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Antimicrobial Agents and Chemotherapy, November 2003, p. 3602-3604, Vol. 47, No. 11
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.11.3602-3604.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
In Vitro Activity of TD-6424 against Staphylococcus aureus
John L. Pace, Kevin Krause, Deborah Johnston, Dmitri Debabov, Terry Wu, Lesley Farrington, Cassie Lane, Deborah L. Higgins, Burt Christensen, J. Kevin Judice,
and Koné Kaniga*
Theravance, Inc., South San Francisco, California 94080
Received 30 May 2003/
Returned for modification 21 July 2003/
Accepted 25 August 2003

ABSTRACT
TD-6424, a rapidly bactericidal agent with multiple mechanisms
of action, is more potent in vitro and more rapidly bactericidal
than currently available agents against methicillin-susceptible
and methicillin-resistant
Staphylococcus aureus. TD-6424 produces
a postantibiotic effect with a duration of 4 to 6 h against
these organisms. The results suggest potential efficacy against
susceptible and resistant strains of
S. aureus.

TEXT
Drug-resistant
Staphylococcus aureus has become an increasingly
important problem for the management of serious infections (
2,
3,
6). TD-6424 is a new agent which is rapidly bactericidal
for gram-positive bacteria. Its activity is mediated via a pair
of biochemically distinct mechanisms. In addition to inhibition
of peptidoglycan synthesis, TD-6424 also inhibits the synthesis
of phospholipids required for integrity of the bacterial cell
membrane (J. L. Pace, Abstr. 42nd Intersci. Conf. Antimicrob.
Agents Chemother., abstr. 454, p. 614, 2002). In the present
study, the susceptibilities of methicillin-susceptible
S. aureus (MSSA), methicillin-resistant
S. aureus (MRSA), and glycopeptide-intermediate
S. aureus (GISA) to TD-6424, vancomycin, oxacillin, linezolid,
and teicoplanin were evaluated. The bactericidal activities
and postantibiotic effects (PAEs) of TD-6424 and vancomycin
against MSSA, MRSA, and GISA were also assessed.
S. aureus strains were clinical isolates obtained within the last 4 years from a variety of hospitals in the United States and Europe. Well-characterized S. aureus strains from the American Type Culture Collection (ATCC; Manassas, Va.), the Centers for Disease Control and Prevention (Atlanta, Ga.), and other sources were also used. TD-6424 was obtained from Theravance, and all other agents were obtained from Sigma-Aldrich (St. Louis, Mo.), the U.S. Pharmacopeia (Rockville, Md.), or Hoechst AG (now Aventis; Frankfurt am Main, Germany).
The MIC was determined by the broth microdilution method according to protocol M7-A5 of the NCCLS (5). The minimum bactericidal concentration (MBC) was determined according to protocol M26-A of the NCCLS (4) from the microtiter plates used to determine MICs with a starting inoculum of
5 x 105 CFU/ml. After a 24-h incubation, the number of survivors from wells with no obvious turbidity was determined by plate counting of 10-µl samples. The bactericidal activity was determined by a time-kill assay (4) in 10 ml of Mueller-Hinton broth with a starting inoculum of
106 CFU/ml of log-phase cultures. At regular intervals, bacteria were enumerated by plate counting from 200 µl samples. For both MBC and time-kill assays, bactericidal activity was defined as a
3-log10 decrease in the number of CFU per milliliter within 24 h. The limit of detection was 10 CFU/ml.
The durations of the PAEs were determined according to a published protocol (1) with the following modifications. In brief, the 20-ml starting inoculum of
106 CFU/ml was exposed to the MIC of the compound for 1 h at 37°C. Bacteria were then removed from the antibiotic-containing medium by centrifugation and washed with saline to remove residual antibiotic. Bacteria were resuspended in 20 ml of prewarmed Mueller-Hinton broth and incubated with shaking. Plate counts were performed from 100-µl samples diluted appropriately at hourly intervals to determine the time at which a 1-log10 increase in CFU per milliliter occurred after antibiotic removal. The duration of PAE was calculated as the number of hours until return to log-phase growth of treated bacteria minus the time for return of control bacteria (no antibiotic but treated identically) to log-phase growth.
Susceptibility testing.
TD-6424 was highly active against MSSA. The MICs of TD-6424 for these organisms were generally lower than those of vancomycin, oxacillin, linezolid, and teicoplanin (Table 1). The MICs of TD-6424 for 47 strains of MSSA ranged from 0.12 to 2 µg/ml, and the MIC at which 90% of organisms were inhibited (MIC90) was 1 µg/ml. The MIC of TD-6424 for ATCC 13709 was 0.5 µg/ml, compared to 0.5 µg/ml for nafcillin, gentamicin, and oxacillin, 1 µg/ml for vancomycin and teicoplanin, and 4 µg/ml for linezolid. TD-6424 was more active against MRSA than were vancomycin, oxacillin, linezolid, and teicoplanin (Table 1). The MICs of TD-6424 for 128 strains of MRSA ranged from
0.06 to 2 µg/ml, and the MIC90 was 1 µg/ml. The MIC of TD-6424 for ATCC 33591 was 0.5 µg/ml, compared to 1 µg/ml for vancomycin, 2 µg/ml for teicoplanin, linezolid, and gentamicin, and 128 µg/ml for nafcillin and oxacillin. TD-6424 (MIC 2 µg/ml) was more active than vancomycin, teicoplanin, nafcillin, and oxacillin (all MICs, 8 µg/ml) against a well-characterized strain of GISA (HIP 5836).
Bactericidal activity.
The MBCs of TD-6424 for MSSA (ATCC 13709), MRSA (ATCC 33591),
and GISA (HIP 5836) were 2, 4, and 4 µg/ml, respectively;
the corresponding values for vancomycin were 2, 4, and 8 µg/ml,
and those for nafcillin were 0.5, >128, and 128 µg/ml.
The results of time-kill assays demonstrated the rapid, concentration-dependent
bactericidal activity of TD-6424. Results for MSSA indicated
that TD-6424 (4 µg/ml) reduced the initial inoculum from
log
10 6.22 ± 0.08 CFU/ml to log
10 3.36 ± 0.28
CFU/ml within 4 h after administration (Fig.
1A). Generally,
similar results were obtained for nafcillin (4 µg/ml).
With vancomycin (4 µg/ml), the initial inoculum was decreased
by only about 1 log
10 at 4 h. Linezolid (8 µg/ml) exhibited
the least bactericidal activity in this assay. Results with
TD-6424 for MRSA were generally similar to those for MSSA (Fig.
1B): TD-6424 at 8 and 32 µg/ml reduced the initial inoculum
from log
10 6.05 ± 0.08 CFU/ml to log
10 4.87 ±
0.05 and 1.26 ± 0.26 CFU/ml, respectively, within 4 h.
Vancomycin at 8 µg/ml exhibited much slower bactericidal
activity, and linezolid at 16 µg/ml had almost no bactericidal
activity against this organism. TD-6424 at 8, 16, and 32 µg/ml
was also rapidly bactericidal against GISA (Fig.
1C). By 4 h,
the 8- and 32-µg/ml concentrations had reduced the initial
inoculum from log
10 5.76 ± 0.07 to 3.21 ± 0.12
and 0.98 ± 0.02 CFU/ml, respectively. Linezolid at 8
µg/ml reduced the initial inoculum from log
10 5.76 ±
0.07 CFU/ml to log
10 2.73 ± 0.08 CFU/ml by 4 h, and vancomycin
at 32 µg/ml decreased it from log
10 5.76 ± 0.07
CFU/ml to log
10 4.82 ± 0.02 CFU/ml over this period.
PAE.
TD-6424 had long durations (

