Latamoxef

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Latamoxef
Latamoxef.svg
Clinical data
AHFS/Drugs.com International Drug Names
Routes of
administration
Intramuscular, intravenous
ATC code
Pharmacokinetic data
Protein binding 35 to 50%
Metabolism Nil
Elimination half-life 2 hours
Excretion Mostly renal, unchanged; also biliary
Identifiers
  • (6R,7R)-7-{[carboxy(4-hydroxyphenyl)acetyl]amino}-7-methoxy-3-{[(1-methyl-1H-tetrazol-5-yl)thio]methyl}-8-oxo-5-oxa-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.059.334 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C20H20N6O9S
Molar mass 520.47 g·mol−1
3D model (JSmol)
Melting point 117 to 122 °C (243 to 252 °F) (dec.)
  • O=C2N1/C(=C(\CO[C@@H]1[C@]2(OC)NC(=O)C(c3ccc(O)cc3)C(=O)O)CSc4nnnn4C)C(=O)O
  • InChI=1S/C20H20N6O9S/c1-25-19(22-23-24-25)36-8-10-7-35-18-20(34-2,17(33)26(18)13(10)16(31)32)21-14(28)12(15(29)30)9-3-5-11(27)6-4-9/h3-6,12,18,27H,7-8H2,1-2H3,(H,21,28)(H,29,30)(H,31,32)/t12?,18-,20+/m1/s1 Yes check.svgY
  • Key:JWCSIUVGFCSJCK-CAVRMKNVSA-N Yes check.svgY
 X mark.svgNYes check.svgY  (what is this?)    (verify)

Latamoxef (or moxalactam) is an oxacephem antibiotic usually grouped with the cephalosporins. In oxacephems such as latamoxef, the sulfur atom of the cephalosporin core is replaced with an oxygen atom.

Latamoxef has been associated with prolonged bleeding time, and several cases of coagulopathy, some fatal, were reported during the 1980s. [1] [2] Latamoxef is no longer available in the United States. As with other cephalosporins with a methylthiotetrazole side chain, latamoxef causes a disulfiram reaction when mixed with alcohol. Additionally, the methylthiotetrazole side chain inhibits γ-carboxylation of glutamic acid; this can interfere with the actions of vitamin K.[ citation needed ]

It has been described as a third-generation cephalosporin. [3]

Synthesis

Oxa-substituted third generation cephalosporin antibiotic (oxacephalosporin).

Moxalactam synthesis: (excerpt from Lednicer book 3) Moxalactam synthesis.svg
Moxalactam synthesis: (excerpt from Lednicer book 3)

The benzhydrol ester of 6-Aminopenicillanic acid (6-APA) is S-chlorinated and treated with base whereupon the intermediate sulfenyl chloride fragments (to 2). Next, displacement with propargyl alcohol in the presence of zinc chloride gives predominanntly the stereochemistry represented by diastereoisomer 3. The side chain is protected as the phenylacetylamide; the triple bond is partially reduced with a 5% Pd-CaCO3 (Lindlar catalyst) and then epoxidized with mCPBA to give 4. The epoxide is opened at the least hindered end with 1-methyl-1H-tetrazole-5-thiol to put in place the future C-3 side chain and give intermediate 5. Jones oxidation followed in turn by ozonolysis (reductive work-up with zinc-AcOH) and reaction with SOCl2 and pyridine give halide 6. The stage is now wet for intramolecular Wittig reaction. Displacement with PPh3 and Wittig olefination gives 1-oxacephem 7. Next a sequence is undertaken of side chain exchange and introduction of a 7-methoxyl group analogous to that which is present in cephamycins and gives them the enhanced beta-lactamase stability. First 7 is converted to the imino chloride with PCl5 and then to the imino methyl ether (with methanol) and next hydrolyzed to the free amine (8). Imine formation with 3,5-di-t-butyl-4-hydroxybenzaldehyde is next carried out leading to 9. Oxidation with nickel(III) oxide gives iminoquinone methide 10, to which methanol is added in a conjugate sense and in the sterechemistry represented by formula 11. The imine is exchanged with Girard's reagent T to give 12, and this is acylated by a suitable protected arylmalonate, as the hemiester hemiacid chloride so as to give 11. Deblocking with aluminium chloride and anisole gives moxalactam 14.

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β-Lactam antibiotic Class of broad-spectrum antibiotics

β-Lactam antibiotics are antibiotics that contain a β-lactam ring in their chemical structure. This includes penicillin derivatives (penams), cephalosporins and cephamycins (cephems), monobactams, carbapenems and carbacephems. Most β-lactam antibiotics work by inhibiting cell wall biosynthesis in the bacterial organism and are the most widely used group of antibiotics. Until 2003, when measured by sales, more than half of all commercially available antibiotics in use were β-lactam compounds. The first β-lactam antibiotic discovered, penicillin, was isolated from a strain of Penicillium rubens.

The following outline is provided as an overview of and topical guide to organic chemistry:

<span class="mw-page-title-main">Cephalosporin</span> Class of pharmaceutical drugs

The cephalosporins are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as Cephalosporium.

<span class="mw-page-title-main">Cephamycin</span> Group of β-lactam antibiotics

Cephamycins are a group of β-lactam antibiotics. They are very similar to cephalosporins, and the cephamycins are sometimes classified as cephalosporins.

