Mueller-Hinton broth), Streptococcus pneumoniae (S. pneumoniae), Streptococcus faecalis (S. faecalis)

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1 Fig. 1 Chemical structure of TA-058 (2S, 5R, 6R)-6- k2r-2- (2R-2- amino-3-n- methyl carbamoylpropionamido) -2- (4- hydroxyphenyl) acetamido l-3, 3-dimethy1-7-oxo- 4-thia-1- azabicycio k3.2,0 l heptane-2-carboxylic acid trihydrate

2 Mueller-Hinton broth), Streptococcus pneumoniae (S. pneumoniae), Streptococcus faecalis (S. faecalis)

3 Fig. 2 MICs of TA-058 and other fl-lactam antibiotics against respiratory pathogenic ABPC-sensitive H. influenzae (27 strains, inoculum size 106 cfu/ml) Fig. 3 MICs of TA-058 and other fl-lactam antibiotics against respiratory pathogenic S. imeumoniae (22 strains, inoculum size 106 cfu/ml)

4 Table 1 MICs of TA-058 and other Ĉ-lactam antibiotics against respiratory pathogenic P. aeruginosa (31 strains, inoculum size 106 cfu/ml) Table 2 MICs of TA-058 and other Ĉ-lactam antibiotics against respiratory pathogenic K. pneumoniae (26 strains, inoculum size 106 cfu/ml) Table 3 MICs of TA-058 and other Ĉ-lactam antibiotics against respiratory pathogenic E. coli (6 strains, inoculum size 106 cfu/ml)

5 Table 4 MICs of TA-058 and other Ĉ-lactam antibiotics against respiratory pathogenic Enterobacter spp. (9 strains, inoculum size 106cfu/ml) Fig. 4 MICs of TA-058 and other Ĉ-lactam antibiotics against respiratory pathogenic S. faecalis (inoculum size 106 cfu/ml) Fig. 5 MICs of TA-058 and other Ĉ-lactam antibiotics against urinary pathogenic S. faecalis (inoculum size 106 cfu/ml)

6 Table 5 MICs of TA-058 combined with Ĉ-lactamase inhibitors against ABPC-resistant H. infiuenzae Fig. 6 MICs of TA-058 alone and with equal concentrations of clavulanic acid (CVA) or CP against 11 strains of respiratory pathogenic B. catarrhalis (inoculum size, 106 cfu/ml)

7 Fig. 7 Bioassay system and standard curves of TA-058 utilizing thin layer cup plate method Table 6 Peak serum levels and maximal sputum levels of TA-058 in 6 patients with respiratory infections

8 Fig. 8 TA-058 concentrations in sputum during 7 consecutive days administered 1 g of TA-058 d. i. over 2 h twice a day and serum and urinary levels of TA-058 after the 13 th dose Fig. 10 Sputum and serum levels of TA-058 K. Y., 71 y.o., F. 38 kg Fig. 11 Concentration of TA-058 in intrabronchiolar lsecretions 60 minutes after a dose of 3 g d. i. over 30 minutes dissolved with 100 ml of isotonic saline in a patient with chronic bronchitis. Fig. 9 Sputum and serum levels of TA-058 S. I., 60 y. o., M. 45 kg Peat serum concentration readied Đg/ml

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13 Table 9 Clinical antibacterial activities of TA-058

14 Fig. 12 Chronic bronchiolitis due to H. influenzae: K. M., 80 y. o., F., 37 kg Fig. 14 H. T., 67y. o., M., 58 kg : Chronic bronchiolitis Fig. 15 Chronic bronchiolitis. H. T., 68 y.o., M., 59.5 kg Fig. 13 The quantitative sputum culture method on a patient with chronic bronchiolitis after the first dose of TA g d. i. K. M., 80 y. o., F., 37 kg

