| 2018 | Combinations of registered drugs reduce treatment times required to deplete Wolbachia in the Litomosoides sigmodontis mouse model. | PLoS Negl Trop Dis | Filarial parasites can be targeted by antibiotic treatment due to their unique endosymbiotic relationship with Wolbachia bacteria. This finding has led to successful treatment strategies in both, human onchocerciasis and lymphatic filariasis. A 4-6 week treatment course using doxycycline results in long-term sterility and safe macrofilaricidal activity in humans. However, current treatment times and doxycycline contraindications in children and pregnant women preclude widespread administration of doxycycline in public health control programs; therefore, the search for shorter anti-wolbachial regimens is a focus of ongoing research. We have established an in vivo model for compound screening, using mice infected with Litomosoides sigmodontis. We could show that gold standard doxycycline treatment did not only deplete Wolbachia, it also resulted in a larval arrest. In this model, combinations of registered antibiotics were tested for their anti-wolbachial activity. Administration of rifamycins in combination with doxycycline for 7 days successfully depleted Wolbachia by > 2 log (>99% reduction) and thus resulted in a significant reduction of the treatment duration. Using a triple combination of a Tetracycline (doxycycline or minocycline), a rifamycin and a fluoroquinolone (moxifloxacin) led to an even greater shortening of the treatment time. Testing all double combinations that could be derived from the triple combinations revealed that the combination of rifapentine (15mg/kg) and moxifloxacin (2 x 200mg/kg) showed the strongest reduction of treatment time in intraperitoneal and also oral administration routes. The rifapentine plus moxifloxacin combination was equivalent to the triple combination with additional doxycycline (>99% Wolbachia reduction). These investigations suggest that it is possible to shorten anti-wolbachial treatment times with combination treatments in order to achieve the target product profile (TPP) requirements for macrofilaricidal drugs of no more than 7-10 days of treatment. |
| 1987 | Comparative in vitro activity of CI934, a new fluoroquinolone, alone and in combination with coumermycin, against gram-positive bacteria. | Drugs Exp Clin Res | The in vitro activity of Cl934, a new quinolone antimicrobial agent, was studied against 314 strains of Gram-positive bacteria representing 6 genera: Staphylococcus aureus, Streptococcus faecalis, S. agalactiae, S. pyogenes, S. pneumoniae, S. milleri, viridans streptococci, Listeria monocytogenes, Corynebacterium JK, Mycobacterium fortuitum and Bacillus spp.; and compared with that of enoxacin, ciprofloxacin, penicillin G, ampicillin, coumermycin, oxacillin, vancomycin, teicoplanin, rifampin, rifapentine, LM 427, erythromycin, minocycline, Tetracycline and clindamycin. The agar dilution method was used. Cl934 was very active in vitro, with MIC90 less than or equal to 0.5 mg/l against most species tested, except for S. faecalis and M. fortuitum. It was usually 2 to 8-fold more active than ciprofloxacin. Cl934 was also tested by the killing curve method, alone and in combination with coumermycin. It was rapidly bactericidal against most species tested, including S. faecalis. A synergistic interaction was observed with coumermycin against S. aureus, S. agalactiae, S. milleri and S. faecalis. The only antagonistic interaction occurred against L. monocytogenes exposed to 8 X MIC of Cl934 with 2 X MIC of coumermycin. |