[go: up one dir, main page]

WO2018193368A1 - Antibacterial compositions - Google Patents

Antibacterial compositions Download PDF

Info

Publication number
WO2018193368A1
WO2018193368A1 PCT/IB2018/052649 IB2018052649W WO2018193368A1 WO 2018193368 A1 WO2018193368 A1 WO 2018193368A1 IB 2018052649 W IB2018052649 W IB 2018052649W WO 2018193368 A1 WO2018193368 A1 WO 2018193368A1
Authority
WO
WIPO (PCT)
Prior art keywords
pharmaceutically acceptable
acceptable derivative
gram
formula
compound
Prior art date
Application number
PCT/IB2018/052649
Other languages
French (fr)
Inventor
Sachin Subhash Bhagwat
Prashant Ratnakar JOSHI
Kushal UMARKAR
Jaykumar Satwaji SATAV
Swapna Shripad TAKALKAR
Vijaykumar Jagdishwar Patil
Ravikumar Tadiparthi
Mahesh Vithalbhai Patel
Original Assignee
Wockhardt Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Wockhardt Limited filed Critical Wockhardt Limited
Publication of WO2018193368A1 publication Critical patent/WO2018193368A1/en

Links

Classifications

    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D471/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00
    • C07D471/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00 in which the condensed system contains two hetero rings
    • C07D471/04—Ortho-condensed systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/04—Antibacterial agents
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
    • C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
    • C07D487/04—Ortho-condensed systems

