogen atom or a fluorine atom; and A is a nitrogen atom or
.dbd.C--X (wherein X is a hydrogen atom, a halogen atom, amino
groups, cyano groups, or an alkyl or alkcxyl group which has 1 to 3
carbon atoms and may be substituted with 1 or 2 or more halogen
atoms).
[0005] Patent Literature 1 also discloses
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid as one example of the quinolone carboxylic acidderivative. A
hydrochloride salt thereof is disclosedin Patent Literature 2.
CITATION LIST
Patent Literature
[0006] Patent Literature 1: WO2005/026147
[0007] Patent Literature 2: WO2013/069297
SUMMARY OF INVENTION
Technical Problem
[0008] An object of the present invention is to provide a novel
respiratory infection treating agent.
Solution to Problem
[0009] The present inventor has studied a safer and more effective
respiratory infection treating agent.
[0010] As a result, the inventor has found that among quinolone
carboxylic acid derivatives represented by the general formula (1),
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid and a pharmaceutically acceptable salt thereof, and in
particular, a hydrochloride salt thereof have significantly high
tissue distribution ratio into the respiratory organ (particularly,
the lung) and distribute into the respiratory organ rapidly after
administration, and therefore, are extremely useful as a
respiratory infection treating agent. The present invention has
thus been completed.
[0011] A summary of the present invention is as follows:
[0012] [1] A respiratory infection treating agent containing, as an
active ingredient,
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof.
[0013] [2] The treating agent according to [1], wherein the
respiratory infection treating agent is a respiratory infection
treating agent for human.
[0014] [3] The treating agent according to [1] or [2], wherein the
respiratory infection is one or two or more infections selected
from the group consisting of pharyngitis, laryngitis, tonsillitis,
acute bronchitis, pneumonia, and secondary infections of chronic
respiratory diseases.
[0015] [4] The treating agent according to any one of [1] to [3],
wherein pathogenic bacteria causing the respiratory infection are
one or two or more types of bacteria selected from the group
consisting of bacteria belonging to Staphylococcus sp., bacteria
belonging to Streptococcus sp., Moraxella catarrhalis, bacteria
belonging to Klebsiella sp., Haemophilus influenzae, and
Escherichia coli.
[0016] [5] The treating agent according to any one of [1] to [4],
wherein the pathogenic bacteria causing the respiratory infection
are one or two or more types of bacteria belonging to any of
Streptococcus sp. and Staphylococcus sp.
[0017] [6] The treating agent according to any one of [1] to [5],
wherein the pathogenic bacteria causing the respiratory infection
have drug resistance.
[0018] [7] The treating agent according to any one of [1] to [6],
wherein the dose of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is 10 mg
or more and 250 mg or less.
[0019] [8] A treating agent for an infection which is one or two or
more selected from the group consisting of pharyngitis, laryngitis,
tonsillitis, acute bronchitis, pneumonia, secondary infections of
chronic respiratory diseases, sinusitis, and tympanitis, and in
which pathogenic bacteria are Streptococcus pneumoniae, the
treating agent including, as an active ingredient,
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof.
[0020] [9] A method for treating a respiratory infection, including
administering
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof in an amount
effective to treat a respiratory infection to a subject in need
thereof.
[0021] [10] The method according to [9], wherein the subject is
human.
[0022] [11] The method according to [9] or [10], wherein the
respiratory infection is one or two or more infections selected
from the group consisting of pharyngitis, laryngitis, tonsillitis,
acute bronchitis, pneumonia, and secondary infections of chronic
respiratory diseases.
[0023] [12] The method according to any one of [9] to [11], wherein
pathogenic bacteria causing the respiratory infection are one or
two or more types of bacteria selected from the group consisting of
bacteria belonging to Staphylococcus sp., bacteria belonging to
Streptococcus sp., Moraxella catarrhalis, bacteria belonging to
Klebsiella sp., Haemophilus influenzae, and Escherichia coli.
[0024] [13] The method according to any one of [9] to [12], wherein
the pathogenic bacteria causing the respiratory infection are one
or two or more types of bacteria belonging to any of Streptococcus
sp. and Staphylococcus sp.
[0025] [14] The method according to any one of [9] to [13], wherein
the pathogenic bacteria causing the respiratory infection have drug
resistance.
[0026] [15] The method according to any one of [9] to [14], wherein
the dose of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-
-6-fluoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxy-
lic acid or a pharmaceutically acceptable salt thereof per day is
10 mg or more and 250 mg or less.
[0027] [16]
7-[(3S,4S)-3-((cyclopropylamino)methyl1-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof for treating a
respiratory infection.
[0028] [17] The compound for treatment of a respiratory infection
according to [16], wherein the respiratory infection is a
respiratory infection in human.
[0029] [18] The compound for treatment of a respiratory infection
according to [16] or [17], wherein the respiratory infection is one
or two or more infections selected from the group consisting of
pharyngitis, laryngitis, tonsillitis, acute bronchitis, pneumonia,
and secondary infections of chronic respiratory diseases.
[0030] [19] The compound for treatment of a respiratory infection
according to any one of [16] to [18], wherein pathogenic bacteria
causing the respiratory infection are one or two or more types of
bacteria selected from the group consisting of bacteria belonging
to Staphylococcus sp., bacteria belonging to Streptococcus sp.,
Moraxella catarrhalis, bacteria belonging to Klebsiella sp.,
Haemophilus influenzae, and Escherichia coli.
[0031] [20] The compound for treatment of a respiratory infection
according to anyone of [16] to [19], wherein the pathogenic
bacteria causing the respiratory infection are one or two or more
types of bacteria belonging to any of Streptococcus sp. and
Staphylococcus Sp.
[0032] [21] The compound for treatment of a respiratory infection
according to any one of [16] to [20], wherein the pathogenic
bacteria causing the respiratory infection have drug
resistance.
[0033] [22] The compound for treating a respiratory infection
according to any one of [16] to [21], wherein the dose of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquin
oline-3-carboxylic acid or a pharmaceutically acceptable salt
thereof per day is 10 mg or more and 250 mg or less.
[0034] [23] Use of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof for
manufacturing of a medicament for treatment of a respiratory
infection.
[0035] [24] The use according to [23], wherein the respiratory
infection is a respiratory infection in human.
[0036] [25] The use according to [22] or [24], wherein the
respiratory infection is one or two or more infections selected
from the group consisting of pharyngitis, laryngitis, tonsillitis,
acute bronchitis, pneumonia, and secondary infections of chronic
respiratory diseases.
[0037] [26] The use according to any one of [23] to [25], wherein
pathogenic bacteria causing the respiratory infection are one or
two or more types of bacteria selected from the group consisting of
bacteria belonging to Staphylococcus sp., bacteria belonging to
Streptococcus sp., Moraxella catarrhalis, bacteria belonging to
Klebsiella sp., Haemophilus influenzae, and Escherichia coli.
[0038] [27] The use according to any one of [23] to [26], wherein
the pathogenic bacteria causing the respiratory infection are one
or two or more types of bacteria belonging to any of Streptococcus
sp. and Staphylococcus sp.
[0039] [28] The use according to any one of [23] to [27], wherein
the pathogenic bacteria causing the respiratory infection have drug
resistance.
[0040] [29] The use according to any one of [23] to [28], wherein
the dose of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fl-
uoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is 10 mg
or more and 250 mg or less.
[0041] [30] A method for treating an infection which is one or two
or more selected from the group consisting of pharyngitis,
laryngitis, tonsillitis, acute bronchitis, pneumonia, secondary
infections of chronic respiratory diseases, sinusitis, and
tympanitis, and in which the pathogenic bacteria are Streptococcus
pneumoniae, the method including administering
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof in an amount
effective to treat the respiratory infection to a subject in need
thereof.