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16 TANI, H. YOSHIDA & S. OHSHIMA: Pharmaco- kinetic studies of TA-058 in laboratory animals. Current Chemotherapy and Immunotherapy. (Proceeding of the 12 th ICC) Voḷ 3) SHISHIDO, H. ; K. MATSUMOTO, Y. UZUKA, T. NAGATAKE, M. YAMAMOTO, Y. SAKUMA & T. YAMAGUCHI : Phase I clinical study of TA Current Chemotherapy and Immunotherapy. (Proceeding of the 12 th ICC) Vol. I: 29 `331, ) CATLIN, B. W.: Iodometric detection of Haemophilus influenzae beta-lactamase : Rapid 6) SLACK, M. P. E.; D. B. WHELDON & D. C. presumptive test for ampicillin resistance. Antimicrob. Agents Chemother. 7: 265 `270, 1975 TURK : A rapid test for beta-lactamase production by Haernophilus influenzae. Lancet 2 : 906, ) MITSUHASHI, S.(Ed.) : Beta-lactam antibiotics. Japan Scientific Societies Press, Biochemical mechanisms of resistance. Mechanisms of resistance to ƒà-lactam antibiotics (MITSU- HASHI, S. & M. INOUS) 41 `56, ) NISHINO, T. ; N. ISHII, T. TANINO, S. OHSHIMA & T. YAMAGUCHI : In vitro and in vivo antibacterial activity of TA-058, a new broadspectrum semisynthetic penicillin. Current Chemotherapy and Infectious Disease. (Proceedings of the 11th ICC and the 19 th ICA 10) BROWN, A. G. ; D. BUTTERWORTH, M. COLE, G. HANSCOMB, J. D. HOOD, C. READING & G. N. AC) Vol. I: 362 `363, 1980 ROLINASON : Naturally-occurring ƒà-lactamase 2) YAMAGUCHI, T. ; I. MAEZAWA, Y. SAKUMA, K. inhibitors with antibacterial activity. J.

17 Antibiotics 29 : 668 `669, 1976 ENGLISH, A. R. ; J. A. RETSEMA, A. E. GIRARD, J. E. LYNCH & W. E. BARTH : CP-45899, a beta-lactamase inhibitor that extends the antibacterial spectrum of beta-lactams : Initial bacteriological characterization. Antimicrob. Agents Chemother. 14 : 414 `419, ) WISE, R. ; J. M. ANDREWS & K. A. BEDFORD : Clavulanic acid and CP : A comparison of their in vitro activity in combination with penicillin. J. Antimicrob. Chemother. 6 : ) PERLMAN, D., (Ed.) : Structure-activity relationships among the semisynthetic antibiotics. Academic Press, New York, ) MATSUMOTO, K. & Y. UZUKA : Concentration of antibiotics in bronchiolar secretions of the patients with chronic respiratory infections. Chemotherapy 4: 73 `78, 1976

18 CLINICAL AND LABORATORY EVALUATION OF TA-058 KEIZO MATSUMOTO, HARUMI SHISHIDO, MASASHI YAMAMOTO, YOSHIO UZUKA, TSUYOSHI NAGATAKE, TOMOYUKI HARADA, ATSUSHI TAKAHASHI, MASAKAZU TAKASUGI, SHIGEO KAIDA and KIWAO WATANABE Department of Internal Medicine, Institute for Tropical Medicine, Nagasaki University HISAO KIMURA Department of Internal Medicine, Fukushima Rosai Hospital Respiratory KUNIO KUDO Division, Sendai National Hospital SIGERU TAMAKI Department of Internal Medicine, Fujita General Hospital TA-058 is a new semisynthetic penicillin which has a unique chemical structure containing an amino-acyl (N-methyl-asparaginyl) function in its side chain. Clinical and laboratory study has been performed on TA-058 in order to evaluate its usefulness mainly in respiratory tract infections. Minimal inhibitory concentrations (MICs) of TA-058 against 27 strains of respiratory pathogenic H. influenzae sensitive to ampicillin were `0.1 Đg/ml. MICs of TA-058 against 22 strains of S. pneumoniae were `0.1 Đg/ml. MICs of TA-058 against respiratory pathogenic P. aeruginosa and K. pneumoniae were 0.39 `>100 Đg/ml and 0.78 `>100 Đg/ml, respectively. The synergistic effects were demonstrated between TA-058 and clavulanic acid or CP against respiratory pathogenic ampicillin-resistant H. influenzae and B. catarrhalis. Ratios of maximum sputum level to peak serum concentration ranged from 3.07 % to 7.45% in 6 patients with chronic respiratory infections, while ratio of maximum intrabronchiolar level to peak serum concentration was as high as 20.1 % in a patient with chronic bronchitis. TA-058 was administered by the intavenous drip infusion of a dose of 1 g twice a day. Eighteen respiratory tract infections and 10 urinary tract infections were subjected to clinical evaluation of TA-058, indicating favorable clinical response, i. e., the rates of clinical therapeutic efficacy were 94.4% and 80 %, respectively. None of them showed adverse effects. The safety of this penicillin antibiotic was very good. From the above results, it was concluded that TA-058 is one of the most effective and useful antibiotics for the treatment of the respiratory bacterial infections, particularly for those due to H. influenzae and S. pneumon iae.

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