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Exploitation of Antibiotic Resistance as a Novel Drug Target: Development of a β‑Lactamase-Activated Antibacterial Prodrug

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posted on 22.04.2019, 00:00 by Lindsay E. Evans, Aishwarya Krishna, Yajing Ma, Thomas E. Webb, Dominic C. Marshall, Catherine L. Tooke, James Spencer, Thomas B. Clarke, Alan Armstrong, Andrew M. Edwards
Expression of β-lactamase is the single most prevalent determinant of antibiotic resistance, rendering bacteria resistant to β-lactam antibiotics. In this article, we describe the development of an antibiotic prodrug that combines ciprofloxacin with a β-lactamase-cleavable motif. The prodrug is only bactericidal after activation by β-lactamase. Bactericidal activity comparable to ciprofloxacin is demonstrated against clinically relevant E. coli isolates expressing diverse β-lactamases; bactericidal activity was not observed in strains without β-lactamase. These findings demonstrate that it is possible to exploit antibiotic resistance to selectively target β-lactamase-producing bacteria using our prodrug approach, without adversely affecting bacteria that do not produce β-lactamase. This paves the way for selective targeting of drug-resistant pathogens without disrupting or selecting for resistance within the microbiota, reducing the rate of secondary infections and subsequent antibiotic use.