Initial efficacy determination and resistance profile of anti-Acinetobacter antibiotics, turnercyclamycins

Drug-resistant Acinetobacter is a challenging, deadly pathogen of increasing prevalence in the US healthcare system. Recently, we described a series of lipopeptides, the turnercyclamycins, which retain potency against Acinetobacter strains that are resistant to the last-line antibiotic, colistin. To further evaluate the potential of turnercyclamycins, we completed mouse efficacy, pharmacokinetics, and toxicity studies. These demonstrate that turnercyclamycin A has a pharmacological profile with similarity to other lipopeptides that are in clinical use. Turnercyclamycin A was well tolerated in mice up to 25 mg/kg, and exhibited >99% and >98% reduction in bacterial load compared to vehicle control in a thigh infection model at 25 and 12.5 mg/kg, respectively. This result closely reflected the anticipated effectiveness based upon in vitro activity and was similar to the colistin control. Acinetobacter strains resistant to colistin often harbor the mcr-1 resistance gene. Here, we show that the effectiveness of turnercyclamycins against Escherichia coli is not greatly altered by mcr-1 (0- to 2-fold) whereas there is a 16-fold increase in the colistin minimal inhibitory concentration when mcr-1 is present. These data suggest that turnercyclamycins are suitable for further investigation and optimization as anti-Acinetobacter lead compounds.