To improve the oral absorption of meropenem (MEPM), we synthesized and evaluated a series of its double-promoiety prodrugs, in which lipophilic promoieties were introduced into carboxyl and pyrrolidinyl groups. Among these prodrugs, pivaloyloxymethyl (1R,5S,6S)-2-[(3S,5S)-5-(N,N-dimethylcarbamoyl)-1-(isobutyryloxymethyloxycarbonyl)pyrrolidin-3-ylthio]-6-[(1R)-1-hydroxyethyl]-1-methylcarbapen-2-em-3-carboxylate (4) and 1-ethylpropyloxycarbonyloxymethyl (1R,5S,6S)-2-[(3S,5S)-5-(N,N-dimethylcarbamoyl)-1-(isobutyryloxymethyloxycarbonyl)pyrrolidin-3-ylthio]-6-[(1R)-1-hydroxyethyl]-1-methylcarbapen-2-em-3-carboxylate (8) were chosen for further evaluation. Compounds 4 and 8 were well absorbed after oral administration to rats and beagles (bioavailability 18.2â38.4%), and expected to show potent therapeutic efficacy in patients infected with various pathogens, such as penicillin-resistant S. pneumoniae and β-lactamase-negative ampicillin-resistant H. influenzae.
为了改善
美罗培南(MEPM)的口服吸收,我们合成并评估了一系列双促渗前药,在这些前药中,疏
水性促渗基团被引入到羧基和
吡咯烷基团中。在这些前药中,匹伐酸氧甲基(1R,5S,6S)-2-[(3S,5S)-5-(N,N-二甲基
氨基甲酰基)-1-(异丁酰氧甲基氧羰基)
吡咯烷-3-基
硫]-6-[(1R)-1-羟基乙基]-1-甲基碳青霉烯-2-烯-3-
羧酸酯(4)和1-乙基丙氧基羰氧甲基(1R,5S,6S)-2-[(3S,5S)-5-(N,N-二甲基
氨基甲酰基)-1-(异丁酰氧甲基氧羰基)
吡咯烷-3-基
硫]-6-[(1R)-1-羟基乙基]-1-甲基碳青霉烯-2-烯-3-
羧酸酯(8)被选为进一步评估的对象。化合物4和8在大鼠和比格犬中口服后被良好吸收(
生物利用度为18.2-38.4%),并预期在感染各种病原体的患者中显示出强大的疗效,例如耐
青霉素的肺炎链球菌和耐β内酰胺酶阴性的
氨苄西林流感嗜血杆菌。