In vitro and in vivo characterization of CB-183,315, a novel lipopeptide antibiotic for treatment of Clostridium difficile

Antimicrob Agents Chemother. 2012 Oct;56(10):5023-30. doi: 10.1128/AAC.00057-12. Epub 2012 Jul 16.

Abstract

CB-183,315 is a novel lipopeptide antibiotic structurally related to daptomycin currently in phase 3 clinical development for Clostridium difficile-associated diarrhea (CDAD). We report here the in vitro mechanism of action, spontaneous resistance incidence, resistance by serial passage, time-kill kinetics, postantibiotic effect, and efficacy of CB-183,315 in a hamster model of lethal infection. In vitro data showed that CB-183,315 dissipated the membrane potential of Staphylococcus aureus without inducing changes in membrane permeability to small molecules. The rate of spontaneous resistance to CB-183,315 at 8× the MIC was below the limit of detection in C. difficile. Under selective pressure by serial passage with CB-183,315 against C. difficile, the susceptibility of the bacteria changed no more than 2-fold during 15 days of serial passages. At 16× the MIC, CB-183,315 produced a ≥3-log reduction of C. difficile in the time-kill assay. The postantibiotic effect of CB-183,315 at 8× the MIC was 0.9 h. At 80× the MIC the postantibiotic effect was more than 6 h. In the hamster model of CDAD, CB-183,315 and vancomycin both demonstrated potent efficacy in resolving initial disease onset, even at very low doses. After the conclusion of dosing, CB-183,315 and vancomycin showed a similar dose- and time-dependent pattern with respect to rates of CDAD recurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Clostridioides difficile / drug effects*
  • Cricetinae
  • Enterocolitis, Pseudomembranous / drug therapy
  • Lipopeptides / pharmacology*
  • Lipopeptides / therapeutic use*
  • Male
  • Mesocricetus
  • Microbial Sensitivity Tests
  • Peptides, Cyclic / pharmacology*
  • Peptides, Cyclic / therapeutic use*
  • Vancomycin / pharmacology

Substances

  • Anti-Bacterial Agents
  • CB-183,315
  • Lipopeptides
  • Peptides, Cyclic
  • Vancomycin