[0042] [31]
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof for treatment of
an infection which is one or two or more selected from the group
consisting of pharyngitis, laryngitis, tonsillitis, acute
bronchitis, pneumonia, secondary infections of chronic respiratory
diseases, sinusitis, and tympanitis, and in which the pathogenic
bacteria are Streptococcus pneumoniae.
[0043] [32] Use of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof in manufacturing
of amedicament for treatment of an infection which is one or two or
more selected from the group consisting of pharyngitis, laryngitis,
tonsillitis, acutebronchitis, pneumonia, secondary infections of
chronic respiratory diseases, sinusitis, and tympanitis, and in
which the pathogenic bacteria are Streptococcus pneumoniae.
[0044] [33] The treating agent according to [8], wherein the dose
of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is 10 mg
or more and 250 mg or less.
[0045] [34] The treating agent according to [1], wherein the dose
of
7-[(3S,4S)-3-1(cyclopropylamino)methyl1-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is 75 mg
or two times the amount.
[0046] [35] A treating agent for an infection which is one or two
or more selected from the group consisting of pharyngitis,
laryngitis, tonsillitis, acute bronchitis, pneumonia, secondary
infections of chronic respiratory diseases, sinusitis, and
tympanitis, the treating agent containing
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoruethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof, wherein the
dose of the compound per day is 75 mg or two times the amount.
[0047] [36] The treating agent according to [35], wherein
pathogenic bacteria causing the infection are Streptococcus
pneumoniae.
[0048] [37] The treating agent according to [1], wherein the
maximum plasma concentration of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof after
administration of the treating agent to human with a respiratory
infection is 3 .mu.g/mL or less.
[0049] [38] The treating agent according to [1], wherein the
maximum plasma concentration of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof after
administration of the treating agent to human with a respiratory
infection is 0.5 .mu.g/ml or more and 1.5 .mu.g/mL or less.
[0050] [39] The treating agent according to [1], wherein the
maximum plasma concentration of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof after
administration of the treating agent to human with a respiratory
infection is 0.7 .mu.g/mL or more and 1.2 .mu.g/mL or less.
[0051] [40] The treating agent according to [37], wherein the dose
of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is 75 mg
or two times the amount.
[0052] [41] The treating agent according to [38] or [39], wherein
the dose of
7-[(3S,4S)-3-{(cyclopropylamino}methyl)-4-fluoropyrrolidine-1-yl]-6-fl-
uoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is 75
mg.
[0053] [42] An infection treating agent containing 7-[(3S,
4S)-3-(cyclopropylamino)methyl1-4-fluoropyrrolidine-1-yl]-6-fluoro-1-(2-f
luoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid
or a pharmaceutically acceptable salt thereof, wherein the tissue
distribution ratio of the compound into an alveolar epithelial
lining fluid 1 hour after administration to human is 10 or
more.
[0054] [43] An infection treating agent containing
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof, wherein the
tissue distribution ratio of the compound into an alveolar
epithelial lining fluid 1 hour after administration to human is 10
or more and 50 or less. [44] An infection treating agent containing
7-[(3S,4S){(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluoro-1-
-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof, wherein the
tissue distribution ratio of the compound into an alveolar
epithelial lining fluid 1 hour after administration to human is 15
or more and 40 or less.
Advantageous Effects of Invention
[0055] The present invention can provide a technique pertaining to
a novel respiratory infection treating agent.
BRIEF DESCRIPTION OF DRAWINGS
[0056] FIG. 1 is a graph showing the number of bacteria in the lung
of mouse after subcutaneous administration of a drug in Test
Example 6.
[0057] FIG. 2 is a graph showing the number of bacteria in the lung
of mouse after oral administration of a drug in Test Example 6.
DESCRIPTION OF EMBODIMENTS
[0058] Hereinafter, one of embodiments of the present invention
will be described in detail.
[0059] A treating agent of the embodiment relates to a respiratory
infection treating agent, and for example, can be used for
treatment of respiratory infection in human.
[0060] The respiratory infection means an infection caused at any
location of the respiratory organ.
[0061] The respiratory organ collectively refers to the organ
pertaining to respiration, and means the organ from the nasal
vestibule to the alveolar through the nasal cavity, the pharynx,
the larynx, the trachea, the bronchus, and the bronchiole.
[0062] Examples of the respiratory infection involved in the
treating agent of the embodiment may include one or two or more
respiratory infections selected from the group consisting of common
cold, pharyngitis, laryngitis, epiglottitis, tonsillitis (including
peritonsillitis and peritonsillar abscess), bronchitis (including
acute bronchitis, chronic bronchitis, and diffuse
panbronchiolitis), pneumonia, secondary infections of chronic
respiratory diseases, and bronchiectasis.
[0063] In order to treat one or two or more respiratory infections
selected from the group consisting of pharyngitis, laryngitis,
tonsillitis, acute bronchitis, pneumonia, and secondary infections
of chronic respiratory diseases among these infections, it is
preferable that the treating agent of the embodiment be used. A
target disease of the treating agent in a more preferred embodiment
maybe one or two or more types of respiratory infections selected
from the group consisting of the acute bronchitis, pneumonia, and
secondary infections of chronic respiratory diseases, since the
compound according to the embodiment can be rapidly transferred to
a location where symptom occurs to achieve more effective
treatment.
[0064] Pathogenic bacteria causing the respiratory infection which
is the target disease of the treating agent of the embodiment are,
for example, one or two or more types of bacteria selected from the
group consisting of bacteria belonging to Staphylococcus sp.,
bacteria belonging to Streptococcus sp., Moraxella (Branhamella)
catarrhalis, bacteria belonging to Klebsiella sp., bacteria
belonging to Enterobacter sp., Haemophilus influenzae, bacteria
belonging to Enterococcus sp., Escherichia coli, Pseudomonas
aeruginosa, Legionella, Chlamydia, Mycoplasma, Coxiellaburnetii,
Bordetella pertussis, and anaerobic bacteria.
[0065] The pathogenic bacteria for which the treating agent of the
embodiment is used is more preferably one or two or more types of
bacteria selected from the group consisting of bacteria belonging
to Staphylococcus sp, bacteria belonging to Streptococcus sp.,
Moraxella catarrhalis, bacteria belonging to Klebsiella sp.,
bacteria belonging to Enterobacter sp., Haemophilus influenzae,
Legionella pneumophila, C. pneumoniae (Chlamydophil apneumoniae),
M. pneumoniae (Mycoplasma pneumoniae), and Escherichia coli,
further preferably one or two or more types of bacteria selected
from the group consisting of bacteria belonging to Staphylococcus
sp., bacteria belonging to Streptococcus sp., Moraxella
catarrhalis, bacteria belonging to Klebsiella sp., Haemophilus
influenzae, and Escherichia coli, and particularly preferably one
or two or more types of bacteria belonging to any of Streptococcus
sp. and Staphylococcus sp.
[0066] Examples of pathogenic bacteria belonging to Streptococcus
sp. may include Pneumococcus, Streptococcus pyogenes, hemolytic
streptococcus, and Streptococcus sanguinis. Among these, the
pathogenic bacteria for which the treating agent of the embodiment
is used is preferably Streptococcus pneumoniae. Examples of the
pathogenic bacteria belonging toStaphylococcus sp. may include
Staphylococcus aureus and Staphylococcus epidermidis. Among these,
the pathogenic bacteria for which the treating agent of the
embodiment is used is preferably Staphylococcus aureus. Therefore,
the treating agent of the embodiment can be used for treatment of
one or two or more types of respiratory infections which are
selected from the group consisting of acute bronchitis,
pneumococcus, and secondary infections of chronic respiratory
diseases and in which pathogenic bacteria are Streptococcus
pneumoniae and/or Staphylococcus aureus.