<span class="mw-page-title-main">Cephem</span> Class of beta-lactam antibiotic

Cephems are a sub-group of β-lactam antibiotics including cephalosporins and cephamycins. It is one of the most common 4-membered ring heterocycle. Produced by actinomycetes, cephamycins were found to display antibacterial activity against a wide range of bacteria, including those resistant to penicillin and cephalosporins. The antimicrobial properties of Cephem include the attachment to certain penicillin-binding proteins that are involved in the production of cell walls of bacteria.

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<span class="mw-page-title-main">Cephaloridine</span> Chemical compound

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<span class="mw-page-title-main">Cefteram</span> Chemical compound

Cefteram (INN) is a third-generation cephalosporin antibiotic.

<span class="mw-page-title-main">Cefazaflur</span> Cephalosporin antibiotic

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<span class="mw-page-title-main">Efaroxan</span> Chemical compound

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<span class="mw-page-title-main">Oxacephem</span> Class of pharmaceutical drugs

An oxacephem is a β-lactam molecule similar to a cephem, but with an oxygen substituted for the sulfur. They are synthetic compounds not seen in nature, generally used as β-lactam antibiotics. Examples include Latamoxef and Flomoxef.

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The Staudinger synthesis, also called the Staudinger ketene-imine cycloaddition, is a chemical synthesis in which an imine 1 reacts with a ketene 2 through a non-photochemical 2+2 cycloaddition to produce a β-lactam3. The reaction carries particular importance in the synthesis of β-lactam antibiotics. The Staudinger synthesis should not be confused with the Staudinger reaction, a phosphine or phosphite reaction used to reduce azides to amines.

Cephalosporins are a broad class of bactericidal antibiotics that include the β-lactam ring and share a structural similarity and mechanism of action with other β-lactam antibiotics. The cephalosporins have the ability to kill bacteria by inhibiting essential steps in the bacterial cell wall synthesis which in the end results in osmotic lysis and death of the bacterial cell. Cephalosporins are widely used antibiotics because of their clinical efficiency and desirable safety profile.

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Avibactam is a non-β-lactam β-lactamase inhibitor developed by Actavis jointly with AstraZeneca. A new drug application for avibactam in combination with ceftazidime was approved by the FDA on February 25, 2015, for treating complicated urinary tract (cUTI) and complicated intra-abdominal infections (cIAI) caused by antibiotic resistant-pathogens, including those caused by multi-drug resistant Gram-negative bacterial pathogens.

Cefoperazone/sulbactam is a combination drug used as an antibiotic. It is effective for the treatment of urinary tract infections. It contains cefoperazone, a β-lactam antibiotic, and sulbactam, a β-lactamase inhibitor, which helps prevent bacteria from breaking down cefoperazone.

References

  1. Weitekamp MR, Aber RC (January 1983). "Prolonged bleeding times and bleeding diathesis associated with moxalactam administration". JAMA. 249 (1): 69–71. doi:10.1001/jama.249.1.69. PMID   6217353.
  2. Brown RB, Klar J, Lemeshow S, Teres D, Pastides H, Sands M (November 1986). "Enhanced bleeding with cefoxitin or moxalactam. Statistical analysis within a defined population of 1493 patients". Archives of Internal Medicine. 146 (11): 2159–2164. doi:10.1001/archinte.146.11.2159. PMID   3778044.
  3. Salem RR, McIndoe A, Matkin JA, Lidou AC, Clarke A, Wood CB (June 1987). "The hematologic effects of latamoxef sodium when used as a prophylaxis during surgical treatment". Surgery, Gynecology & Obstetrics. 164 (6): 525–529. PMID   3296254.
  4. DE 2713370,Nagata W, Narisada M,"1-Oxadethiacephalosporine, Verfahren zu Arzneimittel [1-oxadethiacephalosporins, procedure for medicinal products]",published 1977-09-29, assigned to Shionogi & Co. Ltd.
  5. US 4138486,Nagata W, Narisada M,issued 1979, assigned to Shionogi
  6. Narisada M, Yoshida T, Onoue H, Ohtani M, Okada T, Tsuji T, et al. (July 1979). "Synthetic studies on β-lactam antibiotics. Part 10. Synthesis of 7β-[2-carboxy-2-(4-hydroxyphenyl)acetamido]-7.alpha.-methoxy-3-[[(1-methyl-1H-tetrazol-5-yl)thio]methyl]-1-oxa-1-dethia-3-cephem-4-carboxylic acid disodium salt (6059-S) and its related 1-oxacephems". Journal of Medicinal Chemistry. 22 (7): 757–759. doi:10.1021/jm00193a001. PMID   448673.
  7. Otsuka H, Nagata W, Yoshioka M, Narisada M, Yoshida T, Harada Y, Yamada H (1981). "Discovery and development of Moxalactam (6059-S): the chemistry and biology of 1-oxacephems". Medicinal Research Reviews. 1 (3): 217–248. doi:10.1002/med.2610010302. PMID   6213825. S2CID   45623930.
  8. Narisada M, Onoue H, Nagata W (1977). "Synthetic Studies on b-Lactam Antibiotics. Part 5. A Synthesis of 7b-Acylamino-3-methyl-1-oxadethia-3-cephem-4-carboxylic Acids". Heterocycles. 7 (2): 839. doi: 10.3987/S-1977-02-0839 .