Definitions

  • the invention relates to antibacterial compositions and methods for treating or preventing bacterial infections.
  • Bacterial infections continue to remain one of the major causes contributing towards human diseases.
  • One of the key challenges in treatment of bacterial infections is the ability of bacteria to develop resistance to one or more antibacterial agents over time.
  • Examples of such bacteria that have developed resistance to typical antibacterial agents include: Penicillin-resistant Streptococcus pneumoniae, Vancomycin-resistant Enterococci, and Methicillin-resistant Staphylococcus aureus.
  • Penicillin-resistant Streptococcus pneumoniae Vancomycin-resistant Enterococci
  • Methicillin-resistant Staphylococcus aureus The problem of emerging drug-resistance in bacteria is often tackled by switching to newer antibacterial agents, which can be more expensive and sometimes more toxic. Additionally, this may not be a permanent solution as the bacteria often develop resistance to the newer antibacterial agents as well in due course.
  • bacteria are particularly efficient in developing resistance, because of their ability to multiply very rapidly and pass on the resistance genes as they replicate.
  • A. baumannii Acinetobacter baumannii
  • A. baumannii A. baumannii
  • infections such as pneumonia, bacteremia, wound infections, urinary tract infections and meningitis.
  • compositions comprising meropenem and certain nitrogen containing bicyclic compounds (disclosed in PCT/IB2012/054706) exhibit unexpectedly synergistic antibacterial activity, even against highly resistant bacterial strains.
  • compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
  • compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • methods for treating or preventing a bacterial infection in a subject comprising administering to said subject an effective amount of a pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof; and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof.
  • methods for treating or preventing a bacterial infection in a subject comprising administering to said subject an effective amount of a pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • methods for treating or preventing a bacterial infection in a subject comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof; and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof.
  • methods for treating or preventing a bacterial infection in a subject comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is administered in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • a pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof exhibits unexpectedly improved antibacterial efficacy, even against highly resistant bacteria, including those producing extended spectrum beta-lactamase enzymes (ESBLs).
  • ESBLs extended spectrum beta-lactamase enzymes
  • infection or "bacterial infection” as used herein includes presence of bacteria, in or on a subject, which, if its growth were inhibited, would result in a benefit to the subject.
  • infection in addition to referring to the presence of bacteria also refers to presence of other floras, which are not desirable.
  • infection includes infection caused by bacteria.
  • treat refers to administration of a medicament, including a pharmaceutical composition, or one or more pharmaceutically active ingredients, for prophylactic and/or therapeutic purposes.
  • prophylactic treatment refers to treating a subject who is not yet infected, but who is susceptible to, or otherwise at a risk of infection (preventing the bacterial infection).
  • therapeutic treatment refers to administering treatment to a subject already suffering from infection.
  • treat also refer to administering compositions, or one or more of pharmaceutically active ingredients discussed herein, with or without additional pharmaceutically active or inert ingredients, in order to: (i) reduce or eliminate either a bacterial infection, or one or more symptoms of a bacterial infection, or (ii) retard progression of a bacterial infection, or one or more symptoms of a bacterial infection, or (iii) reduce severity of a bacterial infection, or one or more symptoms of a bacterial infection, or (iv) suppress clinical manifestation of a bacterial infection, or (v) suppress manifestation of adverse symptoms of a bacterial infection.
  • a “therapeutically effective amount” or “pharmaceutically effective amount” or “effective amount” as used herein refer to an amount, which has a therapeutic effect or is the amount required to produce a therapeutic effect in a subject.
  • a “therapeutically effective amount” or “pharmaceutically effective amount” or “effective amount” of an antibacterial agent or a pharmaceutical composition is the amount of the antibacterial agent or the pharmaceutical composition required to produce a desired therapeutic effect as may be judged by clinical trial results, model animal infection studies, and/or in vitro studies (e.g. in agar or broth media).
  • Such effective amount depends on several factors, including but not limited to, the microorganism (e.g.
  • a prophylactically effective amount is that amount which would be effective in preventing the bacterial infection.
  • administration refers to and includes delivery of a composition, or one or more pharmaceutically active ingredients to a subject, including for example, by any appropriate method, which serves to deliver the composition or its active ingredients or other pharmaceutically active ingredients to the site of infection.
  • the method of administration may vary depending on various factors, such as for example, the components of the pharmaceutical composition or type/nature of the pharmaceutically active or inert ingredients, site of the potential or actual infection, the microorganism involved, severity of the infection, age and physical condition of the subject and a like.
  • Some non-limiting examples of ways to administer a composition or a pharmaceutically active ingredient to a subject according to this invention include oral, intravenous, topical, intrarespiratory, intraperitoneal, intramuscular, parenteral, sublingual, transdermal, intranasal, aerosol, intraocular, intratracheal, intrarectal, vaginal, gene gun, dermal patch, eye drop and mouthwash.
  • a pharmaceutical composition comprising more than one ingredients (active or inert)
  • one of the ways of administering such composition is by admixing the ingredients (e.g. in the form of a suitable unit dosage form such as tablet, capsule, solution, powder or a like) and then administering the dosage form.
  • the ingredients may also be administered separately (simultaneously or one after the other) as long as these ingredients reach beneficial therapeutic levels such that the composition as a whole provides a synergistic and/or desired effect.
  • growth refers to a growth of one or more microorganisms and includes reproduction or population expansion of the microorganism (e.g. bacteria).
  • growth also includes maintenance of on-going metabolic processes of the microorganism, including the processes that keep the microorganism alive.
  • ⁇ refers to ability of a treatment, or a composition, or one or more pharmaceutically active ingredients to produce a desired biological effect in a subject.
  • antibacterial effectiveness refers to the ability of the composition or the antibacterial agent to prevent or treat bacterial infection in a subject.
  • separator or “synergy” as used herein refers to the interaction of two or more agents so that their combined effect is greater than their individual effects.
  • antibacterial agent refers to any substance, compound, a combination of substances, or a combination of compounds capable of: (i) inhibiting, reducing or preventing growth of bacteria; (ii) inhibiting or reducing ability of a bacteria to produce infection in a subject; or (iii) inhibiting or reducing ability of bacteria to multiply or remain infective in the environment.
  • antibacterial agent also refers to compounds capable of decreasing infectivity or virulence of bacteria.
  • beta-lactam antibacterial agent refers to compounds with antibacterial properties and containing a beta-lactam nucleus in their molecular structure.
  • beta-lactamase or "beta-lactamase enzyme” as used herein refers to any enzyme or protein or any other substance that breaks down a beta-lactam ring.
  • beta- lactamase includes enzymes that are produced by bacteria and have the ability to hydrolyse the beta-lactam ring in a beta-lactam compound, either partially or completely.
  • extended spectrum beta-lactamase includes those beta- lactamase enzymes, which are capable of conferring bacterial resistance to various beta-lactam antibacterial agents such as penicillins, cephalosporins, aztreonam and the like.
  • beta-lactamase inhibitor refers to a compound capable of inhibiting activity of one or more beta-lactamase enzymes, either partially or completely.
  • colony forming units or "CFU” as used herein refers to an estimate of number of viable bacterial cells per ml of the sample. Typically, a “colony of bacteria” refers to a mass of individual bacteria growing together.
  • pharmaceutically inert ingredient or “carrier” or “excipient” refers to and includes compounds or materials used to facilitate administration of a compound, for example, to increase the solubility of the compound.
  • solid carriers include starch, lactose, dicalcium phosphate, sucrose, and kaolin.
  • Typical, non-limiting examples of liquid carriers include sterile water, saline, buffers, non-ionic surfactants, and edible oils.
  • various adjuvants commonly used in the art may also be included. These and other such compounds are described in literature, e.g., in the Merck Index (Merck & Company, Rahway, N.J.).
  • subject refers to vertebrate or invertebrate, including a mammal.
  • subject includes human, animal, a bird, a fish, or an amphibian.
  • Typical, non-limiting examples of a “subject” include humans, cats, dogs, horses, sheep, bovine cows, pigs, lambs, rats, mice and guinea pigs.
  • pharmaceutically acceptable derivative refers to and includes any pharmaceutically acceptable salt, pro-drug, metabolite, ester, ether, hydrate, polymorph, solvate, complex, and adduct of a compound described herein which, upon administration to a subject, is capable of providing (directly or indirectly) the parent compound.
  • antibacterial agent or a pharmaceutically acceptable derivative thereof includes all derivatives of the antibacterial agent (such as salts, pro-drugs, metabolites, esters, ethers, hydrates, polymorphs, solvates, complexes, and adducts) which, upon administration to a subject, are capable of providing (directly or indirectly) the antibacterial agent.
  • pharmaceutically acceptable salt refers to one or more salts of a given compound which possesses desired pharmacological activity of the free compound and which is neither biologically nor otherwise undesirable.
  • pharmaceutically acceptable salts refer to salts that are suitable for use in contact with the tissues of human and animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio.
  • Pharmaceutically acceptable salts are well known in the art. For example, S. M. Berge, et al. (/. Pharmaceutical Sciences, 66; 1-19, 1977), incorporated herein by reference in its entirety, describes various pharmaceutically acceptable salts in details.
  • stereoisomer refers to and includes isomeric molecules that have the same molecular formula but differ in positioning of atoms and/or functional groups in the space. Stereoisomers may further be classified as enantiomers (where different isomers are mirror-images of each other) and diastereomers (where different isomers are not mirror-images of each other). Diastereomers include isomers such as conformers, meso compounds, cis-trans (E-Z) isomers, and non-enantiomeric optical isomers.
  • compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
