• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
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  • 优先权
    • 专利摘要:
    The invention relates to a potentiated antimicrobial agent for its use in the treatment of a microbial infection, characterized in that in combination with the antimicrobial agent is used a compound corresponding to the following formula I: in a mass ratio compound of formula (I): antimicrobial agent, ranging from 8: 1 to 1:10.
    公开号:FR3025720A1
    申请号:FR1462136
    申请日:2014-12-09
    公开日:2016-03-18
    发明作者:Nicolas Tesse
    申请人:SEPTEOS；
    IPC主号:
    专利说明:

    [0001] The subject of the invention is the compounds of formula (I), used at a dose where they no longer exhibit antimicrobial properties, for their use as agents intended for the potentiation of the antimicrobial active agents with which they are co-administered. - administered. In particular, the combination "potentiator (s) + antimicrobial (s)" is intended to prevent and / or treat bacterial and fungal infections in humans or animals. The invention also relates to a method for potentiating antimicrobials in which is co-administered with said antimicrobial compound (or more) of formula (I). In this process, the compound of formula (I) is used at a dose where it is inactive alone. OBJECT OF THE INVENTION Background The invention aims to provide solutions to problems related to the decline or loss of activity of antimicrobials during their period of commercial and medical use. The invention is therefore a solution that applies to current antimicrobials and will apply to future antimicrobials.
    [0002] After the arrival of antimicrobials in the 1940s it quickly became apparent that microbes (bacteria and fungi) had the ability to adapt to the antimicrobials used. The effectiveness of these decreases over time and their use. Two strategies exist to fight against resistance, the discovery of new antimicrobial molecules on the one hand, and on the other hand the association with molecules intended to selectively block the resistance mechanisms. Over the past twenty years, there has been a decline in the number of new antimicrobial molecules entering the market, leading to a major increase in the global prevalence of resistant microbes. It then follows a complex situation for patients who are more difficult to treat their microbial infections.
    [0003] The invention describes the use of compounds of formulas (I) for potentiating antimicrobials. Surprisingly, these compounds have demonstrated their ability to potentiate the effect of antimicrobials at low doses (from 0.01 to 100 mg / l) very far from those where they alone can exhibit antimicrobial properties. As a result, the antimicrobials with which the compounds of formulas (I) are coadministered have, because of the potentiation, an activity greater than that usually observed. The invention aims to potentiate the "antimicrobials", usable in humans or animals and not all compounds that have "antimicrobial properties", which they are often not administrable to humans or animals. animal because of too high a toxicity or a threshold of antimicrobial activity too high requiring doses incompatible with the health. It is important to remember that any molecule has, in absolute terms, antimicrobial properties. The antimicrobial properties of a molecule must therefore be evaluated in relation to the minimum concentration that inhibits the bacteria. The invention is based on the surprising discovery that compounds which have antimicrobial properties at very high doses (level incompatible with a use in medicine for this purpose) and whose minimum inhibitory concentration (MIC) exceeds 5000 mg / L preferably greater than 10,000 mg / L exhibit potentiating effects at low doses (0.01 to 100 mg / l). At these doses, it becomes possible to use the compounds (I) in humans or animals. Also surprisingly, it has been found that the effect of potentiation is better at low dose of the compound (I), and that the effect (for compounds with very high dose antimicrobial properties) increases when away from the dose at which the compound (I) alone exhibits antimicrobial properties. For example, it has been unexpectedly found that cineole, which has antimicrobial properties at a concentration of about g / L (MIC from 25,000mg / l to 50,000 mg / l or 2.5-5% , depending on the strains), shows effects of potentiation of antibiotics at these concentrations close to the MIC (1 to 3 dilutions). When its concentration is lowered below the MIC, cineole no longer potentiates antibiotics (see examples 2 and 6). Then, very surprisingly, it was found that by decreasing still significantly the cineole concentration, from 10 to 50 times less than the MIC, the cineole again has potentiating effects on a very large number of antibiotics on a very large number of strains, this time at doses compatible with medical use.
    [0004] A great advantage is that the compounds (I) used at these doses, which are far from their efficiency threshold, are most often usable in humans or animals without toxicity constraints because of the absence of toxicity. acceptable levels of toxicity. This would not be the case if it was desired to use them at high doses where they exhibit antimicrobial properties, even at doses close to their MIC or they could potentiate antimicrobials. Just as surprisingly, the potentiating effect observed with the compound according to the invention is not specific for a particular mechanism of resistance but is observed on various strains, whether they have, or have not, developed. one or more distinct resistance mechanisms.
    [0005] PRIOR ART The prior art describes in numerous publications the antimicrobial properties of certain compounds (I). These publications do not anticipate the potentiating effect of the compounds (I) at doses far from their efficiency threshold. The prior art is consequent on the compounds (I) because they belong to chemical classes that are well studied in many fields. The compounds (I) within the scope of the present invention have the following characteristics which make it possible to exclude them from the prior art and which make it possible to envisage their use as a potentiator of antimicrobials administered to humans and animals: A / They are used at low doses (0.01 to 100 mg / l), doses away from their threshold of antimicrobial properties, their potentiating effect is not specific to particular mechanisms of action or resistance B / they have been validated by screening methods adapted to their physico-chemical characteristics C / they have, at the doses or they potentiate, an effect / toxicity ratio which allows a safe use in humans or animals 3025720 4 D / They constitute an isolated chemical entity (s) whose characteristics are reproducible in a constant way to infinity because their method of obtaining (synthesis, hemi-synthesis, extraction) allows it. E / They do not have any particular toxicity that would prohibit their use even at low dose (genotoxicity, cardiotoxicity, ...) A / Concerning the activity levels measured in the prior art In the prior art, the concentration used to observe antimicrobial activity is not compatible with future use in humans or animals, especially during systemic application. In most of the 10 scientific publications, medical use is envisaged while the measured effective concentrations (of the order of several mg / ml) are incompatible with this use. The antimicrobial effects measured have very often been for levels of essential oil, or its active compound, of the order of several mg / ml. However, such a concentration is not suitable for future use in humans or animals, particularly systemically. 1 mg / ml corresponds to 1 g / l or lg / kg or else 0.1%. If the MIC was 1 mg / ml, depending on the pharmacokinetic parameters, at least 1 g / kg / day body weight should be administered. For example, the effective dose for a cow should be at least 500 g / d and at least 60 g / d for man (this corresponds to the minimum dose since it is assumed here that the product is fully absorbed and distributed in the body. 'organization). These doses too important are not possible for safe use in therapy. For example, two publications mention the antibacterial effect of terpenoids and their potential capacity to potentiate antimicrobials: Biointerfacae Vol 2, Issue 1, 2012, 271-276: Marinas et al: Rosmarinus officinalis essential oil as antibiotic potentiator against Staphylococcus aureus. If this publication seems close to the invention, it is important to note the envisaged dose (p274) of eucalyptol which, at 25 .mu.l / ml (ie 25 ml / L or 25 g / l) is very far from the dose. manageable to the man or the animal. The synergy test envisaged is carried out with the storage solution (50% cineole), ie 50 g / l, which is greater than the MIC of cineole in the publication, which dosage is incompatible for use in medicine. 3025720 5 - Journal of Antimicrobial Chemotherapy (2009) 64, 1219-1225: Hendry et al: Antimicrobial efficacy of eucalyptus oil and 1,8-cineole alone and in combination with chlorhexidine digluconate against microorganisms grown in planktonic and biofilm cultures.
    [0006] Here again synergism is envisaged with a product which has antimicrobial properties. The concentration of cineole envisaged is 4 g / L, dose very close to the CMI of the cineole in the publication (8-64 g / L) but too important to be possible in a human or animal administration. Clearly the invention differs from these two publications because in them the 10 doses envisaged are very high while the proposed concentration is close to the MIC. B / Concerning the maladaptation of the methods described in the prior art The authors who have worked according to different approaches (active products alone, natural products, etc.) on the chemical families comprising the compounds (I) have in general used the standard methods of measuring the antibacterial effect without adapting them to the hydrophobic and volatile nature of terpenoid and phenylpropanoids. For example, WO 99/66796 (Wisconsin Alumni Research Foudation) discloses a method for sensitizing microbial cells to antibacterial compounds comprising a contacting step with an antibacterial compound and a sesquiterpenoid, to enhance the effect. antibacterial compound. In this application, the MICs were determined with the agar diffusion method, unsuited to the volatile and hydrophobic nature of the compounds (I) and related families. This method consists in depositing paper disks impregnated with known amounts of test compounds on an agar seeded with the bacterium to be studied. A concentration gradient of the compound around each disc is established on the agar plate; after 18 hours the diameter of the inhibition halo is measured. This method is however not reliable for hydrophobic compounds which, because of very different surface tensions and contact angles on the hydrophilic surfaces, interfere with the formation of the concentration gradient in the agar. In some areas, the concentration of test compounds is much higher than the theoretical concentration. Thus, the tests can not be quantitative, when they can be qualitative. In addition, a dilution of the hydrophobic compound to be tested in ethanol is noted, without, however, correcting the result while ethanol is an antibacterial and volatile compound. Note that this application teaches that no effect is obtained with terpenes other than sesquiterpenes.
