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Antimicrobial Agents and Chemotherapy, April 2008, p. 1391-1395, Vol. 52, No. 4
0066-4804/08/$08.00+0     doi:10.1128/AAC.01045-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Safety, Tolerance, and Pharmacokinetic Studies of OPT-80 in Healthy Volunteers following Single and Multiple Oral Doses

Optimer Pharmaceuticals, San Diego, California,¹ Palm Beach Atlantic University, West Palm Beach, Florida,² Tufts University School of Medicine, Boston, Massachusetts,³ Durect Corporation, Cupertino, California,⁴ University of Miami School of Medicine, Miami, Florida⁵

Received 8 August 2007/ Returned for modification 2 October 2007/ Accepted 4 February 2008

Current therapies for Clostridium difficile infection (CDI) are encumbered by treatment failures and recurrences. Due to its high in vitro activity against C. difficile but low activity against the typical intestinal flora, minimal absorption, and durable cure in the hamster model of C. difficile infection, OPT-80 was considered for clinical development as a therapy for CDI. This trial consisted of two phases. Four single oral doses of OPT-80 (100, 200, 300, and 450 mg) were administered in a crossover manner to 16 healthy volunteers in a double-blind, placebo-controlled phase 1A study; a 1- to 2-week washout interval separated the treatments. In the double-blind phase 1B study, 24 healthy subjects were randomized to receive OPT-80 (150, 300, or 450 mg) or placebo for 10 days. In both studies, OPT-80's safety and tolerability were evaluated and the concentrations of OPT-80 and its primary metabolite (OP-1118) in plasma and feces were determined. OPT-80 levels in the urine were also analyzed for the phase 1A study. In both the single-dose and the multiple-dose studies, OPT-80 was well tolerated by all subjects in all dose groups. Maximal plasma concentrations were near or below the limit of quantification (5 ng/ml) across the dose range; urine concentrations were below the detection limit. The fecal total recovery of OPT-80 plus its major metabolite, OP-1118, approximated 100%. The tolerability, high fecal concentration, and low systemic exposure data from these studies support the further clinical development of OPT-80 as an oral therapy for CDI.

Published ahead of print on 11 February 2008.