  • Compound of Formula (I), according to the invention can be used in various forms including as such, a stereoisomer or a pharmaceutically acceptable derivative thereof.
  • a compound of Formula (I) (CAS Registry Number: 1427462-70-1) may also be known chemically by different names including the following: (a) "trans-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile”; (b) "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile”; or (c) "Sulphuric acid, mono[(lR,2S,5R)-2-cyano-7- oxo-l,6-diazabicyclo[3.2.1]oct-6-yl] ester".
  • a reference to "a compound of Formula (I)" is intended to include compounds chemically known as: (a) "trans-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile”; (b) "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile”; or (c) "Sulphuric acid, mono[(lR,2S,5R)-2-cyano-7- oxo-l,6-diazabicyclo[3.2. l]oct-6-yl] ester".
  • Compound of Formula (I) may also be used in the form of its stereoisomer or a pharmaceutically acceptable derivative thereof.
  • suitable pharmaceutically acceptable derivatives of a compound of Formula (I) include its sodium salt (also known as "sodium salt of sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester” or "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester, sodium salt (1:1); CAS Registry Number: 1427462-59-6"); potassium salt (also known as "potassium salt of sulphuric acid, mono[(lR,2S,5R)-2-cyano-7- oxo-l,6-diazabicyclo[3.2.1]oct-6-y
  • compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • Both, meropenem and a compound of Formula (I) may be present in the composition in their free forms or in the form of their pharmaceutically acceptable derivatives (such as salts, pro-drugs, metabolites, esters, ethers, hydrates, polymorphs, solvates, complexes, or adducts).
  • their pharmaceutically acceptable derivatives such as salts, pro-drugs, metabolites, esters, ethers, hydrates, polymorphs, solvates, complexes, or adducts.
  • a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or pharmaceutically acceptable derivative thereof in the composition may vary depending on clinical requirements.
  • a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof in the composition is present in an amount from about 0.01 gram to about 10 gram.
  • meropenem or a pharmaceutically acceptable derivative thereof in the composition is present in an amount from about 0.01 gram to about 10 gram.
  • the pharmaceutical composition according to the invention comprises about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.250 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition according to the invention comprises about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • compositions according to the invention may include one or more pharmaceutically acceptable carriers or excipients or the like.
  • suitable, non-limiting examples of such carriers or excipients include mannitol, lactose, starch, magnesium stearate, sodium saccharine, talcum, cellulose, sodium crosscarmellose, glucose, gelatine, sucrose, magnesium carbonate, wetting agents, emulsifying agents, solubilizing agents, buffering agents, lubricants, preservatives, stabilizing agents, binding agents and the like.
  • compositions or the active ingredients according to the present invention may be formulated into a variety of dosage forms, such as solid, semi-solid, liquid and aerosol dosage forms.
  • dosage forms such as solid, semi-solid, liquid and aerosol dosage forms.
  • Typical, non-limiting examples of some dosage forms include tablets, capsules, powders, solutions, suspensions, suppositories, aerosols, granules, emulsions, syrups, elixirs and the like.
  • compositions according to the invention are in the form of a powder or a solution. In some other embodiments, pharmaceutical compositions according to the invention are present in the form of a powder or a solution that can be reconstituted by addition of a compatible reconstitution diluent prior to administration. In some other embodiments, pharmaceutical compositions according to the invention are in the form of a frozen composition that can be diluted with a compatible reconstitution diluent prior to administration. Typical, non-limiting example of suitable compatible reconstitution diluent includes water.
  • compositions according to the invention are present in the form ready to use for parenteral administration.
  • compositions according to the invention can be formulated into various dosage forms wherein the active ingredients and/or excipients may be present either together (e.g. as an admixture) or as separate components.
  • the various ingredients in the composition are formulated as a mixture, such compositions can be delivered by administering such a mixture to a subject using any suitable route of administration.
  • pharmaceutical compositions according to the invention may also be formulated into a dosage form wherein one or more ingredients (such as active or inactive ingredients) are present as separate components.
  • the composition or dosage form wherein the ingredients do not come as a mixture, but come as separate components, such composition/dosage form may be administered in several ways.
  • the ingredients may be mixed in the desired proportions and the mixture is reconstituted in suitable reconstitution diluent and is then administered as required.
  • the components or the ingredients may be separately administered (simultaneously or one after the other) in appropriate proportion so as to achieve the same or equivalent therapeutic level or effect as would have been achieved by administration of the equivalent mixture.
  • compositions according to the invention are formulated into a dosage form such that a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as admixture or as a separate components.
  • pharmaceutical compositions according to the invention are formulated into a dosage form such that a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as separate components.
  • compositions according to the invention are used in treatment or prevention of a bacterial infection.
  • a pharmaceutical composition comprising administering to said subject effective amount of a pharmaceutical composition according to the invention.
  • a pharmaceutical composition comprising a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as separate components; a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof may be administered before, after or simultaneously with the administration of meropenem or a pharmaceutically acceptable derivative thereof.
  • methods for treating or preventing bacterial infections in a subject comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
  • methods for treating or preventing bacterial infections in a subject comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein amount of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof administered is from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • a method for treating or preventing a bacterial infection in a subject comprising administering to said subject: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, in any of the following amounts:
  • a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is administered in an amount from about 0.01 gram to about 10 gram. In some other embodiments, in the methods according to the invention, meropenem or a pharmaceutically acceptable derivative thereof is administered in an amount from about 0.01 gram to about 10 gram. In some embodiments, in the methods according to the invention, a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is administered before, after or simultaneously with the administration of meropenem or a pharmaceutically acceptable derivative thereof.
  • the pharmaceutical composition and/or other pharmaceutically active ingredients disclosed herein may be administered by any appropriate method, which serves to deliver the composition, or its constituents, or the active ingredients to the desired site.
  • the method of administration can vary depending on various factors, such as for example, the components of the pharmaceutical composition and the nature of the active ingredients, the site of the potential or actual infection, the microorganism (e.g. bacteria) involved, severity of infection, age and physical condition of the subject.
  • the microorganism e.g. bacteria
  • compositions or one or more active ingredients according to the invention are administered parenterally.
  • a compound of Formula (I) is "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6-diazabicyclo[3.2.1]octane-2- carbonitrile".
  • a compound of Formula (I) is: "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester".
  • a compound of Formula (I) is present as a sodium or potassium salt of "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6-diazabicyclo[3.2.1]oct-6-yl] ester".
  • a method for increasing antibacterial effectiveness of meropenem or a pharmaceutically acceptable derivative thereof in a subject comprising co-administering meropenem or a pharmaceutically acceptable derivative thereof, with a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof.
  • a method for increasing antibacterial effectiveness of meropenem or a pharmaceutically acceptable derivative thereof in a subject comprising co-administering meropenem or a pharmaceutically acceptable derivative thereof, with a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, wherein the amount of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
  • bacterial infections can be treated or prevented using compositions and methods according to the invention.
  • Typical, non-limiting examples of bacterial infections that can be treated or prevented using methods and/or pharmaceutical compositions according to the invention include E. coli infections, Yersinia pestis (pneumonic plague), staphylococcal infection, mycobacteria infection, bacterial pneumonia, Shigella dysentery, Serratia infections, Candida infections, Cryptococcal infection, anthrax, tuberculosis or infections caused by Pseudomonas aeruginosa, Acinetobacter baumannii or methicillin resistant Staphylococcus aurues (MRSA) etc.
  • E. coli infections E. coli infections, Yersinia pestis (pneumonic plague), staphylococcal infection, mycobacteria infection, bacterial pneumonia, Shigella dysentery, Serratia infections, Candida infections, Cryptococcal infection, anthrax, tuberculosis or infections caused by Pseudomona
  • compositions and methods according to the invention are useful in treatment or prevention of several infections, including for example, skin and soft tissue infections, febrile neutropenia, urinary tract infection, intraabdominal infections, respiratory tract infections, pneumonia (nosocomial), bacteremia meningitis, surgical infections and the like.
  • compositions and methods according to the invention are used in treatment or prevention of infections caused by resistant bacteria. In some other embodiments, the compositions and methods according to the invention are used in treatment or prevention of infections caused by bacteria producing one or more beta-lactamase enzymes.
  • compositions and methods disclosed herein are also effective in preventing or treating infections caused by bacteria that are considered to be less or not susceptible to one or more of known antibacterial agents or their known compositions.
  • bacteria known to have developed resistance to various antibacterial agents include Acinetobacter, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacter, Klebsiella, Citrobacter and a like.
  • MIC minimum inhibitory concentrations
  • MHA Muller Hinton Agar
  • CLSI Clinical and Laboratory Standards Institute
  • CFU colony forming units
  • Sterile Meropenem was aseptically blended or mixed with sterile compound of Formula (I) for about 30 minutes at 8 rpm to obtain sterile dry powder for injection (compositions shown in Table 1). Each single vial of this formulation may be reconstituted with suitable reconstitution diluent prior to administration.