    [0007] C / Concerning the toxicity of the compounds of the prior art With regard to the natural compounds and compositions, there is a confusion between the natural origin and the absence of toxicity. Essential oils (and their derivatives) are usually described as being low in toxicity, which is often true in food or perfume applications but erroneous in the context of therapeutic administration. With regard to isolated chemical compounds, the confusion also exists and is based on the natural origin (extraction) of the compounds. For example WO2006 / 120567 (Advanced Scientific developments) describes pharmaceutical compositions comprising at least one active therapeutic substance and described as non-toxic, chosen from carveol, thymol, eugenol, borneol, carvacrol, alpha-ionone, beta-ionone, and their derivatives. isomers, derivatives and mixtures, and comprising, as the second active therapeutic substance an antibiotic. Carveol, thymol, eugenol, borneol, carvacrol, alpha-ionone, or beta-ionone, used alone, exhibit antibacterial activity and many of them also pose toxicity problems, ignored in this application. For example, carvacrol has the following toxicity data: the LD 50 (mouse, intravenous) is 80 mg / kg while the lowest oral lethal dose is 100 mg / kg, in two mammal species (cat and rat). These data are to be compared with the dose of 0.3 mg / ml (or 300 mg / kg), considered in the document.
    [0008] D / Concerning the chemical variability of the compounds described in the prior art The use of essential oil is problematic, on an industrial scale, in terms of quality and reproducibility since the composition of an essential oil varies from 'a batch to another. For example DE 196 31 037 (Boehringer) discloses the use of tea tree essential oil to potentiate the effect of antibiotics on Staphylococcus aureus strains. The main component tea tree essential oil is terpinen-1-ol.
    [0009] This variability has three consequences that limit industrialization for application in humans or animals: - it is difficult to ensure the constancy of the therapeutic effect - It is difficult to ensure the low toxicity products 5 - the cost of supplying and managing the quality and reproducibility of materials is important. The following table recapitulates the teaching of these prior arts: A / Products B / Metrude of CI Toxicity D / Doseperfused dif fi culties at the envisaged dose Suce-ling at the valiabflichemical dose incompatible with the fad of the envisioned COMPOUNDS Maiinasetal Yes Yes Yes No 15 g / L or 15,000 mg / 1 Henchy etal Yes No Yes No 4 g / L ie 4,000 mg / 1 WO 2009/043987 Ammatedinologies Yes Yes Yes Yes 0.1 to 0.4% or 1 to 4000 mg / L WO 2006/120567 Aclvanoed Yes Yes, (not & gent Yes No 0.3 mg / mi ie 3000 mg / 1 having) DE 19631037 & change Yes No (testcanslelait) Yes Yes 1 to 2 mg / ml ie 1000 to 2000 mg / 1 WO 99/66796 Yes Yes Yes No 1 mM ie 222 mg / L (for sesquiterpenoids) WiszonsinAlumni Piéent hwention No No No No 0.01 to 100 mg / L Table 1 Work on compounds (I) at low doses distant from those to which they exhibit antimicrobial activity is new and the prior art has not, to our knowledge, been visaged this use. DEFINITIONS By "microorganism" is meant any living organism, invisible to the naked eye because of its small size.
    [0010] By "organism" is meant any animal or plant biological entity (being alive) able to be born, to develop and normally to reproduce.
    [0011] In this patent the definition of microbe includes the definition of microorganism, limited to the medical field to which the invention refers. Thus "microbes" are living microorganisms potentially pathogenic (bacteria, fungi, yeast and mycobacteria). The term therefore excludes inert pathogens such as viruses and prions. By "antimicrobial" is meant any compound intended to be administered to humans or animals capable of killing or inhibiting the growth of microbes. The pharmaceutically acceptable salts of these antimicrobials are also included in this definition. This includes, for example, the sodium, potassium, calcium, etc. salts. and the amine salts of procaine, dibenzylamine, ethylendiamine, ethanolamine, methylglucamine taurine, etc., as well as acid addition salts such as hydrochlorides and basic amino acids. The term includes antibiotics (their associations with inhibitors of resistance mechanisms), antifungals intended for systemic or local use.
    [0012] By "antimicrobial properties" is meant the properties of any substance capable of destroying or inhibiting the growth of microbes. Products with antimicrobial properties include antimicrobials and biocides. In contrast to the term "antimicrobial" which includes the antibacterials, 20 antifungals to be administered, the term "biocide" groups together products with antimicrobial properties intended to be applied to inert systems (viruses and prions). By "antibacterial properties" and "antifungal properties" is meant not only the bactericidal and fungicidal properties characterized by the destruction of bacteria and fungi (and yeasts, mycobacteria), but also the bacteriostatic and fungistatic properties, characterized by the inhibition of growth of said bacteria and fungi (and yeasts, mycobacteria). Products with antibacterial or antifungal properties include antimicrobials.
    [0013] For the purposes of the present invention, the term "antibiotic-resistant bacterium" is intended to mean a bacterium resistant to at least one, especially at least two, in particular at least three or even at least four antibiotics (s) or family. (s) antibiotic, conventionally used. For the purpose of the present invention, the term "multi-resistant bacterium" is intended to mean a bacterium resistant to several antibiotics, in particular for which the strain should be sensitive, or a priori sensitive, especially a bacterium that has at least two non-resistant resistances. natural. We distinguish between "natural resistances" and "acquired resistances". Some antibiotics have never been effective, at nontoxic doses, against certain strains or bacterial species. This is a natural resistance. When normally effective antibiotics are not or poorly effective against a bacterium, this bacterium has developed acquired resistance. "Microbial infection" in the sense of the present invention refers to an infection caused by one or more microbial strains and includes phases ranging from colonization of the host to pathological phases. The term "microbial infection" therefore encompasses any deleterious effect, clinical sign, symptom or any disease occurring in humans or animals as a result of colonization by the microbe. By "terpenoid" is meant according to the invention any compound comprising a skeleton close to a terpene. A "terpene" refers to a derivative of isoprene that is obtained biologically by the condensation of C5 units, leading for example to monoterpenes, sesquiterpenes. By "near" is meant that the backbone is similar to a terpene or different in that at least one alkyl substituent, normally present, may be absent or carried by another atom. The backbone can be further substituted by various radicals such as aliphatic radicals, saturated or unsaturated, linear or cyclic (alkyl, alkenyl, alkylene), oxy, aldehydes, esters, alcohols, ethers and their sulfur equivalents. or nitrogenous. The terpenoid can advantageously be of natural origin. By "phenylpropanoide" is meant according to the invention any compound comprising a backbone close to a phenylpropane. "Phenylpropane" refers to a derivative obtained by biological synthesis from phenylpropane and resulting in C 6 (aromatic) -C 3 (aliphatic) or C 6 (aromatic) -C 1 (aliphatic) derivatives and corresponding lactones. By "near" is meant that the backbone is similar to phenylpropane, in particular the phenyl moiety, or different in that at least one alkyl substituent, normally present, may be absent or carried by another atom. The backbone can be further substituted by various radicals such as aliphatic radicals, saturated or unsaturated, linear or cyclic (alkyl, alkenyl, alkylene), oxy, aldehydes, esters, alcohols, ethers and their sulfur equivalents. or nitrogenous. The phenylpropanoid can advantageously be of natural origin. The term "prophylaxis" or "prevent an infection" as used in this application refers to any degree of delay in the onset of clinical signs or symptoms of infection, as well as any degree of inhibition of severity of clinical signs or symptoms of infection, including but not limited to, total prevention of said infection. This requires that the antimicrobial and the compound according to the invention are co-administered to the human or animal capable of being colonized with a microbial strain as a preventive measure, for example following an act of surgery, implantation of a medical device, an intrusive medical act. Such prophylactic administration may take place before, during or after the act likely to cause an infection (particularly a nosocomial infection) in order to prevent, improve, and / or reduce the severity of any subsequent infection. The term "treatment" as used herein means that the antimicrobial and the compound of the invention are co-administered to a subject (human or animal) at the time of colonization or after contamination or suspicion of contamination. by a microbial strain likely to cause an infection such as a nosocomial infection. The term "treatment" or "treating an infection" therefore includes: any curative effect (inhibition of growth or destruction of the microbe) obtained by virtue of the antimicrobial co-administration + compound according to the invention as well as the improvement of the clinical signs or observed symptoms as well as improving the condition of the subject. slowing down, interrupting, as well as stopping the progression of the infection. The antimicrobial-compound co-administration according to the invention can indeed also make it possible to slow down the progression of a microbe and / or completely or partially prevent a microbial infection from spreading to the surrounding tissues and beyond. - Inhibition, attenuation or prevention of adverse consequences of infection such as cellular or physiological damage caused by toxins produced by certain microbes in infected or surrounding tissues.