[0067] Herein, pathogenic bacteria mean a concept including
bacteria which have acquired drug resistance. The drug resistance
means a phenomenon in which an organism has resistance to a drug
and the drug is not effective or is unlikely to be effective.
Examples of drug resistance may include resistance to penicillin,
resistance to cephem, resistance to carbapenem, resistance to
aminoglycoside, resistance to macrolide, resistance to lincomycin,
resistance to trimethoprim-sulfa, resistance to tetracycline,
resistance to metronidazole, resistance to glycopeptide, resistance
to oxazolidinone, resistance to daptomycin, and resistance to
quinolone.
[0068] Examples of the bacteria which have acquired drug resistance
may include penicillin-resistant bacteria such as
penicillin-resistant Streptococcus pneumoniae (PRSP),
methicillin-resistant bacteria such as methicillin-resistant
Staphylococcus aureus (MRSA) and methicillin-resistant
Staphylococcus epidemidis (MRSE), vancomycin-resistant bacteria
such as vancomycin-resistant enterococcus (VRE),
macrolide-resistant bacteria such as macrolide-resistant
Streptococcus pneumoniae, and quinolone-resistant bacteria such as
quinolone-resistant Streptococcus pneumoniae.
[0069] A disease to be treated by the treating agent of the
embodiment maybe any of a respiratory infection in which the
pathogenic bacteria are non-drug-resistant bacteria and a
respiratory infection in which the pathogenic bacteria are bacteria
which have acquired drug resistance, and is not particularly
limited. On the other hand, since the treating agent of the
embodiment also exhibits excellent therapeutic effect on a
respiratory infection in which the pathogenic bacteria are bacteria
which have acquired drug resistance, the pathogenic bacteria
causing the target disease of the treating agent of the embodiment
may be preferably quinolone-resistant bacteria, and more preferably
quinolone-resistant Streptococcus pneumoniae and/or
quinolone-resistant Staphylococcus aureus. Therefore, the treating
agent of the embodiment can be used for treatment of one or two or
more types of respiratory infections which are selected from the
group consisting of acute bronchitis, pneumonia, and secondary
infections of chronic respiratory diseases, and in which the
pathogenic bacteria are quinolone-resistant Streptococcus
pneumoniae and/or quinolone-resistant Staphylococcus aureus.
[0070] The treating agent of the embodiment may be composed of
7-[(3S8,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluo-
ro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof alone. The
treating agent of the embodiment may be a pharmaceutical
composition containing
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof, and another
compound acting as an active ingredient, and/or a pharmaceutically
acceptable additive.
[0071] The pharmaceutical composition can contain one or more types
of compounds as the other compound acting as an active ingredient
and/or as the pharmaceutically acceptable additive. The
pharmaceutical composition can be prepared, for example, by mixing
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof with one or more
types of the compound acting as an active ingredient or the
additive.
[0072] Examples of the pharmaceutically acceptable additive
contained with
7-[(3S,4S)-3-{(cyclopropylamino}methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof may include an
excipient, a lubricant, a binder, a disintegrant, a stabilizer, a
flavoring agent, and a diluent. These additives are not
particularly limited as long as they can be used for production of
a pharmaceutical preparation, and for example, an additive listed
in "Japanese Pharmaceutical Excipients Directory (International
Pharmaceutical Excipients Council Japan, YAKUJI NIPPO, LTD. (2007))
can be appropriately used.
[0073] The treating agent of the embodiment can be administered to
a subject such as human in a form well conventionally known as a
pharmaceutical form through an administration route well
conventionally known as a pharmaceutical route. For example, the
treating agent may be orally or non-orally administrated in a form
of preparation such as a powder, a tablet, a capsule, a subtle
granule, a granule, a syrup, an injection, an ophthalmic liquid, an
aqueous nose drop, an aqueous ear drop, or an inhalant liquid.
Specifically, the treating agent of the embodiment may be produced
in the form exemplified above, for example, by mixing a
physiologically acceptable carrier, excipient, binder, and diluent,
and the like with the active ingredient.
[0074] In order to reduce a side effect, form a small preparation
which can be easily administrated, and prevent development of
resistant bacteria, the dose of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day is
preferably 10 mg or more and 250 mg or less, more preferably 20 mg
or more and 200 mg or less, further preferably 30 mg or more and
160 mg or less, still more preferably 40 mg or more and 100 mg or
less, yet more preferably 50 mg or more and 90 mg or less, and
particularly preferably 60 mg or more and 80 mg or less. The
treating agent in a daily dose may be administrated once or in
divided doses two to three times. It is preferable that the
treating agent be administrated once per day. When the effect is
insufficient, the treating agent may be used in an amount which is
two times the daily dose.
[0075] In order to rapidly reach the target blood level, loading
administration maybe performed. The loading administration means an
administration design in which the daily dose or the number of
administration per day is increased at the early stage of
administration to rapidly reach the target blood level. The early
stage of administration means the first to third days of initiation
of the administration, preferably the first to second days, and
further preferably the first day of initiation of the
administration. As an increased daily dose, an amount which is two
times the daily dose is preferably used.
[0076] When the loading administration is performed, it is
preferable that the amount which is two times the daily dose be
used on the first day of initiation of administration.
[0077] A pharmaceutically acceptable salt of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid is not particularly limited as long as it is a
pharmacologically acceptable salt. Examples thereof may include
salts with inorganic acids such as hydrochloric acid, hydrobromic
acid, sulfuric acid, and phosphoric acid, salts with organic acids
such as maleic acid, fumaric acid, succinic acid, malic acid,
malonic acid, methanesulfonic acid, toluenesulfonic acid,
benzenesulfonic acid, lactic acid, oxalic acid, acetic acid,
trifluoroacetic acid, and tartaric acid, and salts with metals such
as sodium, potassium, magnesium, calcium, aluminum, cesium,
chromium, cobalt, copper, iron, zinc, platinum, and silver. In
particular, a hydrochloride salt is particularly preferable from
the viewpoint of stability and the distribution ratio to the
lung.
[0078]
7-[(3S,4S)-3-1(cyclopropylamino)methyl1-4-fluoropyrrolidine-1-yl]-6-
-fluoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxyli-
c acid or the pharmaceutically acceptable salt thereof can be
produced, for example, in accordance with the method described in
Patent Literature 1 or 2.
[0079] Therefore, this embodiment can provide a technique
pertaining to a novel treatment of a respiratory infection.
[0080] 7-[(3S,
4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluoro-1-(2--
fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid
and a pharmaceutically acceptable salt thereof, and in particular,
a hydrochloride salt thereof have significantly high tissue
distribution ratio into the respiratory organ (particularly, the
lung) and distribute into the respiratory organ rapidly after
administration. As compared with other quinolone compounds, the
tissue distribution ratio into the respiratory organ in human is
more excellent.
[0081] For example, the maximum plasma concentration of
7-[(3s,4S)-3-{(cyclopropyldmino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof after
administration of the treating agent according to the embodiment to
human with a respiratory infection may be 3 .mu.g/mL or less. In
this case, the dose of 7-[(3S,
4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluoro-1-(2--
fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid
or a pharmaceutically acceptable salt thereof per day may be 75 mg
or two times the amount.
[0082] In a preferable aspect, the maximum plasma concentration of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof after
administration of the treating agent according to the embodiment to
human with a respiratory infection may be 0.5 .mu.g/ml, or more and
1.5 .mu.g/mL or less, and in a more preferable aspect, the maximum
plasma concentration may be 0.7 .mu.g/mL or more and 1.2 .mu.g/mL
or less. In this case, the dose of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof per day may be
75 mg.