Landscapes

  • Chemical & Material Sciences (AREA)
  • Organic Chemistry (AREA)
  • Health & Medical Sciences (AREA)
  • Communicable Diseases (AREA)
  • Oncology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

Pharmaceutical compositions comprising meropenem or a pharmaceutically acceptable derivative, and a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof are disclosed. They are useful for treating or preventing bacterial infection.

Description

ANTIBACTERIAL COMPOSITIONS
RELATED PATENT APPLICATIONS
This application claims the priority to and benefit of Indian Provisional Patent Application No. 201721013819 filed on April 18, 2017; the disclosures of which are incorporated herein by reference in its entirety as if fully rewritten herein.
FIELD OF THE INVENTION
The invention relates to antibacterial compositions and methods for treating or preventing bacterial infections.
BACKGROUND OF THE INVENTION
Bacterial infections continue to remain one of the major causes contributing towards human diseases. One of the key challenges in treatment of bacterial infections is the ability of bacteria to develop resistance to one or more antibacterial agents over time. Examples of such bacteria that have developed resistance to typical antibacterial agents include: Penicillin-resistant Streptococcus pneumoniae, Vancomycin-resistant Enterococci, and Methicillin-resistant Staphylococcus aureus. The problem of emerging drug-resistance in bacteria is often tackled by switching to newer antibacterial agents, which can be more expensive and sometimes more toxic. Additionally, this may not be a permanent solution as the bacteria often develop resistance to the newer antibacterial agents as well in due course. In general, bacteria are particularly efficient in developing resistance, because of their ability to multiply very rapidly and pass on the resistance genes as they replicate.
Treatment of infections caused by resistant bacteria remains a key challenge for the clinician community. One example of such challenging pathogen is Acinetobacter baumannii (A. baumannii), which continues to be an increasingly important and demanding species in healthcare settings. The multidrug resistant nature of this pathogen and its unpredictable susceptibility patterns make empirical and therapeutic decisions more difficult. A. baumannii is associated with infections such as pneumonia, bacteremia, wound infections, urinary tract infections and meningitis.
Therefore, there is a need for development of newer ways to treat infections that are becoming resistant to known therapies and methods. Surprisingly, it has been found that a compositions comprising meropenem and certain nitrogen containing bicyclic compounds (disclosed in PCT/IB2012/054706) exhibit unexpectedly synergistic antibacterial activity, even against highly resistant bacterial strains.
SUMMARY OF THE INVENTION
Accordingly, there are provided pharmaceutical compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
Formula (I)
Figure imgf000003_0001
In one general aspect, there are provided pharmaceutical compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
In yet another general aspect, there are provided methods for treating or preventing a bacterial infection in a subject, said methods comprising administering to said subject an effective amount of a pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof; and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof.
In another general aspect, there are provided methods for treating or preventing a bacterial infection in a subject, said methods comprising administering to said subject an effective amount of a pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
In yet another general aspect, there are provided methods for treating or preventing a bacterial infection in a subject, said methods comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof; and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof.
In another general aspect, there are provided methods for treating or preventing a bacterial infection in a subject, said methods comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is administered in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
The details of one or more embodiments of the invention are set forth in the description below. Other features, objects and advantages of the invention will be apparent from the following description including claims.
DETAILED DESCRIPTION OF THE INVENTION
Reference will now be made to the exemplary embodiments, and specific language will be used herein to describe the same. It should nevertheless be understood that no limitation of the scope of the invention is thereby intended. Alterations and further modifications of the inventive features illustrated herein, which would occur to one skilled in the relevant art and having possession of this disclosure, are to be considered within the scope of the invention. It must be noted that, as used in this specification and the appended claims, the singular forms "a", "an", and "the" include plural referents unless the content clearly dictates otherwise. All references including patents, patent applications, and literature cited in the specification are expressly incorporated herein by reference in their entirety as if fully rewritten herein. The inventors have surprisingly discovered that a pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof exhibits unexpectedly improved antibacterial efficacy, even against highly resistant bacteria, including those producing extended spectrum beta-lactamase enzymes (ESBLs).
The term "infection" or "bacterial infection" as used herein includes presence of bacteria, in or on a subject, which, if its growth were inhibited, would result in a benefit to the subject. As such, the term "infection" in addition to referring to the presence of bacteria also refers to presence of other floras, which are not desirable. The term "infection" includes infection caused by bacteria.
The term "treat", "treating" or "treatment" as used herein refers to administration of a medicament, including a pharmaceutical composition, or one or more pharmaceutically active ingredients, for prophylactic and/or therapeutic purposes. The term "prophylactic treatment" refers to treating a subject who is not yet infected, but who is susceptible to, or otherwise at a risk of infection (preventing the bacterial infection). The term "therapeutic treatment" refers to administering treatment to a subject already suffering from infection. The terms "treat", "treating" or "treatment" as used herein also refer to administering compositions, or one or more of pharmaceutically active ingredients discussed herein, with or without additional pharmaceutically active or inert ingredients, in order to: (i) reduce or eliminate either a bacterial infection, or one or more symptoms of a bacterial infection, or (ii) retard progression of a bacterial infection, or one or more symptoms of a bacterial infection, or (iii) reduce severity of a bacterial infection, or one or more symptoms of a bacterial infection, or (iv) suppress clinical manifestation of a bacterial infection, or (v) suppress manifestation of adverse symptoms of a bacterial infection.
The terms "pharmaceutically effective amount" or "therapeutically effective amount" or "effective amount" as used herein refer to an amount, which has a therapeutic effect or is the amount required to produce a therapeutic effect in a subject. For example, a "therapeutically effective amount" or "pharmaceutically effective amount" or "effective amount" of an antibacterial agent or a pharmaceutical composition is the amount of the antibacterial agent or the pharmaceutical composition required to produce a desired therapeutic effect as may be judged by clinical trial results, model animal infection studies, and/or in vitro studies (e.g. in agar or broth media). Such effective amount depends on several factors, including but not limited to, the microorganism (e.g. bacteria) involved, characteristics of the subject (for example height, weight, sex, age and medical history), severity of infection and particular type of the antibacterial agent used. For prophylactic treatments, a prophylactically effective amount is that amount which would be effective in preventing the bacterial infection.
