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Page M.G.,Basilea Pharmaceutica International Ltd. | Bush K.,Indiana University
Current Opinion in Pharmacology | Year: 2014

Multidrug-resistant Gram-negative bacteria continue to pose a threat, with many infections caused by these pathogens being virtually untreatable. A number of new antibacterial agents are in late stage clinical development to treat these infections. Drugs in known classes such as new quinolones, aminoglycosides, tetracyclines, and β-lactams have been designed to evade many of the known resistance mechanisms, whereas newer drug classes include novel β-lactamase inhibitors in combination with new or approved β-lactams, and a peptidomimetic that have entered full clinical development. The establishment of public-private partnerships and an increase in pharmaceutical interest in antibacterial R&D are encouraging signs for the future. © 2014 Published by Elsevier Ltd.

Cornely O.A.,University of Cologne | Bohme A.,Onkologikum Frankfurt am Museumsufer | Schmitt-Hoffmann A.,Basilea Pharmaceutica International Ltd. | Ullmann A.J.,Johannes Gutenberg University Mainz | Ullmann A.J.,University of Wurzburg
Antimicrobial Agents and Chemotherapy | Year: 2015

Isavuconazole is a novel broad-spectrum triazole antifungal agent. This open-label dose escalation study assessed the safety and pharmacokinetics of intravenous isavuconazole prophylaxis in patients with acute myeloid leukemia who had undergone chemotherapy and had preexisting/expected neutropenia. Twenty-four patients were enrolled, and 20 patients completed the study. The patients in the low-dose cohort (n = 11) received isavuconazole loading doses on day 1 (400/200/200 mg, 6 h apart) and day 2 (200/200 mg, 12 h apart), followed by once-daily maintenance dosing (200 mg) on days 3 to 28. The loading and maintenance doses were doubled in the high-dose cohort (n = 12). The mean±standard deviation plasma isavuconazole areas under the concentration-time curves for the dosing period on day 7 were 60.1±22.3 μg · h/ml and 113.1±19.6 μg · h/ml for the patients in the low-dose and high-dose cohorts, respectively. The adverse events in five patients in the low-dose cohort and in eight patients in the high-dose cohort were considered to be drug related. Most were mild to moderate in severity, and the most common adverse events were headache and rash (n = 3 each). One patient in the high-dose cohort experienced a serious adverse event (unrelated to isavuconazole treatment), and two patients each in the low-dose and high-dose cohorts discontinued the study due to adverse events. Of the 20 patients who completed the study, 18 were classified as a treatment success. In summary, the results of this analysis support the safety and tolerability of isavuconazole administered at 200 mg and 400 mg once-daily as prophylaxis in immunosuppressed patients at high risk of fungal infections. Copyright © 2015, American Society for Microbiology.

Dreier J.,Basilea Pharmaceutica International Ltd. | Ruggerone P.,University of Cagliari
Frontiers in Microbiology | Year: 2015

Pseudomonas aeruginosa infections are becoming increasingly difficult to treat due to intrinsic antibiotic resistance and the propensity of this pathogen to accumulate diverse resistance mechanisms. Hyperexpression of efflux pumps of the Resistance-Nodulation-Cell Division (RND)-type multidrug efflux pumps (e.g., MexAB-OprM), chromosomally encoded by mexAB-oprM, mexCD-oprJ, mexEF-oprN, and mexXY (-oprA) is often detected in clinical isolates and contributes to worrying multi-drug resistance phenotypes. Not all antibiotics are affected to the same extent by the aforementioned RND efflux pumps. The impact of efflux on antibiotic activity varies not only between different classes of antibiotics but also between members of the same family of antibiotics. Subtle differences in physicochemical features of compound-pump and compound-solvent interactions largely determine how compounds are affected by efflux activity. The combination of different high-resolution techniques helps to gain insight into the functioning of these molecular machineries. This review discusses substrate recognition patterns based on experimental evidence and computer simulations with a focus on MexB, the pump subunit of the main RND transporter in P. aeruginosa. © 2015 Dreier and Ruggerone.

Neuhaus C.M.,ETH Zurich | Liniger M.,ETH Zurich | Stieger M.,Basilea Pharmaceutica International Ltd. | Altmann K.-H.,ETH Zurich
Angewandte Chemie - International Edition | Year: 2013

Key steps in this total synthesis of the antimitotic natural product WF-1360F (3) include the formation of the macrocycle through ring-closing alkyne metathesis and the subsequent conversion of the ensuing alkyne moiety into an E-configured double bond. As illustrated by the synthesis of 4, the macrocyclic vinyl iodide 2 can also serve as a common precursor for the synthesis of side-chain-modified rhizoxin analogues (see scheme; TIPS=triisopropylsilyl). Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Page M.G.P.,Basilea Pharmaceutica International Ltd.
Annals of the New York Academy of Sciences | Year: 2013

There has been considerable effort expended in the investigation of the potential of siderophore conjugates of antibiotics to circumvent the permeability barrier imposed by the outer membrane of Gram-negative bacteria. There is also a small group of natural conjugates, the sideromycins. Among the synthetic analogues that have been investigated are conjugates of nucleosides, glycopeptides, macrolides, fluroquinolones, and, above all, β-lactams. Despite this effort, few compounds have progressed beyond experimental studies. One compound, the siderophore monosulfactam BAL30072, is in early clinical studies. © 2013 New York Academy of Sciences.

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