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Enmetazobactam (AAI-101)

Alias: AAI-101, Enmetazobactam;AAI-101; AAI-101;
Cat No.:V8719 Purity: ≥98%
Enmetazobactam (AAI101) is a novel potent andextended-spectrum beta lactamase inhibitor with thepotential to be used for the treatment of multi-drug resistant gram-negative bacterial infections.
Enmetazobactam (AAI-101)
Enmetazobactam (AAI-101) Chemical Structure CAS No.: 1001404-83-6
Product category: Bacterial
This product is for research use only, not for human use. We do not sell to patients.
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Product Description
Enmetazobactam (AAI101) is a novel potent and extended-spectrum beta lactamase inhibitor with the potential to be used for the treatment of multi-drug resistant gram-negative bacterial infections.
Biological Activity I Assay Protocols (From Reference)
ln Vitro
Enmetazobactam has a MIC50 of 0.125 mg/L and a MIC90 of 64 mg/L, which indicates its strong activity against particular resistance phenotypes. For the majority of strains, cefepime-Enmetazobactam MICs decrease as Enmetazobactam concentrations rise (from 1 to 16 mg/L), indicating that Enmetazobactam's concentration affects the cephalosporin's ability to fight bacteria[1].
ln Vivo
Bacterial density reductions of ≥0.5 log10 CFU and ≥1 log10 CFU are observed in neutropenic animals after treatment with cefepime-Enmetazobactam for 12 out of the 20 tested strains. Only four strains exhibit increases in bacterial density, and regardless of the concentration of Enmetazobactam, three of these strains have cefepime-Enmetazobactam MICs of ≥64 mg/L[2].
Animal Protocol
Each of the 20 Enterobacteriaceae strains is used to infect three mouse groups. Mice are given humanized cefepime or cefepime-AAI101 treatment regimens two hours after being injected. Subcutaneous injections of 0.2 mL are used to administer each dose. Another set of mice receives normal saline through the same route, at the same volume, and on the same frequency to act as control animals. All animals have their thighs taken 24 hours after treatment starts. All study mice were harvested by first being put to sleep with CO2 exposure and then having their cervical dislocations. Thighs are removed from the sacrifice and homogenized one at a time in regular saline. Using a spiral plater, serial dilutions of thigh homogenates are spread onto Trypticase soy agar containing 5% sheep blood in order to calculate the number of CFU. A third group of three infected but untreated mice is harvested at the start of dosing and used as a 0-hour control, in addition to the previously mentioned treatment and control groups. The measurement of the change in the log10 number of CFU obtained in mice after 24 hours of treatment from the densities observed in the 0-hour control animals determines the efficacy, which is expressed as the change in bacterial density.
ADME/Pharmacokinetics
Absorption, Distribution and Excretion
The mean (SD) Cmax is 19.8 (6.3) µg/mL in patients with cUTI and eGFR greater than or equal to 60 mL/min. The mean AUC0-last is 75.3 (30.8) μgxh/mL.
About 90% of enmetazobactam is excreted unchanged in urine.
Mean (SD) steady state volume of distribution (Vss) is 25.26 (9.97) L in patients with cUTI and eGFR greater than or equal to 60 mL/min..
The mean (SD) clearance is 7.6 (2.9) L/h in patients with cUTI and eGFR greater than or equal to 60 mL/min.
Metabolism / Metabolites
Enmetazobactam is minimally metabolized.
Biological Half-Life
The mean (SD) half-life is 2.6 (1.1) hours in patients with cUTI and eGFR greater than or equal to 60 mL/min.
Toxicity/Toxicokinetics
Protein Binding
The percent protein binding of enmetazobactam is negligible.
References

[1]. In Vitro Activity of Cefepime/AAI101 and Comparators against Cefepime Non-susceptible Enterobacteriaceae. Pathogens. 2015 Aug 18;4(3):620-5.