The term "administration" or "administering" refers to and includes delivery of a composition, or one or more pharmaceutically active ingredients to a subject, including for example, by any appropriate method, which serves to deliver the composition or its active ingredients or other pharmaceutically active ingredients to the site of infection. The method of administration may vary depending on various factors, such as for example, the components of the pharmaceutical composition or type/nature of the pharmaceutically active or inert ingredients, site of the potential or actual infection, the microorganism involved, severity of the infection, age and physical condition of the subject and a like. Some non-limiting examples of ways to administer a composition or a pharmaceutically active ingredient to a subject according to this invention include oral, intravenous, topical, intrarespiratory, intraperitoneal, intramuscular, parenteral, sublingual, transdermal, intranasal, aerosol, intraocular, intratracheal, intrarectal, vaginal, gene gun, dermal patch, eye drop and mouthwash. In case of a pharmaceutical composition comprising more than one ingredients (active or inert), one of the ways of administering such composition is by admixing the ingredients (e.g. in the form of a suitable unit dosage form such as tablet, capsule, solution, powder or a like) and then administering the dosage form. Alternatively, the ingredients may also be administered separately (simultaneously or one after the other) as long as these ingredients reach beneficial therapeutic levels such that the composition as a whole provides a synergistic and/or desired effect.
The term "growth" as used herein refers to a growth of one or more microorganisms and includes reproduction or population expansion of the microorganism (e.g. bacteria). The term "growth" also includes maintenance of on-going metabolic processes of the microorganism, including the processes that keep the microorganism alive.
The term, "effectiveness" as used herein refers to ability of a treatment, or a composition, or one or more pharmaceutically active ingredients to produce a desired biological effect in a subject. For example, the term "antibacterial effectiveness" of a composition or of an antibacterial agent refers to the ability of the composition or the antibacterial agent to prevent or treat bacterial infection in a subject. The term "synergistic" or "synergy" as used herein refers to the interaction of two or more agents so that their combined effect is greater than their individual effects.
The term "antibacterial agent" as used herein refers to any substance, compound, a combination of substances, or a combination of compounds capable of: (i) inhibiting, reducing or preventing growth of bacteria; (ii) inhibiting or reducing ability of a bacteria to produce infection in a subject; or (iii) inhibiting or reducing ability of bacteria to multiply or remain infective in the environment. The term "antibacterial agent" also refers to compounds capable of decreasing infectivity or virulence of bacteria.
The term "beta-lactam antibacterial agent" as used herein refers to compounds with antibacterial properties and containing a beta-lactam nucleus in their molecular structure.
The term "beta-lactamase" or "beta-lactamase enzyme" as used herein refers to any enzyme or protein or any other substance that breaks down a beta-lactam ring. The term "beta- lactamase" includes enzymes that are produced by bacteria and have the ability to hydrolyse the beta-lactam ring in a beta-lactam compound, either partially or completely.
The term "extended spectrum beta-lactamase" (ESBL) as used herein includes those beta- lactamase enzymes, which are capable of conferring bacterial resistance to various beta-lactam antibacterial agents such as penicillins, cephalosporins, aztreonam and the like.
The term "beta-lactamase inhibitor" as used herein refers to a compound capable of inhibiting activity of one or more beta-lactamase enzymes, either partially or completely.
The term "colony forming units" or "CFU" as used herein refers to an estimate of number of viable bacterial cells per ml of the sample. Typically, a "colony of bacteria" refers to a mass of individual bacteria growing together.
The term "pharmaceutically inert ingredient" or "carrier" or "excipient" refers to and includes compounds or materials used to facilitate administration of a compound, for example, to increase the solubility of the compound. Typical, non-limiting examples of solid carriers include starch, lactose, dicalcium phosphate, sucrose, and kaolin. Typical, non-limiting examples of liquid carriers include sterile water, saline, buffers, non-ionic surfactants, and edible oils. In addition, various adjuvants commonly used in the art may also be included. These and other such compounds are described in literature, e.g., in the Merck Index (Merck & Company, Rahway, N.J.). Considerations for inclusion of various components in pharmaceutical compositions are described, e.g., in Gilman et al. (Goodman and Gilman' s: The Pharmacological Basis of Therapeutics, 8th Ed., Pergamon Press., 1990), which is incorporated herein by reference in its entirety.
The term "subject" as used herein refers to vertebrate or invertebrate, including a mammal. The term "subject" includes human, animal, a bird, a fish, or an amphibian. Typical, non-limiting examples of a "subject" include humans, cats, dogs, horses, sheep, bovine cows, pigs, lambs, rats, mice and guinea pigs.
The term "pharmaceutically acceptable derivative" as used herein refers to and includes any pharmaceutically acceptable salt, pro-drug, metabolite, ester, ether, hydrate, polymorph, solvate, complex, and adduct of a compound described herein which, upon administration to a subject, is capable of providing (directly or indirectly) the parent compound. For example, the term "antibacterial agent or a pharmaceutically acceptable derivative thereof includes all derivatives of the antibacterial agent (such as salts, pro-drugs, metabolites, esters, ethers, hydrates, polymorphs, solvates, complexes, and adducts) which, upon administration to a subject, are capable of providing (directly or indirectly) the antibacterial agent.
The term "pharmaceutically acceptable salt" as used herein refers to one or more salts of a given compound which possesses desired pharmacological activity of the free compound and which is neither biologically nor otherwise undesirable. In general, the term "pharmaceutically acceptable salts" refer to salts that are suitable for use in contact with the tissues of human and animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salts are well known in the art. For example, S. M. Berge, et al. (/. Pharmaceutical Sciences, 66; 1-19, 1977), incorporated herein by reference in its entirety, describes various pharmaceutically acceptable salts in details.
The term "stereoisomer" as used herein refers to and includes isomeric molecules that have the same molecular formula but differ in positioning of atoms and/or functional groups in the space. Stereoisomers may further be classified as enantiomers (where different isomers are mirror-images of each other) and diastereomers (where different isomers are not mirror-images of each other). Diastereomers include isomers such as conformers, meso compounds, cis-trans (E-Z) isomers, and non-enantiomeric optical isomers.
A person of skills in the art would appreciate that various compounds described herein (including, for example a compound of Formula (I) and meropenem) can exist and are often used as their pharmaceutically acceptable derivatives (such as salts, pro-drugs, metabolites, esters, ethers, hydrates, polymorphs, solvates, complexes, and adducts).
In one general aspect, there are provided pharmaceutical compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
Formula (I)
Figure imgf000009_0001
Compound of Formula (I), according to the invention can be used in various forms including as such, a stereoisomer or a pharmaceutically acceptable derivative thereof. A compound of Formula (I) (CAS Registry Number: 1427462-70-1) may also be known chemically by different names including the following: (a) "trans-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile"; (b) "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile"; or (c) "Sulphuric acid, mono[(lR,2S,5R)-2-cyano-7- oxo-l,6-diazabicyclo[3.2.1]oct-6-yl] ester". A reference to "a compound of Formula (I)" is intended to include compounds chemically known as: (a) "trans-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile"; (b) "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6- diazabicyclo[3.2.1]octane-2-carbonitrile"; or (c) "Sulphuric acid, mono[(lR,2S,5R)-2-cyano-7- oxo-l,6-diazabicyclo[3.2. l]oct-6-yl] ester".
