While drug-susceptible tuberculosis (TB) disease in children currently requires four to six months of treatment, most children may be able to be cured with a shorter treatment of more powerful drugs. Shorter treatment may be easier for children to tolerate and finish as well as ease caregiver strain from managing treatment side effects and supporting children over many months. The primary objective of this study is to evaluate if a 2-month regimen (including isoniazid (H), rifapentine (P), pyrazinamide (Z) and moxifloxacin (M)) is as safe and effective as a 4- to 6-month regimen (isoniazid, rifampicin (R), pyrazinamide, ethambutol (E)) in curing drug-susceptible TB disease in children under 10 years old. The study is also evaluating the safety of the HPZM in children with and without HIV.

开始日期2024-11-15

申办/合作机构

The Johns Hopkins University

100 项与 Bacterial DNA gyrase x Topoisomerase IV 相关的临床结果

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100 项与 Bacterial DNA gyrase x Topoisomerase IV 相关的转化医学

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0 项与 Bacterial DNA gyrase x Topoisomerase IV 相关的专利（医药）

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项与 Bacterial DNA gyrase x Topoisomerase IV 相关的文献（医药）

2019-03-01·International Journal of Antimicrobial Agents2区 · 医学

Analysis of mutational patterns in quinolone resistance-determining regions of GyrA and ParC of clinical isolates

2区 · 医学

Article

作者: Khodursky, Rachel F ; Ostrer, Lev ; Khodursky, Arkady ; Hiasa, Hiroshi ; Johnson, James R

Fluoroquinolone (FQ)-resistant bacteria pose a major global health threat. Unanalysed genomic data from thousands of sequenced microbes likely contain important hints regarding the evolution of FQ resistance, yet this information lies fallow. Here we analysed the co-occurrence patterns of quinolone resistance mutations in genes encoding the FQ drug targets DNA gyrase (gyrase) and topoisomerase IV (topo-IV) from 36,402 bacterial genomes, representing 10 Gram-positive and 10 Gram-negative species. For 19 species, the likeliest routes toward resistance mutations in both targets were determined, and for 5 species those mutations necessary and sufficient to predict FQ resistance were also determined. Target mutation hierarchy was fixed in all examined Gram-negative species, with gyrase being the primary and topo-IV the secondary quinolone target, as well as in six of nine Gram-positive species, with topo-IV being the primary and gyrase the secondary target. By contrast, in three Gram-positive species (Staphylococcus haemolyticus, Streptococcus pneumoniae and Streptococcus suis), under some conditions gyrase became the primary and topo-IV the secondary target. The path through individual resistance mutations varied by species. Both linear and branched paths were identified in Gram-positive and Gram-negative organisms alike. Finally, FQ resistance could be predicted based solely on target gene quinolone resistance mutations for Acinetobacter baumannii, Escherichia coli and Staphylococcus aureus, but not Klebsiella pneumoniae or Pseudomonas aeruginosa. These findings have important implications both for sequence-based diagnostics and for understanding the emergence of FQ resistance.

2016-12-01·Annals of Clinical Microbiology and Antimicrobials3区 · 医学

Chemical structure and pharmacokinetics of novel quinolone agents represented by avarofloxacin, delafloxacin, finafloxacin, zabofloxacin and nemonoxacin

3区 · 医学

ReviewOA

作者: Kocsis, Bela ; Domokos, J ; Szabo, D

Quinolones are potent antimicrobial agents with a basic chemical structure of bicyclic ring. Fluorine atom at position C-6 and various substitutions on the basic quinolone structure yielded fluoroquinolones, namely norfloxacin, ciprofloxacin, levofloxacin, moxifloxacin and numerous other agents. The target molecules of quinolones and fluoroquinolones are bacterial gyrase and topoisomerase IV enzymes. Broad-spectrum and excellent tissue penetration make fluoroquinolones potent agents but their toxic side effects and increasing number of resistant pathogens set limits on their use. This review focuses on recent advances concerning quinolones and fluoroquinolones, we will be summarising chemical structure, mode of action, pharmacokinetic properties and toxicity. We will be describing fluoroquinolones introduced in clinical trials, namely avarofloxacin, delafloxacin, finafloxacin, zabofloxacin and non-fluorinated nemonoxacin. These agents have been proved to have enhanced antibacterial effect even against ciprofloxacin resistant pathogens, and found to be well tolerated in both oral and parenteral administrations. These features are going to make them potential antimicrobial agents in the future.

