Comparison of the Bactericidal Activities and Post-Antibiotic Effects of the Des-F(6)-Quinolone BMS-284756, Levofloxacin, and Ciprofloxacin Against Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus

Abstract.

The bactericidal activities and post-antibiotic effects of BMS-284756 (T-3811ME), levofloxacin, and ciprofloxacin were evaluated against a methicillin-susceptible and a methicillin-resistant Staphylococcus aureus strain. Minimum inhibitory concentrations (MICs), minimum bactericidal concentrations, post-antibiotic effects, and post-antibiotic sub-MIC effects were determined and time-kill studies were performed for BMS-284756, levofloxacin, and ciprofloxacin. At 4-times and 10-times the MIC, time-kill kinetics over 3 h and over 24 h were similar for all three quinolones when effects were considered as multiples of the MIC. All three quinolones achieved a 3 log₁₀ reduction in cfu/ml within 2 h. At 10-times the MIC, the post-antibiotic effects of BMS-284756, levofloxacin, and ciprofloxacin were 1.6–2.6 h for the methicillin-susceptible Staphylococcus aureus strain and 1.5–1.9 h for the methicillin-resistant Staphylococcus aureus strain. When actual concentrations were considered, BMS-284756 achieved results comparable to levofloxacin and ciprofloxacin at concentrations nearly 10-fold less. When relating the pharmacokinetic properties of the three quinolones to their in vitro activities, the resulting C_max/MIC and AUC/MIC ratios were, respectively, 120–240.7 and 1,321.7–2,643 for BMS-284756, 22.8 and 190 for levofloxacin, and 5.9–11.9 and 54.8–109.6 for ciprofloxacin. The greater in vitro activity and favorable human pharmacokinetics of BMS-284756 may translate to improved clinical effectiveness of this agent compared to currently marketed quinolones.