[0083] Therefore, the treating agent in a smaller dose than that of
another drug can be expected to be effective against foci in the
lung tissue or the like. Accordingly, a reduction in side effect,
formation of a small preparation which can be easily administrated,
prevention of development of resistant bacteria, and the like can
be expected.
[0084] Further, the treating agent of the embodiment also exhibits
excellent therapeutic effect on a respiratory infection in which
the pathogenic bacteria are bacteria which have acquired drug
resistance, such as quinolone-resistant bacteria.
[0085] Additionally, the treating agent of the embodiment has the
property that the frequency of development of resistant bacteria is
lower than those in the other quinolone compounds.
[0086] Therefore, this embodiment can provide a respiratory
infection treating agent which has excellent effectiveness and
safety.
EXAMLES
[0087] Hereinafter, the present invention will be described more in
detail with reference to Examples, but the present invention is not
limited to the scope of the present invention by these Examples
.
Reference Example 1-1
[0088]
6,7-difluoro-1-(2-fluoroethyl)-8-methoxy-1,4-dihydro-4-oxo[2-.sup.1-
4C.sub.1]quinoline-3-carboxylic acid ethyl ester (compound A-1)
##STR00002##
[0089] A mixture (reaction liquid) of ethyl
3-(2,4,5-trifluoro-3-methoxy)phenyl-3-oxopropanate (1397.4 mg, 5.06
mmol), acetic anhydride (13.4 mL), and triethyl ortho [.sup.14C]
formate (293 mCi, 851 .mu.L, 758 mg, 5.05 mmol, density: 0.891
g/mL) was heated and refluxed for 1 hour under a nitrogen
atmosphere. The reaction liquid was cooled to room temperature,
toluene (17 mL) was added to the reaction liquid, and the obtained
mixture was concentrated under reduced pressure using a rotary
evaporator. To the residue, toluene (17 mL) was added, and the
mixture was concentrated under reduced pressure using a rotary
evaporator. This operation was repeated 4 times, to obtain a yellow
oily product.
[0090] To the residue as the obtained oily product,
dimethylsulfoxide (13.4 mL),
2-fluoroethylaminehydrochloride(1259.84 mg, 12.7 mmol), and
potassium carbonate (1745.4 mg, 12.6 mmol) were added to obtain a
reaction liquid. The reaction liquid was stirred at 47.degree. C.
for 3 hours under a nitrogen atmosphere. To the reaction liquid,
potassium carbonate (1752.9 mg, 12.7 mmol) was added, and the
mixture was stirred at 78.degree. C. for 1 hour, and then stirred
at room temperature overnight, to obtain a reaction liquid. To the
reaction liquid, water (50.5 mL) and acetone (8.4 mL) were added,
and the mixture was stirred at room temperature for 20 minutes, and
then stirred at 0.degree. C. for 30 minutes, to obtain a
precipitate. The precipitate was collected by filtration, and
washed twice with a mixed liquid (5 mL) of water and acetone
(water:acetone=6:1). The resulting solid was dried under reduced
pressure to obtain 1286.8 mg of crude product.
[0091] To the obtained crude product, ethanol (24 mL) was added.
The mixture was heated and refluxed under a nitrogen atmosphere
until the solidwascompletelydissolved. Themixedsolutionwas
gradually cooled to room temperature, and water (5 mL) was added.
After that, the mixture was stirred at room temperature for 20
minutes, and stirred at 10 to 15.degree. C. for 30 minutes, to
obtain a precipitate. The precipitate was collected by filtration,
and washed twice with ethanol (1.6 mL). The solid was dried at
40.degree. C. until the mass was constant.
[0092] To the obtained solid, ethanol (21.8 mL) was added, and the
mixture was heated and refluxed under a nitrogen atmosphere until
the solid was completely dissolved. The obtained solution was
gradually cooled to room temperature, and stirred at 10 to
15.degree. C. for 30 minutes, to obtain a precipitate. The
precipitate was collected by filtration, washed twice with ethanol
(1.4 mL), and dried at 35 to 40.degree. C. for 1 hour under reduced
pressure. This operation was repeated twice or more to obtain
878.97 mg (2.65 mmol, 153.8 mCi, yield: 53%) of
.sup.14C-6,7-difluoro-1-(2-fluoroethyl)-8-methoxy-1,4-dihydro-4-oxo[2-.su-
p.14C.sub.1]quinoline-3-carboxylic acid ethyl ester (compound
A-1).
Reference Example 1-2
[0093]
6,7-difluoro-1-(2-fluoroethyl)-8-methoxy-1,4-dihydro-4-oxoquinoline-
-3-carboxylic acid ethyl ester (compound A-2)
##STR00003##
[0094] Triethyl orthoformate was used instead of triethyl
ortho[.sup.14C]orthoformate, and the same operation as in Reference
Example 1-1 was performed. Thus,
6,7-difluoro-1-(2-fluoroethyl)-8-methoxy-1,4-dihydro-4-oxoquinoline-3-car-
boxylic acid ethyl ester (compound A-2) was obtained.
Reference Example 2
[0095]
Bis(acetato-O)-[6,7-difluoro-1-(2-fluoroethyl)-8-methoxy-4-oxo
-1,4-dihydro[2-.sup.14C.sub.1]quinoline-3-carboxylato-O.sup.3,O.sup.4]bor-
on (compound B)
##STR00004##
[0096] A mixed liquid (reaction liquid) of boric acid (954 mg, 15.4
mmol), acetic anhydride (8.4 mL), and zinc chloride (7.1 mg, 0.05
mmol) was stirred at room temperature for 10 minutes under a
nitrogen atmosphere. To the reaction liquid, the compound A-1 (878
mg, 2.65 mmol) and the compound A-2 (400 mg, 1.22 mmol) were added.
The reaction liquid was stirred at 55.degree. C. for 2 hours under
a nitrogen atmosphere. The reaction liquid was cooled to 30.degree.
C., and acetone (6.3 mL) was added to the reaction liquid. To a
mixed solution of water (44.5 mL) and aqueous ammonia solution (28%
w/w) (7.7 mL), the resulting mixed liquid containing acetone was
added with stirring at 0.degree. C. The mixed liquid was stirred at
0.degree. C. for 30 minutes, to precipitate a white solid. The
white solid was collected by filtration, and washed twice with
water (1 mL). The resulting solid was dried at 65.degree. C. under
reduced pressure to obtain 1549.6 mg (143.2 mCi) of crude
product.
[0097] To the obtained crude product, acetone (6.3 mL) was added.
The mixture was heated and refluxed under a nitrogen atmosphere
until the solid was completely dissolved. The mixed liquid was
gradually cooled to room temperature, and isopropyl ether (6.3 mL)
was added to the mixed liquid. After that, the mixture was stirred
at room temperature for 15 minutes, and stirred at 10.degree. C.
for 30 minutes, to obtain a precipitate. The precipitate was
collectedby filtration, and washed twice with a mixed liquid (2 mL)
of acetone and diisopropyl ether (1:2). The precipitate was dried
at 65.degree. C. under reducedpressure to obtain 1532.82 mg (3.56
mmol) of compound B (yield: 92%).