    [0014] The term "co-administered" means that the antimicrobial (or the antimicrobial mixture) and the compound according to the invention (or the mixture of compounds according to the invention) are administered in combined or juxtaposed form to the subject (human or animal) ). The combination includes any combination drug, any pharmaceutical composition, any pharmaceutical kit, and any drug comprising (i) at least one antimicrobial and (ii) at least one compound of the invention. Compounds (i) and (ii) may be present as a mixture or in the form of separate formulations or compositions in said combination. The combination may also comprise several antimicrobials, for example 2, 3 or 4 or more antimicrobials, and / or more compounds according to the invention, in particular 2 or 3 or more compounds according to the invention. These constituents form a functional unit because of a common indication, which is the implementation of an antimicrobial treatment. This combination therapy is more specifically intended for the prophylaxis and / or treatment of microbial infections and diseases, in particular nosocomial infections.
    [0015] The co-administration may be simultaneous or spread over time. The term "simultaneous" means that the antimicrobial (or the antimicrobial mixture) and the compound according to the invention (or the mixture of compounds according to the invention) are administered at the same time, at the same time, to a subject (male or female). animal). These compounds can be administered in the form of a mixture or, simultaneously but separately, in the form of separate compositions. The term "sequential administration" means that the antimicrobial (or the antimicrobial mixture) and the compound according to the invention (or the mixture of compounds according to the invention) are administered not simultaneously but separately over time, one after another.
    [0016] The term "potentiate" an antimicrobial means that the use of a compound according to the invention makes it possible to obtain a prophylactic or therapeutic effect superior to the prophylactic or therapeutic effect obtained by using the one or more antimicrobials alone. This can be expressed in different, alternative or cumulative ways: increasing the effect of the antimicrobial, lowering the antimicrobial antimicrobial dose, reducing the MIC. In addition, the potentiation makes it possible to reduce or annihilate the appearance of resistance.
    [0017] The expression to increase the effect of an antimicrobial means: the broadening of the microbial spectrum of the activity of the antimicrobial, the increase in the speed of action of the antimicrobial, the improvement of the clinical success ( cure rate) or the rate of clinical success (time to cure) of the antimicrobial, at a constant dose of antimicrobial.
    [0018] The term "decrease the amount of antimicrobial used" means that the use of the compound according to the invention makes it possible to use an amount of antimicrobial less than the quantity of antimicrobial normally required to obtain a given therapeutic or prophylactic effect. when the antimicrobial is administered alone. The decrease in the amount of antimicrobial used may be more or less important; It is preferably at least 10%, and more preferably at least 20%, still more preferably at least 40% or even 50% or more of the amount normally required to achieve a therapeutic effect or given prophylactic. "MIC" means "minimal inhibitory concentration", which is the lowest concentration of substance at which microbial growth is no longer observed after 18 to 24 hours of contact under conditions conducive to microbial growth. The determination of the MIC is carried out routinely by the "CLSI" method. For the purposes of the present invention, the term "halogen atom" means the fluorine, chlorine, bromine and iodine atoms. For the purposes of the present invention, the term "heteroatom" means N, O or S, advantageously O. By "(C 1 -C 6) alkyl" group, is meant, for the purposes of the present invention, a monovalent hydrocarbon-based chain. saturated, linear or branched, having 1 to 6, preferably 1 to 4, carbon atoms. By way of example, mention may be made of methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, tert-butyl, pentyl or hexyl groups. By "(C2-C6) alkenyl" group is meant, in the sense of the present invention, a monovalent hydrocarbon chain, linear or branched, having at least one double bond and having 2 to 6 carbon atoms. By way of example, mention may be made of ethenyl or allyl groups. For the purposes of the present invention, the term "(C 1 -C 6) haloalkyl" means a (C 1 -C 6) alkyl group, as defined above, for which one or more hydrogen atoms have been replaced by a halogen atom as defined above. It may be in particular a CF3 group. By "(C 1 -C 6) alkoxy" group is meant, within the meaning of the present invention, a (C 1 -C 6) alkyl group as defined above, linked to the remainder of the molecule via an atom oxygen. By way of example, mention may be made of methoxy, ethoxy, propoxy, isopropoxy, butoxy or even tert-butoxy groups. By "(C2-C6) alkenoxy" group is meant, within the meaning of the present invention, a (C2-C6) alkenyl group, as defined above, linked to the rest of the molecule via a oxygen atom. By way of example, mention may be made of the group -OCH 2 CH = CH 2.
    [0019] For the purposes of the present invention, the term "(C 1 -C 6) alkylene" or "(C 1 -C 6) alkanediyl" is intended to mean a divalent linear or branched hydrocarbon-based chain containing 1 to 6 carbon atoms, for example For example, a methylene, ethylene, propylene, butylene, pentylene or hexylene group. For the purposes of the present invention, the term "(C2-C6) alkenylene" or "(C2-C6) alkenediyl" is intended to mean a divalent, linear or branched hydrocarbon-based chain comprising 2 to 6 carbon atoms and at least a double bond, such as, for example, a vinylene (ethenylene) or propenylene group. DESCRIPTION OF THE INVENTION The subject of the invention is an antimicrobial agent potentiated by a compound of formula I for use in the treatment of microbial infection. It thus relates to a combination of an antimicrobial agent and a compound corresponding to the following formula I: R 1, R 2, R 3 (I) 3025720 14 in which R 1, R 2 and R 3 each independently represent one of the other, H, OH (C 1 -C 6) alkyl, (C 2 -C 6) alkenyl, (C 1 -C 6) haloalkyl, (C 1 -C 6) alkoxy, (C 2 -C 6) alkenoxy, (C 1 -C 6) haloalkoxy, -O-00- (C1-C6) alkyl; A represents a heteroatom or an R- (Het) -R 'or - (Het) -R group where R, R', each independently of one another represents a (C 1 -C 4) alkanediyl group optionally substituted by C1-C4 alkyl radicals and Het represents a heteroatom in a mass ratio, compound of formula (I): antimicrobial agent, varying from 8: 1 to 1:10, and in that the antimicrobial agent is not a terpenoid or a phenylpropanoide. The antimicrobial agent is advantageously an active ingredient of Western conventional medicine, as will be described later. In particular, the antimicrobial agent is not a terpenoid or phenylpropanoid, such as an essential oil extract or an essential oil component. The compound mass ratio of formula (I): antimicrobial agent more preferably from 4: 1 to 1:10, more preferably from 1: 1 to 1:10, still more preferably from 1: 1 to 1: 5. This means that the dose administered to the compound of formula (I) is of the same order of magnitude as that of the antimicrobial agent. The mass ratio corresponds to the ratio of doses in mg / kg of the compound and the antimicrobial agent to be administered to humans or animals. Surprisingly, it has been found that the effect of potentiation decreases when the dose of the compound according to the invention (or mixture of compounds according to the invention) increases. This potentiating effect can reappear at the MIC of the compound alone, but this is not the subject of the invention. In the context of the present invention, in vitro, the concentration of inactive compound, at which a potentiating effect is observed, is far removed from the threshold of antimicrobial properties (MIC), when antimicrobial properties are observed. Far away, it is meant that the concentration in vitro is at least 10-fold, advantageously at least 20-fold, more preferably at least 50-fold, still more preferably at least 100-fold less than the MIC.
    [0020] In particular, on a strain A, the concentration of compound (I) advantageously corresponds to the following equation: [C] <[CMI] / x Where [C] is the concentration according to the invention of compound (I) to be used on strain A [MIC] is the MIC measured for compound (I), alone, on this strain A x is greater than or equal to 100, advantageously 1000, more preferably x is between 2000 and 10 In vitro, the doses of compound (I) are less than 100 mg / l, advantageously less than 64 mg / l, more preferably between 0.01 and 25 mg / l, and even more so. advantageously between 1 and 16 mg / l. In the compositions administered, the concentration, per unit dose per kilogram, of compound of formula (I) is advantageously less than 100 mg, more advantageously less than 64 mg.
    [0021] The compounds (I) can be used at a low concentration (in vitro at concentrations of the order of μg / ml) to potentiate antimicrobials, which is entirely compatible with future use in humans or humans. animal (especially if systemic administration is sought). This makes it possible to envisage dosages in humans or animals below 64 mg / kg, advantageously between 0.01 and 64 mg / kg, more advantageously between 0.5 and 40 mg / kg, and even more advantageously between 5 and 30 mg / kg. The potentiating compound according to the invention is advantageously administered at a concentration such that its maximum serum concentration is less than 250 mg / l, advantageously less than 150 mg / l, more advantageously between 10 and 150 mg / l after administration. Of course, at these concentrations, the compound can be administered to humans and animals, including systemically, and does not present major adverse effects, in particular carcinogenicity or genotoxicity.
    [0022] The compound mass ratio according to the invention (or mixture of compounds according to the invention): antimicrobial depends in each case on the antimicrobial used and it will be adapted case by case.