Compound of Formula (I) may also be used in the form of its stereoisomer or a pharmaceutically acceptable derivative thereof. Typical, non-limiting examples of suitable pharmaceutically acceptable derivatives of a compound of Formula (I) include its sodium salt (also known as "sodium salt of sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester" or "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester, sodium salt (1:1); CAS Registry Number: 1427462-59-6"); potassium salt (also known as "potassium salt of sulphuric acid, mono[(lR,2S,5R)-2-cyano-7- oxo-l,6-diazabicyclo[3.2.1]oct-6-yl] ester" or "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo- l,6-diazabicyclo[3.2.1]oct-6-yl] ester, potassium salt (1: 1); CAS Registry Number: 1427462-60- 9"); and other salts such as "1-Butanaminium, Ν,Ν,Ν-tributyl-, (lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl sulphate (1: 1); CAS Registry Number: 1427462-72-3".
In another general aspect, there are provided pharmaceutical compositions comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
Both, meropenem and a compound of Formula (I) may be present in the composition in their free forms or in the form of their pharmaceutically acceptable derivatives (such as salts, pro-drugs, metabolites, esters, ethers, hydrates, polymorphs, solvates, complexes, or adducts).
Individual amounts of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or pharmaceutically acceptable derivative thereof in the composition may vary depending on clinical requirements. In some embodiments, a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof in the composition is present in an amount from about 0.01 gram to about 10 gram. In some other embodiments, meropenem or a pharmaceutically acceptable derivative thereof in the composition is present in an amount from about 0.01 gram to about 10 gram.
In some embodiments, the pharmaceutical composition according to the invention comprises about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some other embodiments, the pharmaceutical composition according to the invention comprises about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some other embodiments, the pharmaceutical composition according to the invention comprises about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some other embodiments, the pharmaceutical composition according to the invention comprises about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 0.250 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, the pharmaceutical composition according to the invention comprises about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
The pharmaceutical compositions according to the invention may include one or more pharmaceutically acceptable carriers or excipients or the like. Typical, non-limiting examples of such carriers or excipients include mannitol, lactose, starch, magnesium stearate, sodium saccharine, talcum, cellulose, sodium crosscarmellose, glucose, gelatine, sucrose, magnesium carbonate, wetting agents, emulsifying agents, solubilizing agents, buffering agents, lubricants, preservatives, stabilizing agents, binding agents and the like.
The pharmaceutical compositions or the active ingredients according to the present invention may be formulated into a variety of dosage forms, such as solid, semi-solid, liquid and aerosol dosage forms. Typical, non-limiting examples of some dosage forms include tablets, capsules, powders, solutions, suspensions, suppositories, aerosols, granules, emulsions, syrups, elixirs and the like.
In some embodiments, pharmaceutical compositions according to the invention are in the form of a powder or a solution. In some other embodiments, pharmaceutical compositions according to the invention are present in the form of a powder or a solution that can be reconstituted by addition of a compatible reconstitution diluent prior to administration. In some other embodiments, pharmaceutical compositions according to the invention are in the form of a frozen composition that can be diluted with a compatible reconstitution diluent prior to administration. Typical, non-limiting example of suitable compatible reconstitution diluent includes water.
In some other embodiments, pharmaceutical compositions according to the invention are present in the form ready to use for parenteral administration.
The compositions according to the invention can be formulated into various dosage forms wherein the active ingredients and/or excipients may be present either together (e.g. as an admixture) or as separate components. When the various ingredients in the composition are formulated as a mixture, such compositions can be delivered by administering such a mixture to a subject using any suitable route of administration. Alternatively, pharmaceutical compositions according to the invention may also be formulated into a dosage form wherein one or more ingredients (such as active or inactive ingredients) are present as separate components. The composition or dosage form wherein the ingredients do not come as a mixture, but come as separate components, such composition/dosage form may be administered in several ways. In one possible way, the ingredients may be mixed in the desired proportions and the mixture is reconstituted in suitable reconstitution diluent and is then administered as required. Alternatively, the components or the ingredients (active or inert) may be separately administered (simultaneously or one after the other) in appropriate proportion so as to achieve the same or equivalent therapeutic level or effect as would have been achieved by administration of the equivalent mixture.
In some embodiments, pharmaceutical compositions according to the invention are formulated into a dosage form such that a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as admixture or as a separate components. In some other embodiments, pharmaceutical compositions according to the invention are formulated into a dosage form such that a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as separate components.
In one general aspect, pharmaceutical compositions according to the invention are used in treatment or prevention of a bacterial infection.
In another general aspect, there are provided methods for treating or preventing a bacterial infection in a subject, said method comprising administering to said subject effective amount of a pharmaceutical composition according to the invention. In case of dosage forms wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as separate components; a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof may be administered before, after or simultaneously with the administration of meropenem or a pharmaceutically acceptable derivative thereof.
In yet another general aspect, there are provided methods for treating or preventing bacterial infections in a subject, said methods comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
Formula (I)
Figure imgf000015_0001
In another general aspect, there are provided methods for treating or preventing bacterial infections in a subject, said methods comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof; wherein amount of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof administered is from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, there is provided a method for treating or preventing a bacterial infection in a subject, said method comprising administering to said subject: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, in any of the following amounts:
(i) about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof; (ii) about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(iii) about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(iv) about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(v) about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(vi) about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(vii) about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(viii) about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(ix) about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(x) about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof; (xi) about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xii) about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xiii) about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xiv) about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xv) about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xvi) about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof; or