Reference Example 3
[0098]
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-
-fluoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydro[2-.sup.14C.sub.1]qui-
noline-3-carboxylic acid hydrochloride (compound C)
##STR00005##
[0099] A mixture (reaction liquid) of
(3R,4S)-3-cyclopropylaminomethyl-4-fluoropyrrolidine (880 mg, 3.81
mol), triethylamine (2.9 mL, 2.1 g, 20.8 mmol), and
dimethylsulfoxide (14.9 mL) was stirred at room temperature for 10
minutes under a nitrogen atmosphere. To the reaction liquid, the
compound B prepared in Reference Example 2 (1489.2 mg, 3.46 mmol)
was added, and the mixture was stirred at room temperature for 2
hours under a nitrogen atmosphere. To the reaction liquid, ethyl
acetate (30 mL), water (30 mL), and an aqueous 2 mol/L sodium
hydroxide solution (3.0 mL, 6.00 mmol) were added, and the mixture
was stirred at room temperature for 5 minutes, and separated into
an aqueous layer and an organic layer. The aqueous layer was washed
twice with ethyl acetate (30 mL), and the combined organic layer
was washed with water (30 mL) and saturated brine (30 mL), dried
with anhydrous sodium sulfate, and concentrated under reduced
pressure.
[0100] To the residue, 2-propanol (30 mL) and 2 mol/L hydrochloric
acid (7.7 mL, 15.4 mmol) were added to obtain a reaction liquid.
The reaction liquid was stirred at room temperature for 30 minutes.
To the reaction liquid, 2-propanol (14.8 mL) was added, and the
reaction liquid was stirred at 60.degree. C. for 45 minutes. The
reaction liquid was cooled to room temperature, and stirred at
0.degree. C. for 30 minutes, to obtain a precipitate. The
precipitate was collected by filtration, and washed three times
with 2-propanol (1.5 mL). The resultant was dried under reduced
pressure to obtain 843.53 mg of crude product.
[0101] To the obtained crude product, ethanol (30 mL) and water
(2.6 mL) were added. The obtained solution was stirred at
97.degree. C. for 25 minutes, and cooled to 25.degree. C. at a
speed of about 1.degree. C./min. The solution was stirred at about
25.degree. C. for 30 minutes, and stirred for 1 hour under
ice-cooling, to obtain a precipitate. The precipitate was collected
by filtration, washed twice with ethanol (3 mL), and dried at
50.degree. C. A mother liquid was concentrated under reduced
pressure, and dried at 50.degree. C.
[0102] The product collected by filtration (569.2 mg, 47 mCi, 82.6
.mu.Ci/mg), the concentrated mother liquid (228.3 mg, 17.9 mCi,
78.4 .mu.Ci/mg), and a compound D (383.8 mg) were combined using
ethanol (42 mL) and water (3.6 mL). The resulting mixture was
stirred at 80.degree. C. under a nitrogen atmosphere until the
solid was completely dissolved. The mixed liquid was gradually
cooled to 39 to 40.degree. C. at a speed of 1.degree. C./min. The
mixed liquid was held to 39.degree. C. for 30 minutes, and then
gradually cooled to 23.degree. C. at a speed of 1.degree. C./min.
The mixed liquid was held at room temperature for 30 minutes, and
then held for 45 minutes under ice-cooling, to obtain a
precipitate. The precipitate was collected by filtration, and
washed twice with ethanol (3 mL), to obtain a white solid. The
white solid was dried under reduced pressure, to obtain a compound
C. ESI MS(positive) m/z:440(M+H).sup.+, 442(M+H).sup.+
Reference Example 4
[0103]
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-
-fluoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquin
olive-3-carboxylic acid hydrochloride (compound D)
[0104]
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-
-fluoro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydr
oquinoline-3-carboxylic acid hydrochloride (compound D) was
synthesized in accordance with the method of Example 1 in Patent
Literature 2. The amounts of the compound D described in the
following Test Examples were values in terms of free form.
Test Example 1
Concentration ir. Tissue (Rat, Oral Administration)
[0105] The compound C (10.83 mg/kg) (solvent:water) was single
orally administrated to a SD rat under fasting. 1, 6, and 24 hours
after the administration, the lung tissue and the plasma were
collected. The lung tissue was dried and treated by a sample
oxidizer system (Sample Oxidizer: Model 307, PerkinElmer Inc.,
glass vial: 20 mL, Wheaton Industries, carbon dioxide absorbent:
Carbo-Sorb 8 mL, PerkinElmer Inc., scintillation cocktail:
Permafluor 12 mL, PerkinElmer Inc.), and the radioactivity
concentration was measured. The plasma was fractionated in a
midi-vial (8 mL, PerkinElmer Inc.), 6 mL of scintillation cocktail
(Ultima Gold) was added, and the radioactivity concentration was
measured. The radioactivity concentration was measured using a
liquid scintillation counter (Tri-Carb 2500TR or 2700TR,
PerkinElmer Inc.) (average value, n=3).
[0106] The results are shown in Table 1.
TABLE-US-00001 TABLE 1 RADIOACTIVITY CONCENTRATION IN TISSUE (.mu.g
eq./mL or g) 1 hr 6 hr 24 hr TISSUE TISSUE TISSUE DISTRIBUTION
DISTRIBUTION DISTRIBUTION CONCENTRATION RATIO* CONCENTRATION RATIO*
CONCENTRATION RATIO* PLASMA 2.79 -- 0.815 -- 0.0294 -- LUNG 10.3
3.7 2.44 3.0 0.0541 1.9 *The tissue distribution ratio represents a
value obtained by dividing the radioactivity concentration in the
lung tissue by the radioactivity concentration in the plasma.
[0107] As seen from Table 1, the compound C distributed into the
lung tissue rapidly after administration, and 1 hour after the
administration, the tissue distribution ratio into the lung was as
very high as "3.7".
[0108] This value was higher than values of marketed quinolone
preparations, such as "2.7" of sitafloxacin (tissue distribution
ratio into the lung tissue of a male rat 0.5 hours after single
oral administration) (from the interview forms of Gracevit
(registered trademark) tablets 50 mg and Gracevit (registered
trademark) granules 10%), and "2.7" of ofloxacin (tissue
distribution ratio into the lung tissue of a rat 1.0 hour after
oral administration) (from the interview form of Tarivid
(registered trademark) tablets 100 mg).
Test Example 2
Concentration in Tissue (Human, Oral Administration)
[0109] Concentration of compound D in lung tissue (epithelial
lining fluid and alveolar macrophages) and plasma was measured to
investigate intrapulmonary distribution of compound D after oral
single administration of this drag, with reference to a method in
Document (Antimicrobial Agents and Chemotherapy, February 2010, pp.
866-870).
[0110] The measurement was as follows. Healthy adult male
volunteers were given oral single dose of compound D (75 mg). The
bronchoalveolar lavage fluid and blood samples were collected from
the subjects at 1, 2, 4, 6, and 24 hours after the administration.
The collection of the fluid and blood samples was carried out at
each time point for six subjects. The bronchoalveolar lavage fluid
was centrifuged to separate from epithelial lining fluid and
alveolar macrophages for measurement of the drug concentration. The
concentrations of compound D in lung tissue and plasma were
measured by LC/MS/MS. The mean ratios of lung tissue-to-plasma
concentration are shown as tissue distribution ratio in Table 2 at
each sampling points.
TABLE-US-00002 TABLE 2 TISSUE DISTRIBUTION RATIO 1 hr 2 hr 4 hr 6
hr 24 hr ALVEOLAR EPITHELIAL 22.5 18.4 16.5 15.2 15.0 LINING FLUID
ALVEOLAR MACROPHAGES 31.9 18.5 21.9 56.4 38.0
[0111] As shown in Table 2, the tissue distribution ratio of
compound D in epithelial lining fluid and alveolar macrophages is
extremely high with the ranges of 15.0-22.5 and 18.5-56.4,
respectively. The compound D can reach to the respiratory
infectious lesion with high concentration and indicate strong
antibiotic action against the target pathogens causing respiratory
tract infection. Therefore, it is suggested that compound D is
particularly excellent for the treatment of respiratory tract
infection.