    [0023] For example, for amoxicillin in cases where it is usually administered at a dose of 1000 mg per dose, the dose of the compound of formula (I) may vary between 300 and 850 mg per dose, or less. On the other hand, for colistin which is usually administered at a dose of 1 MUI by the pulmonary route, the dose of compound of formula 5 (I) may vary between 0.1 and 0.8 MUI, or even less. In another form, the subject of the invention is a method for potentiating the antimicrobial activity of an antimicrobial independently of the resistance mechanism comprising the steps of: a) selecting a compound of formula (I) which is therapeutically inactive (at 10 intended anti-infectious) only at the dose envisaged, b) Prepare a composition comprising the compound chosen in step a) with the antimicrobial The invention also relates to a method for treating and / or preventing a microbial infection in a subject, comprising co-administration in the subject suffering from said microbial infection of an antimicrobial and a compound of formula (I). The compound and the antimicrobial are suitable for simultaneous, separate or spread administration over time to humans or animals. The antimicrobial is preferably an antibiotic. It can also be an antifungal.
    [0024] Surprisingly, it has been found that the compounds of formula (I), used at this low concentration, are capable of potentiating the activity of antimicrobials. Thus, the use of these potentiators advantageously makes it possible to use said antimicrobial at a lower concentration and / or, at usual concentration, while having a higher activity than the antimicrobial alone at the same dose (increase in the effect or kinetics of the effect). Concretely, the invention makes it possible in particular: A / decrease the constant-effect doses: decrease the necessary amount of an antimicrobial to inhibit / destroy the usually sensitive microbes B / increase the effect at a constant dose: increase in the capacity of d an antimicrobial to inhibit / destroy susceptible organisms (improving the kinetics of the effect, the intensity of the effect, and broadening the spectrum of activity of an antimicrobial to germs that were inconsistently sensitive or resistant antimicrobial).
    [0025] Reducing the administered dose (A /) of an antimicrobial is of interest not only from the point of view of the treatment of microbial infections in humans or animals, in particular the reduction of side effects, but also, and this is not the case. is not negligible, from an environmental point of view (decrease in the appearance of 5 resistance to antimicrobials). The use of known antimicrobials at lower doses may help in the fight against the emergence of new resistance mechanisms. In particular, the antimicrobial can be used at a reduced dose, in which the antimicrobial dose administered corresponds to 1/50 to 3/4 of the antimicrobial dose required in the absence of the co-administration of a 10-μl compound. invention for administration to a subject (man, animal) for treating microbial infections. The decrease in the dose of antimicrobial constant effect limits the toxicity of said antimicrobial. In application in the farm animal, this reduces latency before slaughter. Dose reduction also allows for the re-use of some antimicrobials, which to date can no longer be administered because they have significant side effects at their effective doses, and can again be effectively administered. in humans or animals with few side effects. Increasing the effect of a constant dose antimicrobial (B /) is of quantitative clinical interest in improving the kinetics of an antimicrobial and qualitative effect by making it possible to treat a patient (human or animal) suffering from microbial infection with an antimicrobial for which the strain was sensitive or inconsistently sensitive in the absence of potentiation. Increasing the rate of effect of the antimicrobial reduces the time spent in the "infective" state by the patient or animal, thereby reducing the epidemiology of the disease as well as the appearance and the diffusion of the resistances. Thanks to the presence of the compounds according to the invention, it is possible to increase the bactericidal rate of antimicrobial antimicrobial constant dose. Thus, the rate of action of a potentiated antimicrobial can be increased. This is especially true for concentration-dependent antimicrobials.
    [0026] Thanks to the presence of the compounds according to the invention, the spectrum of the antimicrobial can be broadened, in particular at a constant dose of antimicrobial agent. Thus, an antimicrobial potentiated by the compounds according to the invention can be used on strains on which it is no longer sensitive in the absence of potentiation (in particular because of the appearance of resistances). In one embodiment, the compound of formula (I) is sufficient to potentiate the antimicrobial, with the result that the use of a single compound of formula (I) is sufficient to potentiate the antimicrobial. However, in some cases, a combined use of inactive compounds may be considered. This is especially true when broad spectrum activity is sought. In particular, to potentiate an antibiotic on Gram + and Gram - bacteria, it may be useful to co-administer a particularly potentiating compound according to the invention on Gram + bacteria and a compound according to the invention that is particularly potentiating. on Gram - bacteria. In the formula (I), R 2 and R 3 each represent H, R 1 represents a (C 1 -C 6) alkyl group, and A represents the heteroatom O or a group ROR 'or -O-R', where R, R ', represent each , independently of one another, a (C 1 -C 2) alkanediyl group, optionally substituted by C 1 -C 4 alkyl radicals. Advantageously, the compound of formula (I) is cineole. In the context of the present invention, the microbial infection is advantageously an infection induced by a pathogen selected from the following potentially pathogenic genera: Acetobacter, Acetobacterium, Acinetobacter, Citrobacter, Enterobacter, Enterococcus, Escherichia, Helicobacter, Klebsiella, Proteus, Providencia , Pseudomonas, Salmonella, Serratia, Staphylococcus, Streptococcus, Actinobacillus, Neisseria, Mannheima, Pasteurella, Candida, Aspergillus, Cryptococcus, Trichosporon, Malassezia, and Mycobacterium. The strain or bacterial species is advantageously chosen from the group consisting of: Acetobacter, Acetobacterium, Acinetobacter, Actinobacillus, Citrobacter, Enterobacter, Enterococcus, Escherichia, Helicobacter, Klebsiella, Mannheima, Pasteurella, Proteus, Providencia, Pseudomonas, Salmonella, Serratia, Staphylococcus, And Streptococcus. More particularly, the strain or bacterial species is advantageously chosen from the group consisting of Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella 3025720 pneumoniae, Proteus mirabilis, Providencia stuartii, Salmonella sp, Serratia marcescens, Acinetobacter baumannii , Burkholderia cepacia, Pseudomonas aeruginosa, Staphylococcaceae, Staphylococcus aureus, Enterococcus faecium, and Enterococcus sp. Thus, the bacterium can indifferently be a gram bacterium or a gram + bacterium. The bacterium is more preferably selected from the group consisting of Pseudomonas aeruginosa, Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae and Staphylococcus aureus. The fungus is advantageously selected from the group consisting of: Candida, Aspergillus, Cryptococcus, Trichosporus. The fungus is more advantageously candida albicans. The mycobacterium is advantageously Mycobacterium tuberculosis The antimicrobial agent may be an antibiotic and / or an antifungal agent.
    [0027] In a preferred variant, the compound of formula (I) and the antimicrobial do not belong to the same family of chemical compounds. Thus, the compound of formula (I) being derived from a terpenoid, the antimicrobial is not a terpenoid, or even is not an essential oil extract or a phenylpropanoid. The antibiotics which can be used in the present invention are advantageously chosen from: 1. Membrane-active antibiotics, in particular beta-lactams, penicillins, cephalosporins, glycopeptides, fosfomycin, polymixins, bacitracin, cycloserine; 2. Antibiotics inhibiting the synthesis of proteins, in particular aminoglycosides, tetracyclines, fusidic acid, chloramphenicol and its derivatives, macrolides, lincosamides, streptogramins, synergistines and oxazolidinones; 3. Antibiotics inhibiting the synthesis of nucleic acids, in particular quinolones, nitrofurans, ansamycins and fucidic acid; 4. Antibiotics inhibiting folate synthesis, particularly sulfonamides and sulfonamide combinations; 5. Antibiotics inhibiting the synthesis of mycolic acids, in particular isoniazid, prothionamide, ethionamide, pyrazynamide 6. Any of their pharmaceutically acceptable salts, and 7. Any combination thereof. Preferably, the antibiotic is selected from: antibiotics inhibiting peptidoglycan synthesis, antibiotics inhibiting nucleic acid synthesis, antibiotics inhibiting folate synthesis, antibiotics inhibiting mycolic acid synthesis, any of their pharmaceutically acceptable salt, and any combination thereof. The particularly advantageous class of antibiotic is that of antibiotics inhibiting the synthesis of peptidoglycan. In particular, the antibiotic is selected from: amoxicillin, amoxicillin / clavulanic acid, imipenem, vancomycin, erythromycin, azithromycin, gentamicin, amikacin, colistin, clindamycin, ciprofloxacin, tigecycline. In one variant of the invention, the microbial infection is a bacterial infection induced by a bacterial strain, of the cocci type or gram-positive bacilli, and the antimicrobial is amoxicillin.
    [0028] In one variant of the invention, the amoxicillin is dosed at 1000 mg / dose and the cineole is dosed at 1000 mg / dose, advantageously 500 mg / dose and more advantageously at 250 mg / dose. In another variant of the invention, the microbial infection is a bacterial infection induced by a methicillin-resistant E. coli or S. aureus strain and the antimicrobial is an amoxicillin / clavulanic acid mixture. In another variant of the invention, the ratio of amoxicillin / clavulanic acid: cineole is 10: 1, 1: 1 or even 1: 5. In another variant of the invention, the microbial infection is a bacterial infection induced by a enterobacterium, Pseudomonas or S. aureus strain and the antimicrobial is ciprofloxacin.