(xvii) about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
In some embodiments, in the methods according to the invention, a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is administered in an amount from about 0.01 gram to about 10 gram. In some other embodiments, in the methods according to the invention, meropenem or a pharmaceutically acceptable derivative thereof is administered in an amount from about 0.01 gram to about 10 gram. In some embodiments, in the methods according to the invention, a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is administered before, after or simultaneously with the administration of meropenem or a pharmaceutically acceptable derivative thereof.
In the methods according to the invention, the pharmaceutical composition and/or other pharmaceutically active ingredients disclosed herein may be administered by any appropriate method, which serves to deliver the composition, or its constituents, or the active ingredients to the desired site. The method of administration can vary depending on various factors, such as for example, the components of the pharmaceutical composition and the nature of the active ingredients, the site of the potential or actual infection, the microorganism (e.g. bacteria) involved, severity of infection, age and physical condition of the subject. Some non-limiting examples of administering the composition to a subject according to this invention include oral, intravenous, topical, intrarespiratory, intraperitoneal, intramuscular, parenteral, sublingual, transdermal, intranasal, aerosol, intraocular, intratracheal, intrarectal, vaginal, gene gun, dermal patch, eye drop, ear drop or mouthwash. In some embodiments, the compositions or one or more active ingredients according to the invention are administered parenterally.
In some embodiments, in the compositions and methods according to the invention, a compound of Formula (I) is "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6-diazabicyclo[3.2.1]octane-2- carbonitrile". In some other embodiments, in the compositions and methods according to the invention, a compound of Formula (I) is: "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester". In some embodiments, in compositions and methods according to the invention, a compound of Formula (I) is present as a sodium or potassium salt of "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6-diazabicyclo[3.2.1]oct-6-yl] ester".
In some embodiments, there is provided a method for increasing antibacterial effectiveness of meropenem or a pharmaceutically acceptable derivative thereof in a subject, said method comprising co-administering meropenem or a pharmaceutically acceptable derivative thereof, with a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof. In some other embodiments, there is provided a method for increasing antibacterial effectiveness of meropenem or a pharmaceutically acceptable derivative thereof in a subject, said method comprising co-administering meropenem or a pharmaceutically acceptable derivative thereof, with a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, wherein the amount of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
A wide variety of bacterial infections can be treated or prevented using compositions and methods according to the invention. Typical, non-limiting examples of bacterial infections that can be treated or prevented using methods and/or pharmaceutical compositions according to the invention include E. coli infections, Yersinia pestis (pneumonic plague), staphylococcal infection, mycobacteria infection, bacterial pneumonia, Shigella dysentery, Serratia infections, Candida infections, Cryptococcal infection, anthrax, tuberculosis or infections caused by Pseudomonas aeruginosa, Acinetobacter baumannii or methicillin resistant Staphylococcus aurues (MRSA) etc.
The pharmaceutical compositions and methods according to the invention are useful in treatment or prevention of several infections, including for example, skin and soft tissue infections, febrile neutropenia, urinary tract infection, intraabdominal infections, respiratory tract infections, pneumonia (nosocomial), bacteremia meningitis, surgical infections and the like.
In some embodiments, pharmaceutical compositions and methods according to the invention are used in treatment or prevention of infections caused by resistant bacteria. In some other embodiments, the compositions and methods according to the invention are used in treatment or prevention of infections caused by bacteria producing one or more beta-lactamase enzymes.
In general, the pharmaceutical compositions and methods disclosed herein are also effective in preventing or treating infections caused by bacteria that are considered to be less or not susceptible to one or more of known antibacterial agents or their known compositions. Some non-limiting examples of such bacteria known to have developed resistance to various antibacterial agents include Acinetobacter, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacter, Klebsiella, Citrobacter and a like.
EXAMPLES
The following examples illustrate embodiments of the invention that are presently best known. However, it is to be understood that the following are only exemplary or illustrative of the application of the principles of the present invention. Numerous modifications and alternative compositions, methods, and systems may be devised by those skilled in the art without departing from the spirit and scope of the present invention. The appended claims are intended to cover such modifications and arrangements. Thus, while the present invention has been described above with particularity, the following examples provide further detail in connection with what are presently deemed to be the most practical embodiments of the invention.
The antibacterial activity of combinations according to the invention was investigated against various bacterial strains. In a typical study, minimum inhibitory concentrations (MIC) were determined using Muller Hinton Agar (MHA) (BD, USA) according to Clinical and Laboratory Standards Institute (CLSI) recommendations, (Clinical and Laboratory Standards Institute (CLSI), Performance Standards for Antimicrobial Susceptibility Testing, 20th Informational Supplement, M 100-S20, Volume 30, No. 1, 2010). In short, the inocula were adjusted to deliver about 104 colony forming units (CFU) per spot with a multipoint inoculator (Applied Quality Services, UK). The plates were pored with doubling concentration range of the test combinations according to invention containing MHA. The plates were inoculated and were incubated at 35°C for 18 hours. MICs were read as the lowest concentration of drug that completely inhibited bacterial growth.
Example 1
The results of antibacterial activity of combination of meropenem and the compound of Formula (I) against highly resistant strains like Acinetobacter baumannii harbouring carbapenem hydrolyzing (CHDL) OXA beta-lactamases, K. pneumonia harbouring Klebsiella pneumonia carbapenemases (KPC) and Enterobacter cloacae harbouring Klebsiella pneumonia carbapenemases are given in Table 1. As may be seen, the data in Table 1 reveals that both meropenem and compound of Formula (I) when used alone exhibited higher MIC values. However, the MIC values of meropenem lowered significantly in presence of the compound of Formula (I) (at 4 and 8 mcg/ml). The MIC values of meropenem reduced from 8 - 256 mcg/ml to about 0.12 - 2 mcg/ml in presence of the compound of Formula (I) (at 4 and 8 mcg/ml).
The results given in the Table 1, clearly and surprisingly demonstrate the potent antibacterial activity of combinations comprising meropenem and a compound of Formula (I) against highly resistant bacterial strains. Thus, combination of meropenem and a compound of Formula (I) has tremendous beneficial effect in inhibiting highly resistant bacterial strains demonstrating the noteworthy therapeutic advance in the treatment of infections caused by such pathogens.
Figure imgf000021_0001
Example 2
Sterile Meropenem was aseptically blended or mixed with sterile compound of Formula (I) for about 30 minutes at 8 rpm to obtain sterile dry powder for injection (compositions shown in Table 1). Each single vial of this formulation may be reconstituted with suitable reconstitution diluent prior to administration.
Figure imgf000022_0001