[0112] Furthermore, the tissue distribution ratio of compound D at
1 hour after administration in epithelial lining fluid and alveolar
macrophages is 22.5 and 31.9, respectively, which shows
significantly good distribution. Initial antimicrobial effect after
infection is important to the respiratory tract infection
treatment. Compound D is distributed rapidly to intrapulmonary
infectious lesion in one hour after administration. Therefore,
compound D is especially useful for the treatment of respiratory
tract infection.
[0113] The tissue distribution ratio in human of levofloxacin in
the bronchoalveolar lavage fluid is 1.1 to 3.0 (0.5 to 8 hours
after administration), and the tissue distribution ratioin the
alveolar macrophages is 4.1 to 18.9 (0.5 to 24 hours after
administration) (from the interview forms of Cravit (registered
trademark) tablets 250 mg and 500 mg, and Cravit (registered
trademark) granules 10%). The tissue distribution ratio in human of
garenoxacin in the epithelial lining fluid is 0.95.+-.0.41 (2.5 to
3.5 hours after administration), and the tissue distribution ratio
in the alveolar macrophages is 11.15.+-.8.16 (2.5 to 3.5 hours
after administration) (from the interview form of Geninax
(registered trademark) tablets 200 mg). The tissue distribution
ratio in human of moxifloxacin in the airway secretory fluid is
6.78 (3 hours after administration), and the tissue distribution
ratio in the the alveolar macrophages is 18.59 (3 hours after
administration) (from the interview form of Avelox (registered
trademark) tablets 400 mg). These datas indicate that the tissue
distribution ratio of compound D is remarkably high, compared with
marketed quinolone.
[0114] It is excellent that the property of high distributionratio
of lung tissue can be expected high clinical efficacy with a small
dosage. Due to this property, the daily dosage can be set to be
lower compared with the other quinolone compounds. It is suggested
that side effects can be reduced.
[0115] Due to the high distribution ratio into lung tissue,
compound D can provide high concentration in the respiratory
infectious lesion and can be contributed to preventing appearance
of antimicrobial resistant bacteria.
[0116] These advantages contribute to the efficacy to respiratory
tract infection of
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof.
[0117] It is understood that an infection treating agent containing
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluor-
o-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof and having a
tissue distribution ratio of the compound into an alveolar
epithelial lining fluid 1 hour after administration in
administration to human of 1 C or more can be configured. The
tissue distribution ratio into alveolar epithelial lining fluid
after 1 hour of administration is preferably within the range of 10
or more 50 or more less, and more preferably 15 or more 40 or more
less.
Test Example 3
Enzyme Inhibitory Activity of Streptococcus pneumoniae
[0118] The inhibitory activity of the compound D against DNA gyrase
derived from S. pneumoniae IID553 was measured on the basis of the
production amount of Supercoiled form DNA using Relaxed pBR322 as a
substrate in accordance with Antimicrob. Agents Chemother. 47:
77-81(2003). The inhibitory activity of the compound D against
Topoisomerase IV was measured based on the production amount of
Decatenated form DNAusingKinetoplast DNA as a substrate. Similarly,
the inhibitory activities of levofloxacin (LVFX) and garenoxacin
(GRNX) were measured. The results were compared. The results are
shown in Table 3. The 50% inhibitory concentration (IC.sub.50)
value in Table 3 means an average value of results measured three
times.+-.SD.
TABLE-US-00003 TABLE 3 IC.sub.50 VALUE (.mu.g/mL) DRUG DNA gyrase
Topoisomerase IV COMPOUND D 6.0 .+-. 0.2 1.3 .+-. 0.3 LVFX 160 .+-.
40 11 .+-. 5 GRNX 36 .+-. 2 2.2 .+-. 0.5
[0119] In terms of inhibitory activity against an enzyme derived
from Streptococcus pneumoniae, it can be seen that the compound D
is more excellent than levofloxacin and garenoxacin.
Test Example 4
Antibacterial Activity against Quinolone-Resistant Strain (In
Vitro)
[0120] The antibacterial activities in vitro of the compound D,
levofloxacin, garenoxacin, and ciprofloxacin (CPFX) against
quinolone-resistant strains of Streptococcus pneumoniae were
measured in accordance with a Clinical and Laboratory Standards
Institute (CLSI) microdilution method. The results are shown in
Table 4.
TABLE-US-00004 TABLE 4 MUTATION MIC (.mu.g/mL) No STRAIN NAME gyrA
parC COMPOUND D LVFX GRNX CPFX 1 S. pneumoniae IID553 NONE NONE
0.06 1 0.06 1 2 S. pneumoniae NF9884 NONE Ser79Tyr 0.125 2 0.125 2
3 S. pneumoniae CF9842 NONE Asp81Phe 0.06 2 0.125 2 4 S. pneumoniae
SF9863 Ser81Phe NONE 0.06 2 0.25 2 5 S. pneumoniae GF9821 Ser81Tyr
NONE 0.125 2 0.25 2 6 S. pneumoniae ST9941 Ser81Phe Ser79Phe 0.5 16
2 64 7 S. pneumoniae SN9981 Ser81Phe Asp83Tyr 0.25 16 1 32
[0121] In Table 4, the strain No. 1 is a non-quinolone-resistant
strain (parent strain), and the strains No. 2 to 7 area
quinolone-resistant strain. As seen from the results, the compound
D maintains excellent activity also against the quinolone-resistant
strain as compared with the other quinolone compounds. In
particular, the compound D exhibits high activity against the
strains Nos. 6 (S. pneumoniae ST9941) and 7 (S. pneumoniae SN9981),
which are a double mutant strain, as compared with the other
quinolone compounds.
Test Example 5
Antibacterial Activity Against Streptococcus pneumoniae (In
Vitro)
[0122] The antibacterial activities in vitro of the compound D,
garenoxacin, and levofloxacin against a strain in a mouse infected
with Streptococcus pneumoniae (S. pneumonia KY-9) were measured in
accordance with a CLSI microdilution method. The results are shown
in Table 5.
TABLE-US-00005 TABLE 5 MIC (.mu.g/mL) STRAIN NAME COMPOUND D GRNX
LVFX S. pneumoniae KY-9 0.06 0.03 1
Test Example 6
Number of Bacteria in the Lung
[0123] S. pneumoniae KY-9 was inoculated at 7.4.times.10.sup.5
CFO/mouse via the respiratory tract into the lung in a mouse in
which cyclophosphamide had been administrated. 2.9 to 3.1 hours,
17.3 to 19.1 hours, and 24.4 to 26.1 hours after the inoculation,
the drug (the compound D, levofloxacin, or garenoxacin) was
subcutaneously administrated (SC) or orally administrated (PO)
three times in total. The number of bacteria in the lung 16.5 to
17.0 hours after the final administration was measured. The results
are shown in FIGS. 1 and 2.
[0124] "*" described in FIGS. 1 and 2 means that a significant
difference of p<0.05 in a Vehicle group was observed, and "**"
means that a significant difference of p<0.001 in the Vehicle
group was observed (Dunne's multiple comparison test,
parametric).
[0125] As seen from FIG. 1, after subcutaneous administration of
the compound D (6.3 mg and 25 mg/kg), a significant dose-dependent
decrease in number of bacteria in the lung was observed. After
subcutaneous administration of garenoxacin of 6.3 mg/kg, a
significant decrease in number of bacteria in the lung was not
observed. However, when the dose of garenoxacin was increased to 25
mg/kg, a significant decrease in number of bacteria in the lung was
observed. Here, CFU is an abbreviation of Cclony Forming Unit, and
represents the unit of number of bacteria. Log CFU/Lung means the
number of viable bacteria in the lung. Log CFU/Lung was determined
as follows. The lung obtained from the mouse was homogenated to
obtain a bacterial culture. The bacterial culture was appropriately
diluted, applied to an agar plate medium, and cultured. Log
CFU/Lung was determined on the basis of the number of developed
colonies.