    [0029] The antifungals which may be used in the present invention are advantageously chosen from: Antifungals acting on the membrane, in particular polyenes, azoles, allylamines and thiocarbamates, echinocandins 2. Antifungal agents acting on the synthesis of nucleic acids, in particular griseofulvin, fluorocytosine 3. Antifungal agents acting on microtubules, in particular griseofulvin The antifungal is advantageously chosen from polyenes, azoles, allylamines, thiocarbamates, echinocandins and griseofulvin, and fluorocytosine. In another variant of the invention, the microbial infection is a vaginal yeast infection and the antibiotic is sertaconozole.
    [0030] The compounds according to the invention are advantageously administered systemically. They are thus adapted for systemic administration. The compounds according to the invention can be used in any pharmaceutical composition formulated to facilitate its administration. The pharmaceutical composition may include any pharmaceutically acceptable excipients commonly used such as vehicle (s) or diluent (s). The pharmaceutical composition can be administered orally, enterally, parenterally (intravenously, intramuscularly or subcutaneously, intraperitoneally), transcutaneously (or transdermally or percutaneously), cutaneous, mucosal, (especially transmucosa-oral, nasal, ophthalmic, otological , vaginal, rectal), intragastric, intracardiac, intraperitoneal, intrapulmonary or intratracheal. The pharmaceutical composition may be in dry form, dry form to be reconstituted at the time of use (powder, lyophilizate, etc.), solid (especially cachet, powder, capsule, pill, granule, suppository, tablet, and more specifically accelerated release tablet, enteric-coated tablet or sustained-release tablet), paste (in particular gel, ointment, cream or ovum), liquid (in particular syrup, solution for injection, infusible or drinkable or eye drops), in the form of an aerosol (spray, vapor or gas), in the form of a patch, in injectable form (in an aqueous, non-aqueous or isotonic solution). Furthermore, the pharmaceutical composition can be packaged for administration in the form of a single dose (single dose) or multiple dose (multidose). The antimicrobial (s) and the compound (s) according to the invention may be administered in the same pharmaceutical composition or in separate pharmaceutical compositions, simultaneously, sequentially or spread over time. In case of separate administration, the forms of the pharmaceutical compositions may be similar or distinct; the routes of administration may be identical or different. The administration scheme will be adapted by the practitioner according to the case. The routes of administration and dosages vary depending on a variety of parameters, for example depending on the condition of the patient, the type of infection and the severity of the infection to be treated or the antimicrobial. used. The animal is preferably a mammal, especially humans, pets, livestock. The following examples illustrate the invention.
    [0031] Description of test protocols / test strains. bacterial strains The strains tested are isolated from various human samples (blood, urine, pulmonary aspirations, etc.). The strains studied in the following examples are chosen from the strains of the following table: Enterobacteriaceae, n = 11 Escherichia coli Phenotypic characterization: ESBL, wild, penicillinase, resistance to fluoroquinolones, resistance to nalixidic acid. Other gram bacilli, n = 10 Pseudomonas aeruginosa Genotypic characterization: ESBL, cephalosporinase, penicillinase, absence of porin, multiresistance, wild 3025720 23 Staphylococcaceae, n = 10 Staphylococcus Phenotypic characterization: resistance to methicillin, fluoroquinolone, kanamicin, tobramicin, multiresistance, wild Streptococcus and app, n = 2 Enterococcus sp Phenotypic characterization: resistance to erythromycin, clindamycin, pristinamicin, wild Table 2 The yeast strains tested (n = 33) belong to the species Candida albicans, Candida tropicalis, Candida krusei, Candida parapsilosis, Candida glabrata.
    [0032] EXAMPLE 1 Measurement of Minimum Inhibitory Concentrations The minimum inhibitory concentration measurement tests are carried out in solid agar medium according to the international standards in force (CLSI standards). An adaptation relating to the hydrophobicity of the compounds and compositions is however necessary to disperse them in the medium. The compounds and compositions incorporated in the agar may be first diluted in one or more solvents (Tween® 80 diluted in water -3.4 ml of Tween for 9.6 ml of water-, tween® 80 diluted in propylene 10 - 3.4 ml of Tween for 9.6 ml of propylene-, or DMSO diluted in water). The strains are deposited on the surface of the agar with a steers apparatus. Different methods of dissolving the products are tested in parallel to circumvent the problems of water / solvent distribution coefficient of the molecules (antimicrobial and potentiator) while the bacteria grow in the single aqueous phase. The technical constraint will not intervene in the in vivo tests. The same dilution methods can be implemented in a liquid medium (microplates and tubes).
    [0033] The same methodology is implemented with fungi. The MICs 50 and MIC 90 respectively represent the concentrations that inhibit 50% and 90% of the strains of the same genus. The contribution of the booster compared to the MIC of the antibiotic alone is expressed as a ratio (MIC ATB) / (MIC ATB + booster). Aerobic vs anaerobic test in DMSO and Tween® 80 The potentiation effect of Augmentin® with cineole on different strains was tested under aerobic / anaerobic conditions. The Augmentin® / cineole mass ratio is 64 percent (1: 1.5). MICs are measured on different strains. Then, on the strains belonging to the same genus, the MIC gain is calculated. The gain in MIC expresses the following ratio: MIC (50 or 90) with potentiator / MIC (50 or 90) without potentiator. The results are reported in the following table: anaerobic aerobic Tween® 80 DMSO Tween® 80 DMSO E. Coli Gain MIC 50 0.75 1.00 0.67 0.67 Gain MIC 90 1.00 0.77 0.37 0 , 37 Stapyilloccoccus Gain MIC 50 0.50 0.50 0.50 0.50 Gain MIC 90 1.00 1.00 0.55 0.60 Table 3 This test shows that cineole allows to potentiate the effect of Augmentin® on 10 large series of strains. The potentiating effect is expressed under aerobic or anaerobic conditions and can be influenced by the solvent used for the dispersion of the products. 2 / Test with direct dilution in water, aerobic The same measurements and calculations are carried out in water, with Augmentin® or amoxicillin alone. The weight ratio: Augmentin® / cineole is 64% (1 for 1.5) Augmentin® / cineole is 32% (1 for 0.75) amoxicillin / cineole is 64% (1 for 1.5) The results are shown in the following table: Augmentin® / cineole Augmentin® / cineole amoxicillin 1: 1.5 1: 0.75 / cineole 1: 1.5 E. Coli Gain MIC 50 1.33 1.33 1.00 Staphyllococcus Gain MIC 130 0.50 0.75 0.83 Gain CMI 170 0.55 0.50 1.00 Table 4 3025720 This test shows that the cineole tested in vitro in another solvent shows slightly different potentiating effects. Here the synergy is no longer apparent on E. coli with a direct dilution in water while it is clearly visible in another solvent (Ex1 -1). Thus a neutral result in one solvent does not predict a neutral result in another solvent. This test also shows that the effect is ratio-dependent. 3 / Amoxicillin and Augmentin® tests in Tween®80 / water vs DMSO The mass ratios are: amoxicillin (AMX) / cineole 64/600 m / m (1 for 8) 10 amoxicillin / cineole 64/100 m / m (1 for 1.5) amoxicillin / cineole 64/10 m / m (1 for 0.15) The results are reported in the following table: AMX / AMX / AMX / AMX / AMX / Cineole 1: 0.15 Tween AMX / Cineole 1 : 0.15 DMSO Cineole Cineole Cineole Cineole Water 1: 8 1: 1.5 1: 1.5 Tween DMSO Tween DMSO Water Water E. Coli Gain MIC 2.00 1.33 2.00 1.33 2.00 2.00 Staphilloccoccus Gain MIC 50 0.75 1.33 0.38 1.33 1.00 1.50 Gain MIC 90 0.50 1.00 1.00 1.00 0.50 1.00 Table Here again, potentiations seem to disappear according to the bacterial type and the solvent. The tween associated with water allows a clear enhancement of the potentiation of amoxicillin by cineole. The mass ratios are: Augmentin® (Aug) / Cineole 64/600 m / m (1 for 8) Augmentin® / Cineole 64/100 m / m (1 for 1.5) 20 Augmentin® / Cineole 64/10 m / m m (1 for 0.15) The results are reported in the following table: 3025720 26 Aug / Cineole 1: 8 Aug / Cineole 1: 1.5 Aug / Cineole 1: 0.15 Tween Water DMSO Tween Water DMSO Tween Water DMSO Coli Gain CMI 50 1.00 2.00 0.75 2.00 1.00 2.00 Gain CMI 90 0.77 2.00 1.00 1.00 0.77 1.30 Staph. Gain MIC 50 1.00 1.00 0.50 0.50 1.00 1.00 Gain MIC 90 1.00 1.00 1.00 1.00 1.00 2.00 Table 6 Dilution of Augmentin ® in water and tween allows demonstration of the effect of potentiation at low doses (up to 0.025 mg / l cineole) since the MIC of Augmentin® alone on these strains can be 0.25 mg / l on some 5 staphylococci .. 