Claims

1. A pharmaceutical composition comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
Formula (I)
Figure imgf000023_0001
2. A pharmaceutical composition according to Claim 1, wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.125 gram to about 4 gram per gram of meropenem or a pharmaceutically acceptable derivative thereof.
3. A pharmaceutical composition according to any of the Claims 1 or 2, wherein a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.01 gram to about 10 gram.
4. A pharmaceutical composition according to any of the Claims 1 or 2, wherein meropenem or a pharmaceutically acceptable derivative thereof is present in the composition in an amount from about 0.01 gram to about 10 gram.
5. A pharmaceutical composition according to any of the Claims 1 to 4, comprising: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, in any of the following amounts:
(i) about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(ii) about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof; (iii) about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(iv) about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(v) about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(vi) about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(vii) about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(viii) about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(ix) about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(x) about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof; (xi) about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xii) about 0.125 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xiii) about 0.25 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xiv) about 0.5 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xv) about 1 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof;
(xvi) about 2 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof; or
(xvii) about 4 gram of a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or a pharmaceutically acceptable derivative thereof.
6. A pharmaceutical composition according to any of the Claims 1 to 5, wherein a compound of Formula (I) is: "(2S, 5R)-7-oxo-6-(sulphooxy)-l,6-diazabicyclo[3.2.1]octane-2- carbonitrile".
7. A pharmaceutical composition according to any of the Claims 1 to 5, wherein a compound of Formula (I) is: "sulphuric acid, mono[(lR,2S,5R)-2-cyano-7-oxo-l,6- diazabicyclo[3.2.1]oct-6-yl] ester".
8. A pharmaceutical composition according to any of the Claims 1 to 5, wherein a compound of Formula (I) is present as a sodium or potassium salt of "sulphuric acid, mono[( 1R,2S ,5R)-2-cyano-7-oxo- 1 ,6-diazabicyclo [3.2.1 ]oct-6-yl] ester" .
9. A pharmaceutical composition according to any of the Claims 1 to 8, wherein the composition is formulated into a dosage form such that a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as admixture or as separate components.
10. A pharmaceutical composition according to Claim 9, wherein the composition is formulated into a dosage form such that a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof, and meropenem or a pharmaceutically acceptable derivative thereof, are present in the composition as separate components.
11. A pharmaceutical composition according to any of the Claims 1 to 10, wherein the composition is in form of a powder or a solution.
12. A pharmaceutical composition according to Claim 11, wherein the composition is in the form of a powder or a solution that can be reconstituted by addition of a compatible reconstitution diluent for use in parenteral administration.
13. A pharmaceutical composition according to any of the Claims 1 to 12 for use in treatment or prevention of a bacterial infection.
14. A method for preventing or treating a bacterial infection in a subject, said method comprising administering to said subject an effective amount of a pharmaceutical composition according to any of the Claims 1 to 12.
15. A method of treating or preventing a bacterial infection in a subject, said method comprising administering to said subject an effective amount of: (a) meropenem or a pharmaceutically acceptable derivative thereof, and (b) a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof: Formula (I)
Figure imgf000027_0001
16. A method according to Claim 15, wherein the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof is administered in an amount from about 0.125 gram to about 4 gram per gram of meropenem or the pharmaceutically acceptable derivative thereof.
17. A method according to any one of the Claims 15 or 16, wherein meropenem or the pharmaceutically acceptable derivative thereof and the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, are administered in any one of the following amounts:
(i) about 0.125 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(ii) about 0.25 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(iii) about 0.5 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(iv) about 1 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(v) about 2 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 0.5 gram of meropenem or the pharmaceutically acceptable derivative thereof; (vi) about 0.125 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(vii) about 0.25 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(viii) about 0.5 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(ix) about 1 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(x) about 2 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(xi) about 4 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 1 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(xii) about 0.125 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(xiii) about 0.25 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(xiv) about 0.5 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or the pharmaceutically acceptable derivative thereof; (xv) about 1 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or the pharmaceutically acceptable derivative thereof;
(xvi) about 2 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or the pharmaceutically acceptable derivative thereof; or
(xvii) about 4 gram of the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof, and about 2 gram of meropenem or the pharmaceutically acceptable derivative thereof.
18. The method according to any one of the Claims 15 to 17, wherein the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof is administered before, after or simultaneously with the administration of meropenem or the pharmaceutically acceptable derivative thereof.
19. A method of increasing antibacterial effectiveness of meropenem or the pharmaceutically acceptable derivative thereof in a subject, said method comprising coadministering meropenem or a pharmaceutically acceptable derivative thereof, with a compound of Formula (I) or a stereoisomer or a pharmaceutically acceptable derivative thereof:
Formula (I)
Figure imgf000029_0001
20. A method according to Claim 19, wherein the compound of Formula (I) or the stereoisomer or the pharmaceutically acceptable derivative thereof is administered in an amount from about 0.125 gram to about 4 gram per gram of meropenem or the pharmaceutically acceptable derivative thereof.
PCT/IB2018/052649 2017-04-18 2018-04-17 Antibacterial compositions WO2018193368A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IN201721013819 2017-04-18
IN201721013819 2017-04-18

Publications (1)

Publication Number Publication Date
WO2018193368A1 true WO2018193368A1 (en) 2018-10-25

Family

ID=62196646

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2018/052649 WO2018193368A1 (en) 2017-04-18 2018-04-17 Antibacterial compositions

Country Status (1)

Country Link
WO (1) WO2018193368A1 (en)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013038330A1 (en) * 2011-09-13 2013-03-21 Wockhardt Limited Nitrogen containing compounds and their use
WO2015059642A1 (en) * 2013-10-22 2015-04-30 Wockhardt Limited Pharmaceutical compositions comprising antibacterial agents

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013038330A1 (en) * 2011-09-13 2013-03-21 Wockhardt Limited Nitrogen containing compounds and their use
WO2015059642A1 (en) * 2013-10-22 2015-04-30 Wockhardt Limited Pharmaceutical compositions comprising antibacterial agents

Non-Patent Citations (6)

* Cited by examiner, † Cited by third party
Title
"Clinical and Laboratory Standards Institute (CLSI", PERFORMANCE STANDARDS FOR ANTIMICROBIAL SUSCEPTIBILITY TESTING, 20TH INFORMATIONAL SUPPLEMENT, M 100-S20, vol. 30, no. 1, 2010
.: "Merck Index", MERCK & COMPANY
CASTANHEIRA M ET AL: "Antimicrobial activities of doripenem and other carbapenems against Pseudomonas aeruginosa, other nonfermentative bacilli, and Aeromonas spp", DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, ELSEVIER, AMSTERDAM, NL, vol. 63, no. 4, 1 April 2009 (2009-04-01), pages 426 - 433, XP026007294, ISSN: 0732-8893, [retrieved on 20090226], DOI: 10.1016/J.DIAGMICROBIO.2009.01.026 *
GOODMAN; GILMAN: "The Pharmacological Basis of Therapeutics, 8th Ed.", 1990, PERGAMON PRESS
KRISZTINA M. PAPP-WALLACE ET AL: "Strategic Approaches to Overcome Resistance against Gram-Negative Pathogens Using [beta]-Lactamase Inhibitors and [beta]-Lactam Enhancers: Activity of Three Novel Diazabicyclooctanes WCK 5153, Zidebactam (WCK 5107), and WCK 4234", JOURNAL OF MEDICINAL CHEMISTRY, vol. 61, no. 9, 7 April 2018 (2018-04-07), pages 4067 - 4086, XP055487958, ISSN: 0022-2623, DOI: 10.1021/acs.jmedchem.8b00091 *
S. M. BERGE ET AL., J. PHARMACEUTICAL SCIENCES, vol. 66, 1977, pages 1 - 19

Similar Documents

Publication Publication Date Title
WO2016151543A1 (en) Pharmaceutical compositions comprising antibacterial agents
US20180243274A1 (en) Antibacterial compositions
JP2019116508A (en) Pharmaceutical composition containing antibacterial agent
US9789097B2 (en) Pharmaceutical compositions comprising antibacterial agents
WO2015063653A1 (en) Pharmaceutical compositions comprising antibacterial agents
WO2015136387A1 (en) Pharmaceutical compositions comprising antibacterial agents
AU2014338612A1 (en) Pharmaceutical compositions comprising antibacterial agents
EP3107539A1 (en) Pharmaceutical combinations comprising antibacterial agents
EP3062794A1 (en) Pharmaceutical compositions comprising antibacterial agents
EP3125887A1 (en) Pharmaceutical compositions comprising cefepime or sulbactam
WO2018193368A1 (en) Antibacterial compositions
EP3131555A1 (en) Pharmaceutical compositions comprising antibacterial agents
WO2015159263A1 (en) Pharmaceutical compositions comprising antibacterial agents
EP3217979A1 (en) Pharmaceutical compositions comprising antibacterial agents
EP3060212A1 (en) Pharmaceutical compositions comprising sulbactam and imipenem

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18725636

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 18725636

Country of ref document: EP

Kind code of ref document: A1