[0126] The therapeutic effects of the compound D and garenoxacin in
25 mg/kg administration groups were compared. The number of viable
bacteria in the lung for the compound D is 10.sup.2.6 CFU/Lung, and
the number for garenoxacin is 10.sup.5.5 CFU/Lung. An about 1,000
times difference is observed. The minimum inhibitory concentration
(MIC) of the compound D against Streptococcus pneumoniae (S.
pneumoniae KY-9) is comparable with garenoxacin (see Table 5), but
the compound D having excellent tissue distribution into the lung
exerts a therapeutic effect which is higher than that of
garenoxacin.
[0127] For levofloxacin, a significant decrease in number of
bacteria in the lung was not found even after subcutaneous
administration of 100 mg/kg.
[0128] FIG. 2 is a graph showing the number of bacteria in the lung
after oral administration. Similarly to the subcutaneous
administration, the therapeutic effect of the compound D is
excellent as compared with garenoxacin and levofloxacin.
[0129] As seen from Test Examples 3 to 6, excellent effect of the
compound D on Streptococcus pneumoniae can be understood and the
compound D is effective as a treating agent for a disease in which
the pathogenic bacteria are Streptococcus pneumoniae. Examples of
the disease in which the pathogenic bacteria are Streptococcus
pneumoniae may include otolaryngologic diseases such as sinusitis
and tympanitis, in addition to respiratory infections such as
pharyngitis, laryngitis, tonsillitis, acute bronchitis, pneumonia,
and secondary infections of chronic respiratory diseases.
Therefore, as one aspect of the present invention, a treating agent
for an infection which is one or two or more selected from the
group consisting of pharyngitis, laryngitis, tonsillitis, acute
bronchitis, pneumonia, secondary infections of respiratory
diseases, sinusitis, and tympanitis and in which the pathogenic
bacteria are Streptococcus pneumoniae, the treating agent
containing, as an active ingredient,
7-[(3S,4S)-3-({(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]-6-fluo-
ro-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof can be
exemplified.
Test Example 7
Antibacterial Activity against Clinically Isolated Strain (In
Vitro)
[0130] The antibacterial activities in vitro of the compound D,
garenoxacin, and levofloxacin against each clinically isolated
strain of Streptococcus pneumoniae, Moraxella catarrhalis, and
Haemophilus influenzae were measured in accordance with a CLSI
microdilution method or a CLSI agar dilution method. A MIC.sub.90
value was the minimum concentration in which the growth of 90%
strain of all the measured strains was inhibited. The results are
shown in Table 6.
TABLE-US-00006 TABLE 6 STRAIN NAME AND MIC.sub.90 (.mu.g/mL) STRAIN
NUMBER COMPOUND D GRNX LVFX PSSP.sup.1) (26 STRAINS) 0.06 0.06 1
PCG-LOW SENSITIVE S. pneumoniae 0.06 0.06 1 (22 STRAINS) M.
catarrhalis.sup.2) (26 STRAINS) 0.06 0.015 0.03 H.
influenzaes.sup.3) (26 STRAINS) 0.06 0.015 0.03 .sup.1)PSSP means
Penicillin-Resistant Stereptococcus Pneunomiae.
.sup.2)AMPICILLIN-INSENSITIVE STRAIN; 7 STRAINS,
AMPICILLIN-SENSITIVE STRAIN; 19 STRAINS
.sup.3)AMPICILLIN-INSENSITIVE STRAIN; 2 STRAINS,
AMPICILLIN-SENSITIVE STRAIN; 24 STRAINS
Test Example 8
AUC and Cmax
[0131] Six Japanese healthy adult males received oral doses of 75
mg compound D once daily for seven consecutive days. The plasma
concentration of compound D was measured by the HPLC method, and
the pharmacokinetic parameters were calculated.
[0132] The maximum drug concentration (Cmax) value and and the area
under the curve (AUC) on day 7 was 0.998 .mu.g/mL and 20.6
.mu.gh/mL, respectively. These values were very low as compared
with garenoxacin or levofloxacin. After concecutive administration
of garenoxacin in a daily dose of 400 mg, Cmax is 11.06 .mu.g/mL
and AUC is 110.9 .mu.gh/mL (Japanese Journal of Chemotherapy Vol.
55, No. S-1, pp. 95 to 115). After concecutive administration of
levofloxacin in a daily dose of 500 mg, Cmax is 6.32 .mu.g/mL and
AUC is 49.67 .mu.gh/mL (Japanese Journal of Chemotherapy Vol. 57,
No. S-2, pp. 1 to 10).
Test Example 9
Clinical Efficacy
[0133] We investigated efficacy of compound D for the patients with
community-acquired pneumonia. 50 patients with community-acquired
pneumonia were orally administered 75 mg of compound D once daily
for 7 days. The clinical efficacy (cure rate) was evaluated at
seven days after treatment completion. The clinical trial was
performed in accordance with a part of evaluation on patients with
community-acquired pneumonia (pp. 34 to 38) in "general guidelines
for the evaluation of new antimicrobial agents for the treatment of
respiratory tract infections (second version)."
[0134] The clinical efficacy (cure rate) of the compound D was
90.0%. This efficacy rate is not less than those of garenoxacin and
levofloxacin.
[0135] In the clinical trial of 400 mg of garenoxacin for the
patient with bacterial pneumonia, the clinical efficacy rate was
94.9% (Japanese Journal of Chemotherapy Vol. 55, No. S-1, pp. 127
to 142). In the clinical trial of 500 mg of levofloxacin for
patients with community-acquired pneumonia, bacterial respiratory
infection secondary to chronic respiratory diseases and acute
bronchitis, the clinical efficacy rate was 89.3% (Japanese Journal
of Chemotherapy Vol. 57, No. S-2, pp. 20 to 32).
[0136] From the results of Test Examples 7 to 9, the MIC of
compound D is not less than those of garenoxacin and levofloxacin
(Test Example 7). Although the concentration of compound D in
plasma is low (see Test Example 8), the compound D indicate the
therapeutic high efficacy rate similar to garenoxacin and
levofloxacin for the treatment of respiratory tract infection (Test
Example 9)
[0137] As shown in Table 2, compound D has very excellent
distribution into lung tissue in human. Therefore, compound D can
indicate high therapeutic efficacy even with low plasma
concentration. Compound D does not need high plasma concentration
unlike another drug. For this reason, the dose of compound D can be
reduced, and it can be expected to reduce side effects and
miniaturize the formulation which can be easily administrated.
Test Example 10
Frequency of Development of Resistant Bacteria
[0138] The frequencies of development of bacteria resistant to the
compound D, levofloxacin, garenoxacin, and ciprofloxacin for S.
aureus ATCC29213, S. pneumoniae ATCC49619, and E coli ATCC25922
were investigated. During cultivation of strains for about 70 hours
in the presence of a drug having a concentration 4, 8, and 16 times
(4.times.MIC, 8.times.MIC, and 16.times.MIC) the MIC value of each
strain, the frequency of development of resistant bacteria was
investigated.
[0139] S. aureus ATCC29213 is Staphylococcus aureus, S. pneumoniae
ATCC49619 is Streptococcus pneumoniae, and E. coli ATCC25922 is
Escherichia coli. Escherichia coli is known as a main causative
microorganism of chronic respiratory tract infection.
[0140] The frequency of development of resistant bacteria was
calculated by dividing the number of colonies developed on an agar
medium having each drug concentration by the number of initially
inoculated bacteria. The results are shown in Table 7.