4 h) of PAE against
MSSA, MRSA, and GISA (Table
2). Vancomycin had substantially
shorter PAEs, whereas nafcillin did not generate a PAE against
the MSSA strain in this assay.
In summary, TD-6424 is highly active against MSSA, MRSA, and
GISA and has significant bactericidal activity and a long PAE
against these organisms. The in vitro properties of TD-6424
suggest that it may be effective in infections caused by both
susceptible and resistant strains of
S. aureus.

FOOTNOTES
* Corresponding author. Mailing address: Theravance, Inc., 901 Gateway Blvd, South San Francisco, CA 94080. Phone: (650) 808-6158. Fax: (650) 808-6186. E-mail:
kkaniga{at}theravance.com.

Present address: Department of Medicinal Chemistry, Genentech, Inc., South San Francisco, CA 94080. 

REFERENCES
1 - Craig, W. A., and S. Gudmundsson. 1996. Postantibiotic effect, p. 296-329. In V. Lorian (ed.), Antibiotics in laboratory medicine, 4th ed. Williams and Wilkins, Baltimore, Md.
2 - Hiramatsu, K., L. Cui, M. Kuroda, and T. Ito. 2001. The emergence and evolution of methicillin-resistant Staphylococcus aureus. Trends Microbiol. 9:486-493.[CrossRef][Medline]
3 - Maranan, M. C., B. Moreira, S. Boyle-Vavra, and R. S. Daum. 1997. Antimicrobial resistance in staphylococci. Epidemiology, molecular mechanisms, and clinical relevance. Infect. Dis. Clin. N. Am. 11:813-849.[CrossRef][Medline]
4 - National Committee for Clinical Laboratory Standards. 1999. Methods for determining bactericidal activity of antimicrobial agents; approved guideline M26-A. National Committee for Clinical Laboratory Standards, Wayne, Pa.
5 - National Committee for Clinical Laboratory Standards. 2000. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved guideline 5th ed., M7-A5. National Committee for Clinical Laboratory Standards, Wayne, Pa.
6 - Panlilio, A. L., D. H. Culver, R. P. Gaynes, S. Banerjee, T. S. Henderson, J. S. Tolson, and W. J. Martone. 1992. Methicillin-resistant Staphylococcus aureus in U. S. hospitals, 1975-1991. Infect. Control. Hosp. Epidemiol. 13:582-586.[Medline]
Antimicrobial Agents and Chemotherapy, November 2003, p. 3602-3604, Vol. 47, No. 11
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.11.3602-3604.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
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