4 / CIP tests (ciprofloxacin) in Tween®80 / water, vs DMSO The mass ratios are: - ciprofloxacin / cineole 64/600 m / m (1 in 8) - ciprofloxacin / cineole 64 / 100 m / m (1 for 1.5) 10 - ciprofloxacin / cineole 64/10 m / m (1 for 0.15) The results are reported in the following table: CIP / Cineole 1: 8 CIP / Cineole 1: 1.5 CIP / Cineole 1: 0.015 Tween Water DMSO Tween Water DMSO Tween Water DMSO Pyo. Gain MIC 90 0.91 0.55 1.82 0.50 1.00 0.50 Coli Gain MIC 90 0.53 0.30 0.53 0.27 0.60 0.27 Staph. Gain MIC 90 1.00 0.19 1.16 1.43 1.16 1.43 Table 7 The test shows that cineole also potentiates ciprofloxacin at low doses of cineole (synergies are observed at doses of 0.125 mg of cineole). The solvent and the ratio both have an influence on the result. 5 / TE tests in water, tween, TE, T / P The mass ratios are: T99C1: tetracycline / cineole 64/100 m / m (1 for 1.5) The results are reported in the following table: ## EQU1 ## T99C1 Tween T99C1 T99C1 T99C1 Water Tween Propylene Glycol DMSO Water Pyo Gain CMI 50 0.50 2.00 0.67 1.50 Gain CMI 90 1.00 1.00 0.50 1.00 Coli Gain MIC 50 1.00 2 , 00 1.00 1.00 Gain CMI 90 0.50 1.20 1.00 1.00 Staph Gain CMI 50 1.00 1.00 1.00 1.00 Gain CMI 90 0.91 1.00 0, 91 1.00 Table 8 The test demonstrates the ability of cineole to potentiate tetracycline, especially in DMSO and the Tween-water mixture. 6 / GEN tests (gentamycin) in WATER / Tween®80 + water / Tween®80 + Propylene glycol 5 The mass ratios are: - GEN95C5: gentamycin / cineole 64/600 m / m (1 for 8) - GEN99C1: gentamycin / The results are reported in the following table: water Tween Tween dilution prop glycol GEN95C5 GEN99C1 GEN95C5 GEN99C1 GEN95C5 GEN99C1 Pyo Gain CMI 50 1.00 1.00 1.00 1, 00 2.00 2.00 Gain CMI 90 1.00 1.11 1.00 0.90 3.98 1.00 Coli Gain CMI 50 1.00 2.00 1.00 1.00 2.00 0.50 Gain CMI 90 1.00 1.00 1.00 0.55 2.00 0.50 Staph Gain CMI 50 1.00 2.00 1.00 1.00 1.00 0.50 Gain CMI 90 1.00 1 The test demonstrates the ability of cineole to potentiate gentamycin, especially in the tween + propylene mixture. 7 / Sertaconazole in DMSO The effect of potentiation of cineole on yeasts (candida albicans is also tested The sertaconazole / cineole mass ratio is 64/100 The results are reported in the following table: 3025720 28 Sertaconazole + cineole 1: 1.5 - DMSO Gain MIC 90 0.5 Gain MIC 0.25 Table 10 This test demonstrates that cineole is able to potentiate sertaconazole Example 2: double dilution test The double dilution test is a test Measurement of MIC carried out on successive dilutions of the 2 products of the composition Thus 12 dilutions of the booster (cineole) are tested with 12 dilutions of the antibiotic (Amoxicillin) The summary table expresses for each strain and for each dilution of the boost the measured MIC of Antibiotic in CMI of cineole (in mg / L) 50000 25000 c, cz 2500 c, 0 0 0 .4) r --- 'kn 0 x cz cz., n 0 0 .4 ## EQU1 ## wherein: ## EQU1 ## ) 5 2.5 1 0.5 0.2 5 0.1 0.0 6 0.0 3 0.0 0.00 0.003 75 0.0 0.0 0 Cineole alone Z = 25 15 75 02 01 i, 111 ATCC 25922 II. I) 8 16 8 8 8 8 8 8 8 0.5 8> 2, 6 5 rrn, -, oc 0.2 5 4 8 8 8 8 8 8 8 8 8 0.5 8> 2, 5, - -, 0.2 5 4 4 8 8 8 8 8 8 8 8 8 0.5 8> 2,, -, 5 oc, r) 0.2 5 8 8 8 8 8 8 8 8 8 8 0.5 8> 2, 00 5 3025720 29 -, 4 8 8 8 16 8 8 8 8 8 8 8 0.5 8> 2, 5 oc Staphylococcus 0.2 16 4 8 8 8 8 8 8 8 8 8 0.5 8> 2.5 oc Table 11 The color code used to interpret the results is as follows: no color if the MIC is equivalent with and without booster, gray if the value is lower with booster. It is found that cineole is able to potentiate (additive phenomena) amoxycillin at very high concentrations (MIC 50 000mg / L). When the concentration of cineole decreases, there is no more potentiation phenomena. Surprisingly, this potentiation reappears when the cineole dose is very low. Assays were also performed with augmentin® (amoxycillin / clavulanic acid) where the same results are observed. An isobologram establishing the curve of the amoxicillin MIC observed as a function of the concentration (dilution) of cineole (strain: SA8238) is shown in FIG. 1. Synergy is observed at high and low cineole doses, with a discontinuous unexpected. Example 3: The corresponding tests are carried out on the basis of the usual MIC test: the etest® (Biomérieux) strip is deposited on the surface of a seeded agar in which the booster has been incorporated. This test makes it possible to minimize the risks of solvent effect, namely a possible interaction with the solvent used in vitro. The MIC of the antibiotic alone or in combination with the cineole at three different concentrations (lmg / L, 4mg / L, 16mg / L) in different solvents (Tween®80 or DMSO) is measured. Colony 8150 Coli 8138 MRSA 10178 (penicillinase) MIC in mg / L (.7 = Pipera tazo Meropenen Cefoxitin Pipera tazo Cefoxitin = "t; a)" t; 0>, a) =>, e E-, 5 .e 0. e H witness 0.125 0.75 0.047 3 6 6 0.125 0.094 1 witness Tween water 0.125 1 0.094 6 6 6 0.125 0.19 0.5 DMSO control 0.19 1.5 0.094 8 16 6 0.25 0.064 1.5 Cineole lmg Tween / water 0.125 1.5 0.064 3, 4 0.125 0.064 0.5 Cineole lmg DMSO 0.19 1 0.064 8 6 4 0.19 0.094 0.-5 Cineole 4mg Tween / water 0.094 0.-5 (or 3 6 3 0.094 0.064 0.38 Cineole 4mg DMSO 0.125 I 0.064 3 8 4 0.19 0.064 0.5 Cineole 16mg 0.1 0.1 0.1 1 2 1 0.094 0.047 0.125 Tween / water Cineole 16mg DMSO 0.0 (4 0.-5 6.064 3 6 4 0.125 0.047 0.19 Table 12 Other e-tests are also carried out in DMSO with amoxycillin in the presence or absence of cineole The tests are reported in the following table: Control Cineole 16 mg / L Cineole 4 mg / L Amox Amox Amox ATCC25922 16 12 Liu 8141 8 0.1 8150 8 0.1 6 8156 12 Staphylococcus 8143 2 1.5 8146 0.5 0.19 0.38 8149 1 0 38 38 40 40 24 16 12 8241 32 12 10168 Table 13 Potentiation is observed on all strains Other e-tests are also performed with amoxycillin / clavulanic acid (Augmentin®) in the presence or absence of cineole (control: no cineole, CIN16: cineole 3025720 31 to 16mg / L, CIN4: cineole at 4mg / L) DMSO. The tests are reported in the following table: control CIN16 CIN4 ATCC25922 12 6 E.coli 8141 6 0.1 zJ zJ o zJ 8146 0.38 019 0.25 z4 o '' '8149 0.75 0.38 0.5 8238 1 0.75 0.38 8239 6 6 8240 4 8241 12 12 10168 0.75 0.5 0.38 Table 14 Other e-tests are also performed on Pasteurelles. The results are reported in the following tables: 14012 Amox Augmentin ciprofloxacin meropenem cefoxitin Witness ED 0.032 0.094 0.004 0.008 0.5 Witness DMSO 0.094 0.094 0.006 0.008 0.5 Witness TE 0.19 0.19 0.006 0.023 0.75 Cineole 5mg Water 0.094 0.094 0.003 0.006 0.5 Cineole 5mg DMSO 0.094 0.094 0.004 0.006 0.5 Cineole 5mg TE 0.094 0.094 0.004 0.008 0.5 Cineole 10 mg water 0.094 0.125 0.004 0.008 0.5 Cineole 10 mg 0.125 0.125 0.004 0.006 0.38 DMSO Cineole 10 mg TE 0.094 0.125 0.006 0.008 0.5 Table 15 14013 Amox Augmentin ciprofloxacin Control ED 0.19 0.19 0.012 Control DMSO 0.19 0.25 0.012 Control TE 0.25 0.25 0.016 Cineole 5mg Water 0.25 0 , 0.012 Cineole 5mg DMSO 0.25 0.19 0.012 Cineole 5mg TE 0.25 0.25 0.012 Cineole 10 mg water 0.19 0.19 0.016 Cineole 10 mg DMSO 0.25 0.19 0.012 Cineole 10 mg TE 0.125 0.19 0.012 Table 16 3025720 32 14014 Control ED Amox meropenem cefoxitin Control DMSO 0.125 0.016 0.38 TE control 0.094 0.012 0.5 Cineole 5mg water 0.19 0.016 0.5 Cineole 5mg DMSO 0.094 0.012 0.19 Cineole 5mg TE 0.094 0.016 0.38 Cineole 10 mg water 0.125 0.016 0.38 Cineole 10 mg DMSO 0.125 0.016 0.5 Cineole 10 mg TE 0.094 0.012 0.38 Control ED 0.094 0.012 0.38 Table 17 Example 4: growth test / bactericidal assay 5 1 Growth test on the strain 10168 The growth tests are made in a liquid medium with a dispersion of the antibiotic booster beforehand in a suitable solvent. The growth kinetics of the bacteria are measured in the presence of Augmentin®, Augmentin® boosted cineole or cineole.
