A panel of six imidazo[1,2-a]pyridine-3-carboxamides (IAPs) were shown to have low-micromolar activity against Mycobacterium avium strains. Compound ND-10885 (compound 2) showed significant activity in the lung, spleen, and liver in a mouse M. avium infection model. A combined regimen consisting of ND-10885 (compound 2) and rifampin was additive in its anti-M. avium activity in the lung. Our data indicate that IAPs represent a new class of antibiotics that are active against M. avium and could potentially serve as an effective addition to a combined treatment regimen.
The incidence of nontuberculous mycobacteria (NTM) infections has been increasing in the United States (1, 2). Mycobacterium avium complex (MAC), which consists of M. avium and M. intracellulare, is an important cause of pulmonary disease in individuals with underlying lung diseases, such as cystic fibrosis and chronic obstructive pulmonary disease, and is an opportunistic pathogen in immunocompromised patients (3, 4). Among the NTM species isolated from U.S. patients, 80% are classified as MAC (5). MAC is ubiquitous within the environment and is found in soil, treated or untreated water, house plumbing systems, and animals (6). MAC infection is difficult to treat and has been shown to be resistant to many of the clinically used antituberculosis agents (7,8). We previously disclosed a novel family of compounds, imidazo[1,2-a]pyridine-3-carboxamides (IAPs), with potent activity against Mycobacterium tuberculosis (9-12). The mechanism of action and anti-M. tuberculosis in vivo efficacy of this exciting new class has been documented by us and other groups (9, 13-16). Through a hit-to-lead optimization effort aided by the Lilly TB Drug Discovery Initiative (LTBDDI), additional IAP compounds (1 to 6) were generated and found to have encouraging in vivo pharmacokinetics (PK). Herein, we describe the activity of these latest analogs against M. avium both in vitro and in vivo.Activity of selected compounds in vitro. Six compounds having diverse PKs were selected and synthesized according to our published methods (9-11). Experimental data and information on all previously uncharacterized compounds (1, 2, and 6) can be found in the supplemental material. MIC studies were performed using a resazurin-based colorimetric assay and CFU quantification, as described previously (17). Screening the IAPs against M. avium strains 101 and 2151 using standard protocols indicated that they had moderate potency (Table 1). The activities of these compounds against M. avium (2.6 to 27.8 M, two strains) were limited relative to M. tuberculosis (see Table S1 in the supplemental material) but comparable to positive controls of clarithromycin and azithromycin (1.4 and 13.4 M, respectively). These compounds also had a good therapeutic window when screened against Vero cells (9) (Table S1).All six compounds were evaluated for their ability to kill or inhibit M. avium replication in vitro. Five out of six compounds were bactericidal or bacteriostatic (Fig. 1). Consistent with its M...