2016-06-01·Ophthalmology and Therapy3区 · 医学

Besifloxacin: Efficacy and Safety in Treatment and Prevention of Ocular Bacterial Infections

3区 · 医学

ReviewOA

作者: Mah, Francis S ; Sanfilippo, Christine M

This comprehensive review summarizes the mechanism of action, pharmacokinetics, efficacy, and safety of besifloxacin ophthalmic suspension, 0.6% and examines its role in the treatment of ocular surface bacterial infections. Besifloxacin possesses balanced activity against bacterial topoisomerase II (also called DNA gyrase) and topoisomerase IV. It has shown a low potential to select for bacterial resistance in vitro and demonstrated strong in vitro activity against many Gram-positive, Gram-negative, and anaerobic organisms, including methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis (MRSA and MRSE, respectively). Ocular pharmacokinetic studies have shown that besifloxacin achieves high, sustained concentrations in the tear fluid and conjunctiva following topical administration, with negligible systemic exposure. Large randomized, controlled clinical trials have established the efficacy and safety of besifloxacin administered three times daily for 5 days for treatment of acute bacterial conjunctivitis in both adults and children, with high rates of clinical resolution (up to more than 70% by day 5) and bacterial eradication (more than 90% by day 5), and a low incidence of adverse events. Additionally, besifloxacin applied twice daily for 3 days demonstrated greater efficacy than vehicle in treating bacterial conjunctivitis. Case reports, a large retrospective chart review, and animal studies have provided supporting evidence for the efficacy of besifloxacin in the management of acute bacterial keratitis. There is some evidence to suggest that besifloxacin may provide an advantage over other current-generation fluoroquinolones in antimicrobial prophylaxis for ocular surgery. Besifloxacin is an appropriate option for treatment of bacterial conjunctivitis, and its use in the treatment of bacterial keratitis and lid disorders, as well as for surgical prophylaxis, appears promising and warrants further evaluation.

项与 Bacterial DNA gyrase x Topoisomerase IV 相关的新闻（医药）

2024-10-16

·药明康德

有望成为20年来首款！GSK潜在"first-in-class"小分子疗法获FDA优先审评资格

▎药明康德内容团队编辑 GSK今天宣布，美国FDA已接受其潜在"first-in-class"口服抗生素gepotidacin的新药申请（NDA），用于治疗患有单纯性尿路感染（uUTI，也称为急性膀胱炎）成年或青少年（≥12岁）女性患者，患者体重须≥40公斤。FDA授予该申请优先审评资格，并预计在2025年3月26日前完成审评。根据新闻稿，若获批，gepotidacin将成为20多年来首个用于治疗uUTI的新型口服抗生素药物。超过一半的女性一生中会罹患uUTI，其中约30%的女性会发生复发。由于耐药细菌引起的uUTI病例不断增加，可能导致更高的治疗失败率，因此急需开发新的治疗方法。该新药申请得到了关键性3期EAGLE-2和EAGLE-3试验积极结果的支持。在这些研究中，与目前uUTI标准疗法nitrofurantoin抗生素相比，gepotidacin在治疗确诊的uUTI成年与青少年女性患者中展现非劣效性，这些患者已知对nitrofurantoin应答。 ▲Gepotidacin分子结构（图片来源：PubChem）在EAGLE-3试验中，gepotidacin与活性对照药物相比具有统计学显著优势，58.5%（n=162/277）的gepotidacin组患者治疗成功，而此数值在活性对照药物组中为43.6%（n=115/264，差异14.6%，95% CI：6.4~22.8）。在EAGLE-2试验中，50.6%（n=162/320）的gepotidacin组患者显示出治疗成功，而此数值在活性对照组中为47.0%（n=135/287，差异4.3%，95% CI：-3.6~12.1）。 Gepotidacin在EAGLE-2和EAGLE-3试验中的安全性和耐受性结果与先前试验一致。 Gepotidacin是一款具有全新作用机制的抗生素，它可以口服，并具有双重作用机制，能同时选择性地结合并抑制DNA促旋酶和DNA拓扑异构酶IV，从而诱发在复制进程的DNA发生单链断裂，进而达到杀死病原体的目的。 ▲欲了解更多前沿技术在生物医药产业中的应用，请长按扫描上方二维码，即可访问“药明直播间”，观看相关话题的直播讨论与精彩回放参考资料： [1] Gepotidacin accepted for priority review by US FDA for treatment of uncomplicated urinary tract infections in female adults and adolescents. Retrieved October 16, 2024 from https://www.gsk.com/en-gb/media/press-releases/gepotidacin-accepted-for-priority-review-by-us-fda-for-treatment-of-uncomplicated-urinary-tract-infections-in-female-adults-and-adolescents/ 免责声明：药明康德内容团队专注介绍全球生物医药健康研究进展。本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。版权说明：本文来自药明康德内容团队，欢迎个人转发至朋友圈，谢绝媒体或机构未经授权以任何形式转载至其他平台。转载授权请在「药明康德」微信公众号回复“转载”，获取转载须知。分享，点赞，在看，聚焦全球生物医药健康创新

优先审批临床结果临床3期