    [0034] The results are shown in FIG. 2 (strain 10168, genus Staphylococcus), the caption of which is: Square: control (bacterium alone) Triangle: Augmentin® diluted in a Tween®80 / water mixture at a concentration of 4 times its MIC Cross (x): Augmentin® and cineole, diluted in Tween®80 / water mixture, Augmentin® is at a concentration of 4 times its MIC, Augmentin® / Cineole mass ratio of 64/100 Etoile (*) : cineole alone diluted in Tween®80 / water mixture. It is found that the presence of cineole at a very low dose makes it possible to accelerate the bactericidal rate of Augmentin®.
    [0035] 2 Post-antibiotic effect on strain 08150 (MIC of Augmentin = 4 mg / L) Count the number of bacteria after 16h of contact in the presence of augmentin® (AC) and / or cineole, then several hours after end of contact. Augmentin® is used at its MIC. The results are reported in the following table: contact time of augmentin® + cineole 16h time (h) control AC MIC AC CMI AC CMI Cineole 16mg / L Cineole 4mg / L Cineole 16mg / L Cineole 4mg / L 0 2,47E + 07 2,53E + 05 1,40E + 04 1,00E + 02 2,20E + 07 2,17E + 07 1 9,20E + 06 3,40E + 04 7,80E + 03 9,00E +03 3,88E + 07 4,92E + 07 2 7,10E + 07 1,60E + 05 5,10E + 04 3,00E + 03 6,40E + 07 5,50E + 07 3 2,07E + 08 1 , 84E + 06 7,60E + 05 3,60E + 04 2,70E + 08 3,90E + 08 4 3,10E + 08 9,90E + 06 6,40E + 06 3,40E + 05 4,20E + 08 3,50E + 08 5 6,60E + 08 3,70E + 07 3,55E + 07 2,37E + 06 5,50E + 08 5,90E + 08 6 4,10E + 08 2,10E + 08 2,00E +08 1.27E + 07 5.90E + 08 6.00E + 08 Table 18 It is found that the addition of cineole significantly reduces the number of bacteria, including after contacting.
    [0036] Post-antibiotic effect on strain 08152 (MIC of Augmentin = 0.5 mg / L) The number of bacteria is counted after 16 hours of contact in the presence of augmentin® (AC) and / or cineole, then several hours. after the end of contact. Augmentin® is used at a concentration of 4 times its MIC. The results are reported in the following table: Control time (h) AC 4x AC 4xCMI AC4xCMI Cineole 4mg / L Cineole 16mg / L Cineole 4mg / L CMI Cineole 16mg / L 0 1.24E + 07 5.50E + 02 2.90E +02 1,50E + 02 9,00E + 06 8,00E + 06 1 9,30E + 06 1,18E + 03 5,50E + 02 3,00E + 02 1,64E + 07 1,50E + 07 2 2 , 74E + 07 1,19E + 03 4,60E + 02 <10E01 5,50E + 06 1,78E + 07 3,60E + 07 3,50E + 03 3,40E + 02 3,90E + 02 7,50E +07 5,60E + 07 4 2,16E + 07 8,10E + 03 1,59E + 03 1,80E + 03 5,90E + 08 7,30E + 08 5 2,00E + 08 9,60E + 04 2 , 30E + 03 3,10E + 03 3,42E + 08 3,44E + 08 6 2,50E + 08 3,40E + 04 1,32E + 04 1,40E + 04 5,70E + 08 5,30E + 08 24 3,70E + 08 4,50E + 08 4,60E + 08 2,30E + 08 9,70E + 08 9,30E + 08 Table 19 10 It can be seen that the addition of cineole significantly reduces the number of bacteria , including after contacting.
    [0037] Example 5: 100 μl resistance of a Mueller Hinton broth culture of the strain to be studied (heavy inoculum> 101 ° CFU / ml) are spread on a Mueller Hinton dish containing an oil concentration equal to 4 times the MIC of the product to be tested. After 48 hours of incubation, the presence or absence of colonies likely to be resistant mutants is observed. It has been found that the use of cineole also makes it possible to reduce the appearance of resistant bacteria. The results are reported in the following tables: Control DMSO invaded invaded Ciprofloxacin DMSO Ciprofloxacin / cineole 1: 1.5 DMSO invaded 0 Table 20 - Strain 10168 / MRSA 10 While ciprofloxacin alone on methicillin-resistant S. aureus ( MRSA) leads to the appearance of innumerable mutants, the addition of cineole to ciprofloxacin no longer causes the appearance of mutants Control DMSO invaded invaded control Ciprofloxacin DMSO Ciprofloxacin / cineole 1: 1,5 DMSO Many 26 Table 21 - Strain 9003 / BLSE Again, cineole leads to a decrease in the appearance of mutants on a gram-negative 15 gram strain. Example 6: Model of sepsis 200 μl of a bacterial solution (IVIRSA) adjusted to 5 × 10 8 CFU / ml is injected intravenously (retro-orbital route) to CD1 mice. The treatment is started 1 hour after the bacterial injection subcutaneously. At 24 h, the mice are euthanized and a bacterial count is made in the kidney. Vivo 1 test: amoxicillin injection: clavulanic acid (CMA) at a variable dose (0.25 mg / kg, 2 mg / kg, 16 mg / kg and 128 mg / kg) + cineole (B) at a constant dose (30 mg / kg), 3025720 injected twice per 24 (H + 1 and H + 4). Controls: untreated group and group receiving 30 mg / kg cineole without antibiotic. Number of bacteria 1og10 CFU / g kidney The results are shown in FIG. 3. In vivo test 2 Injection of amoxicillin: clavulanic (CMA) at a constant dose (8 mg / kg) + 5 cineole (B) at a variable dose (4 mg / ml) kg, 64 mg / kg, 128 mg / kg, 256 mg / kg, 512 mg / kg) injected twice daily. Controls: untreated group receiving 32 mg / kg antibiotic-free cineole (CIN), group receiving 8 mg / kg antibiotic without cineole (AMC8). (*) p <0.05 vs control, AMC8 and CIN 10 (£) p <0.05 vs control and CIN ($) p <0.05 vs control, AMC8, CIN, AMC + CIN 128, AMC + CIN The results are shown in FIG. 4 and also in the following table: Treatment regimen Mean ± SD log10 CFU / g kidney Control 6.27 ± 0.27 AMC, 8 mg / kg 5.92 ± 0.36 CIN, 32 mg / kg 6.35 ± 0.29 AMC + CIN, 4 mg / kg 5.42 ± 0.32 * AMC + CIN, 64 mg / kg 5.61 ± 0.44 £ AMC + CIN, 128 mg / kg 5.90 ± 0.32 AMC + CIN, 256 mg / kg 6.06 ± 0.64 AMC + CIN, 512 mg / kg 4.87 ± 0.47 $ Table 22 There is again a low dose potentiation or at high dose, without potentiation in the meantime. This is in line with the in vitro results which surprisingly demonstrate that the synergy with cineole appears at low dose (and compatible with medical use) and at very high doses (incompatible with medical use). Between these dose extremes, and as was the case in vitro, there is surprisingly a range of concentrations in which the effect of potentiation is absent.
    [0038] EXAMPLE 7 Antibacterial Effectiveness of the Plasma Balb / c mice are injected (sc) with the antimicrobial product or the antimicrobial + booster mixture. The doses administered are as follows: Group 1: Gentamycin (GE) 6 mg / kg Group 2: Gentamycin 6 mg / kg + cineole 30 mg / kg Group 3: Amoxicillin (AMX) 30 mg / kg Group 4: Amoxicillin 30 mg / kg + 30 mg / kg cineole Augmentin® Group 5 (AMC) 30 mg / kg Group 6 Augmentin® 30 mg / kg + 30 mg / kg cineole.