TABLE-US-00007 TABLE 7 FREQUENCY OF DEVELOPMENT OF RESISTANT
BACTERIA MIC (AVERAGE OF TWO MEASURED VALUES) STRAIN DRUG
(.mu.g/mL) 4 .times. MIC 8 .times. MIC 16 .times. MIC S. aureus
COMPOUND D 0.008 <2.1 .times. 10.sup.-9 <2.1 .times.
10.sup.-9 <2.1 .times. 10.sup.-9 ATCC29213 LVFX 0.125 <2.1
.times. 10.sup.-9 <2.1 .times. 10.sup.-9 <2.1 .times.
10.sup.-9 GRNX 0.015 8.2 .times. 10.sup.-9 <2.1 .times.
10.sup.-9 <2.1 .times. 10.sup.-9 CPFX 0.25 .sup. 6.2 .times.
10.sup.-9* .sup. 3.1 .times. 10.sup.-9* <2.1 .times. 10.sup.-9
E. coli COMPOUND D 0.06 <1.9 .times. 10.sup.-9* <1.9 .times.
10.sup.-9 <1.9 .times. 10.sup.-9 ATCC25922 LVFX 0.015 .sup. 3.9
.times. 10.sup.-9* <1.9 .times. 10.sup.-9 <1.9 .times.
10.sup.-9 GRNX 0.03 <1.9 .times. 10.sup.-9 <1.9 .times.
10.sup.-9 <1.9 .times. 10.sup.-9 CPFX 0.008 .sup. 1.2 .times.
10.sup.-9* <1.9 .times. 10.sup.-9 <1.9 .times. 10.sup.-9 S.
pneumoniae COMPOUND D 0.06 <1.1 .times. 10.sup.-8 <1.1
.times. 10.sup.-8 <1.1 .times. 10.sup.-8 ATCC49619 LVFX 1
<1.1 .times. 10.sup.-8 <1.1 .times. 10.sup.-8 <1.1 .times.
10.sup.-8 GRNX 0.06 <1.1 .times. 10.sup.-8 <1.1 .times.
10.sup.-8 <1.1 .times. 10.sup.-8 CPFX 1 .sup. 1.1 .times.
10.sup.-8* <1.1 .times. 10.sup.-8 <1.1 .times. 10.sup.-8
CULTIVATION TIME: The cultivation time for S. aureus and E. coli
was 70 hours 50 minutes, and the cultivation time for S. pneumoniae
was 69 hours. In Table 7, *shows that resistant bacteria were
developed.
[0141] The development of bacteria resistant to the compound D for
all the three types of bacteria which had been evaluated was not
observed.
[0142] On the other hand, bacteria resistant to levofloxacin were
developed for E. coli ATCC25922, and bacteria resistant to
garenoxacin were developed for S. aureus ATCC29213. For all the
three types of bacteria, bacteria resistant to ciproxacin were
developed.
[0143] The results suggest that the bacteria resistant to the
compound D are unlikely to be developed as compared with the other
quinolone compounds.
Test Example 11
Enzyme Inhibitory Activity of Staphylococcus aureus
[0144] The inhibitory activities of the compound D against DNA
gyrase derived from S. aureus and quinolone-resistant S. aureus
were measured on the basis of the production amount of Supercoiled
form DNA using Relaxed pBR322 as a substrate in accordance with
Antimicrob. Agents Chemother. 45: 3544-3547 (2001). The inhibitory
activity of the compound D against Topoisomerase IV was measured on
the basis of the production amount of Decatenated form DNA using
Kinetoplast DNA as a substrate. The measurement was performed in
the same manner as in Test Example 3. Similarly, the inhibitory
activities of ciproxacin, levofloxacin, and garenoxacin were
measured. The results were compared.
[0145] The results are shown in Tables 8 to 9.
TABLE-US-00008 TABLE 8 IC.sub.50 VALUE (.mu.g/mL) DNA QUINOLONE
RESISTANT DRUG gyrase DNA gyrase COMPOUND D 1.7 .+-. 0.4 17 .+-. 3
CPFX 25 .+-. 5 >1200 LVFX 16 .+-. 6 1300 .+-. 100 GRNX 11 .+-. 1
420 .+-. 80 IC.sub.50 VALUE: AVERAGE OF THREE MEASURED VALUES OR
AVERAGE .+-. SD
TABLE-US-00009 TABLE 9 IC.sub.50 VALUE (.mu.g/mL) QUINOLONE
RESISTANT DRUG Topoisomerase IV Topoisomerase IV COMPOUND D 0.73
.+-. 0.06 2.8 .+-. 0.3 CPFX 1.8 .+-. 0.7 69 .+-. 7 LVFX 2.8 .+-.
0.9 86 .+-. 19 GRNX 1.9 .+-. 0.6 27 .+-. 1 IC.sub.50 VALUE: AVERAGE
OF THREE MEASURED VALUES .+-. SD
[0146] As understood from Tables 8 and 9, the inhibitory effects of
the compound D against DNA gyrase derived from S. aureus and
Topoisomerase IV are higher than those of the other compounds
regardless of whether or not each enzyme is derived from a
quinolone-resistance strain.
[0147] The comparison of the inhibitory effect against an enzyme
derived from a non-quinolone-resistant strain and the inhibitory
effect against an enzyme derived from a quinolone-resistant strain
suggests that the inhibitory activities of the compound D against
these enzymes are unlikely to be affected by quinolone-resistant
mutation as compared with the other compounds.
Test Example 12
Antibacterial Activity against Quinolone-Resistant Strain (In
Vitro)
[0148] The antibacterial activities in vitro of the compound D,
levofloxacin, garenoxacin, and ciprofloxacin against a
quinolone-resistant strain of Streptococcus pneumoniae were
measured in accordance with a CLSI agar microdilution method or a
CLSI microdilution method.
[0149] The results are shown in Table 10.
TABLE-US-00010 TABLE 10 STRAIN MUTATION LEVEL OF MUTATION MIC
(.mu.g/mL) NAME QUINOLONE RESISTANCE gyrA gr1A COMPOUND D LVFX GRNX
CPFX S. aureus PARENT STRAIN None None 0.015 0.125 0.015 0.25
MS5935 S. aureus gyrA MUTANT STRAIN Ser84Leu None 0.03 0.25 0.06
0.25 MS5935 gyrA mutant S. sureus 1st step gr1A MUTANT STRAIN None
Ser80Phe 0.03 0.5 0.03 2 MS5935 lst S. aureus 2nd step gr1A, gyrA,
Ser84Leu Ser80Phe 0.125 8 2 16 MS5935 2nd DOUBLE MUTANT STRAIN S.
aureus 3rd step gr1A gyrA, gr1A Ser84Leu Ser80Phe, 0.3 32 8 32
MS5935 3rd TRIPLE MUTANT STRAIN Glu84Lys S. aureus 4th step gr1A,
gyrA, gr1A, gyrA Ser84Leu, Ser80Phe, 2 128 32 32 MS5935 4th
QUADRUPLE MUTANT STRAIN G1u88Va1 G1u84Lys
[0150] As seen from Table 10, the compound D maintains excellent
activity also against the quinolone-resistant strain in addition to
a parent strain (non-quinolone-resistant strain) as compared with
the other quinolone compounds. The MIC of the compound D against
high quinolone-resistant S. aureus (4th step gr1A, gyrA, gr1A, gyrA
quadruple mutant strains) was 2 .mu.g/mL, and the potency (action
strength) 16 or more times those of the other quinolone compounds
was observed.
INDUSTRIAL APPLICABILITY
[0151] The embodiment can provide a novel respiratory infection
treating agent containing
7-[(3S,4S)-3-{(cyclopropylamino)methyl}-4-fluoropyrrolidine-1-yl]6-fluoro-
-1-(2-fluoroethyl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic
acid or a pharmaceutically acceptable salt thereof, which is
industrially useful.
* * * * *