    [0039] At different post-injection times, the mice are euthanized, and the blood removed, heparinized and centrifuged to extract the plasma. A series of serial dilutions (1/3) of the plasma is made and a drop of these different plasma concentrations is deposited on a Baird Parker seeded medium (MSSA 8238 for the GE and AMX groups, MRSA 10168 for the AMC group). Antibacterial effects are measured after incubation. Successive dilutions determine the antimicrobial effect and report it to the MIC. The ratio of effective concentration to MIC is thus determined. The results are reported in the following tables: c / MIC 0.083 hrh 2h 5h 8h 24h AUC 0-24h Time above the MIC Mean group 1 10 3 4 0.2 0, 2 0.15 19.2005 <5h Medium group 2 2 5.4 5.4 1.5 12.65 1.15 2 73.9679> 24h Medium group 3 25 3.5 2.45 0.1505 0.5005 0.3 27, 3235 <5h Average group 4 30 7 1.95 1.2 0.95 1.1 45.7895> 24h Table 23 20 3025720 37 0.25 h 0.5 1 h 2h 4h 8h 24 h AUC 0-24h Time h above the MIC Average group 5 5.5 1.75 2.15 1.75 0.3 0.3 0.01 9.56125 <4h Average group 6 6.5 2 1.65 3.15 2 1 The ratio of the plasma concentration to the MIC is obtained by successive dilution of the plasma. Although this method is semi-quantitative, it nevertheless makes it possible to show that the effect is more intense when the cineole is present (higher AUC). Similarly and unambiguously, the addition of cineole makes it possible to extend the time spent above the MIC. This result is in line with the curve of Figure 2, performed in vitro. List of Abbreviations: Amoxicillin amoxicillin Augainin Staphylococcus coli E. coli Pyo Pseudomonas aeruginosa 15 AUC area under the curve
    权利要求:
    Claims (11)
    [0001]
    REVENDICATIONS1. A combination of an antimicrobial agent and a compound of formula I for use in the treatment of a microbial infection, the compound has the following formula I: R1, R2, R3 (I) wherein R1, R2, R3 are each, independently of each other, H, OH (C 1 -C 6) alkyl, (C 2 -C 6) alkenyl, (C 1 -C 6) haloalkyl, (C 1 -C 6) alkoxy, (C 2 -C 6) alkenoxy, -C6) haloalkoxy, -O-CO (C1-C6) alkyl; A represents a heteroatom or a group - (Het) -R 'or R- (Het) -R' where R, R ', each independently of one another represents a (C 1 -C 4) alkanediyl group optionally substituted by C 1 -C 4 alkyl radicals and Het represents a heteroatom. in a mass ratio, compound of formula (I): antimicrobial agent, varying from 8: 1 to 1:10, and in that the antimicrobial agent is not a terpenoid or a phenylpropanoid.
    [0002]
    2. Association for its use according to claim 1, characterized in that in the formula (I) R2 and R3 each represent H, R1 represents a (C1-C6) alkyl group, and A represents the heteroatom O a group ROR ' or -OR 'wherein R, R', each independently of one another represents a (C 1 -C 2) alkanediyl group optionally substituted by C 1 -C 4 alkyl radicals.
    [0003]
    3. Association for use according to claim 1 or 2, characterized in that the compound of formula (I) is cineole.
    [0004]
    4. Association for its use according to one of the preceding claims, characterized in that said antimicrobial is an antibiotic, in particular an antibiotic selected from: antibiotics inhibiting the synthesis of peptidoglycan, the antibiotics inhibiting the synthesis of nucleic acids, antibiotics inhibiting folate synthesis, antibiotics inhibiting the synthesis of mycolic acids, any of their pharmaceutically acceptable salts, and any combination thereof. 5
    [0005]
    5. Association for its use according to any one of the preceding claims, characterized in that the antimicrobial is an antifungal, in particular an antifungal chosen from: polyenes, azoles, allylamines, thiocarbamates, echinocandins, griseofulvin , and fluorocytosine. 10
    [0006]
    6. Association for use according to one of the preceding claims wherein the mass ratio compound of formula (I): antimicrobial agent ranges from 4: 1 to 1:10, preferably from 1: 1 to 1:10, more preferably from 1: 1 to 1: 5. 15
    [0007]
    7. Association for use according to one of the preceding claims, characterized in that the microbial infection is induced by a pathogen selected from the following potential pathogenic genera: Acetobacter, Acetobacterium, Acinetobacter, Citrobacter, Enterobacter, Enterococcus, Escherichia, Helicobacter , Klebsiella, Proteus, Providencia, Pseudomonas, Salmonella, Serratia, Staphylococcus, Streptococcus, Actinobacillus, Neisseria, Mannheima, Pasteurella, Candida, Aspergillus, Cryptococcus Trichosporon, Malassezia, and Mycobacterium.
    [0008]
    8. Association for its use according to one of the preceding claims, characterized in that the antimicrobial is amoxicillin. 25
    [0009]
    9. Association for use according to one of the preceding claims, characterized in that the antimicrobial is an amoxicillin / clavulanic acid mixture.
    [0010]
    10. Association for its use according to one of the preceding claims, characterized in that the antimicrobial is sertaconazole. 3025720 40
    [0011]
    11. Association for use according to one of the preceding claims, characterized in that the compound of formula (I) is suitable for administration systemically.
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    同族专利:
    公开号 | 公开日
    FR3025719A1|2016-03-18|
    CN107073124A|2017-08-18|
    EP3193936B1|2020-06-17|
    CN107073124B|2020-10-13|
    EP3193936A1|2017-07-26|
    US20180021296A1|2018-01-25|
    WO2016041958A1|2016-03-24|
    DK3193936T3|2020-09-21|
    US10668043B2|2020-06-02|
    BR112017005089A2|2018-01-23|
    FR3025720B1|2018-11-09|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US3787566A|1969-07-29|1974-01-22|Holliston Labor Inc|Disinfecting aerosol compositions|
    US20060134237A1|2004-12-20|2006-06-22|Greene Sharon L|Anti-microbial composition and methods of use thereof|
    US6319958B1|1998-06-22|2001-11-20|Wisconsin Alumni Research Foundation|Method of sensitizing microbial cells to antimicrobial compound|
    WO2006120494A1|2005-05-13|2006-11-16|Advanced Scientific Developements|Pharmaceutical combination comprising an antibacterial agent and an active substance selected from carveol, thymol, eugenol, borneol and carvacrol|
    EP2648703A1|2010-12-09|2013-10-16|Septeos|Pharmaceutical composition comprising trans-cinnamaldehyde and its use in the treatment of infections|
    WO2012076718A1|2010-12-09|2012-06-14|Societe De Developpement Scientifique - Sds|Anti-microbial composition|FR3048612B1|2016-03-14|2020-10-02|Septeos|POTENTIALIZED TULATHROMYCIN|
    FR3052066B1|2016-06-02|2019-09-13|Advanced Scientific Developements|PHARMACEUTICAL FORMULATION OF CINEOL AND AMOXICILLIN|
    EP3463479A2|2016-06-02|2019-04-10|Advanced Scientific Developements|Pharmaceutical formulation comprising cineol and amoxicillin|
    FR3052065B1|2016-06-02|2019-11-22|Advanced Scientific Developements|COMBINATION OF CINEOL AND AMOXICILLIN FOR USE IN THE TREATMENT OF BACTERIAL INFECTION|
    法律状态:
    2016-01-22| PLFP| Fee payment|Year of fee payment: 2 |
    2016-03-18| PLSC| Publication of the preliminary search report|Effective date: 20160318 |
    2016-12-07| PLFP| Fee payment|Year of fee payment: 3 |
    2017-12-13| PLFP| Fee payment|Year of fee payment: 4 |
    2019-12-12| PLFP| Fee payment|Year of fee payment: 6 |
    2020-12-14| PLFP| Fee payment|Year of fee payment: 7 |
    2021-12-29| PLFP| Fee payment|Year of fee payment: 8 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1458663|2014-09-15|
    FR1458663A|FR3025719A1|2014-09-15|2014-09-15|POTENTIAL ANTIMICROBIALS|
    FR1462136A|FR3025720B1|2014-09-15|2014-12-09|POTENTIAL ANTIMICROBIALS|FR1462136A| FR3025720B1|2014-09-15|2014-12-09|POTENTIAL ANTIMICROBIALS|
    US15/510,988| US10668043B2|2014-09-15|2015-09-15|Potentiated antimicrobial agents|
    EP15766125.7A| EP3193936B1|2014-09-15|2015-09-15|Potentiated antimicrobial agents|
    BR112017005089-7A| BR112017005089A2|2014-09-15|2015-09-15|combination of an antimicrobial agent and a compound of formula i for their use|
    CN201580055896.6A| CN107073124B|2014-09-15|2015-09-15|Synergistic antimicrobial agents|
    DK15766125.7T| DK3193936T3|2014-09-15|2015-09-15|Antimicrobials with increased effect|
    PCT/EP2015/071093| WO2016041958A1|2014-09-15|2015-09-15|Potentiated antimicrobial agents|
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