[2]. In vivo activities of simulated human doses of cefepime and cefepime-AAI101 against multidrug-resistant Gram-negative Enterobacteriaceae. Antimicrob Agents Chemother. 2015 May;59(5):2688-94.

Additional Infomation
Enmetazobactam is a penicillanic acid sulfone extended-spectrum beta (β)-lactamase (ESBL) inhibitor. Because ESBL enzymes can hydrolyze important antibiotics such as penicillins, broad-spectrum cephalosporins and monobactams, ESBL-producing bacteria poses challenges in the treatment of serious infections. The combination product of enmetazobactam and [cefepime] was first approved by the FDA on February 23, 2024, for the treatment of complicated urinary tract infections. Enmetazobactam is used as cefepime-sparing therapy by preventing its breakdown by ESBL.
Drug Indication
In combination with [cefepime], enmetazobactam is indicated for the treatment of adults with complicated urinary tract infections (cUTI) including pyelonephritis caused by designated susceptible microorganisms.
Mechanism of Action
Extended-spectrum beta-lactamases (ESBLs) are a group of bacterial serine beta-lactamases that hydrolyze third-generation cephalosporins (3GC), leading to the development of 3GC-resistant bacteria. When used in combination with cefepime, enmetazobactam protects cefepime from degradation by ESBLs and prevents antibiotic resistance.
Pharmacodynamics
Enmetazobactam is an antibacterial agent that is active against most gram-positive and gram-negative bacteria.
These protocols are for reference only. InvivoChem does not independently validate these methods.
Physicochemical Properties
Molecular Formula
C11H14N4O5S
Molecular Weight
314.317660808563
Exact Mass
314.07
Elemental Analysis
C, 42.03; H, 4.49; N, 17.83; O, 25.45; S, 10.20
CAS #
1001404-83-6
PubChem CID
23653540
Appearance
White to off-white solid powder
LogP
-0.6
Hydrogen Bond Donor Count
0
Hydrogen Bond Acceptor Count
6
Rotatable Bond Count
2
Heavy Atom Count
21
Complexity
597
Defined Atom Stereocenter Count
3
SMILES
S1([C@@H]2CC(N2[C@@H](C(=O)[O-])[C@]1(C)CN1C=C[N+](C)=N1)=O)(=O)=O
InChi Key
HFZITXBUTWITPT-YWVKMMECSA-N
InChi Code
InChI=1S/C11H14N4O5S/c1-11(6-14-4-3-13(2)12-14)9(10(17)18)15-7(16)5-8(15)21(11,19)20/h3-4,8-9H,5-6H2,1-2H3/t8-,9+,11+/m1/s1
Chemical Name
(2S,3S,5R)-3-methyl-3-((3-methyl-1H-1,2,3-triazol-3-ium-1-yl)methyl)-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate 4,4-dioxide
Synonyms
AAI-101, Enmetazobactam;AAI-101; AAI-101;
HS Tariff Code
2934.99.9001
Storage

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Note: (1). This product requires protection from light (avoid light exposure) during transportation and storage.  (2). Please store this product in a sealed and protected environment (e.g. under nitrogen), avoid exposure to moisture.
Shipping Condition
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
Solubility Data
Solubility (In Vitro)
DMSO : ≥ 113.3 mg/mL (~360.46 mM)
Solubility (In Vivo)
Solubility in Formulation 1: ≥ 2.08 mg/mL (6.62 mM) (saturation unknown) in 10% DMSO + 40% PEG300 + 5% Tween80 + 45% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 20.8 mg/mL clear DMSO stock solution to 400 μL PEG300 and mix evenly; then add 50 μL Tween-80 to the above solution and mix evenly; then add 450 μL normal saline to adjust the volume to 1 mL.
Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution.

Solubility in Formulation 2: ≥ 2.08 mg/mL (6.62 mM) (saturation unknown) in 10% DMSO + 90% (20% SBE-β-CD in Saline) (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 20.8 mg/mL clear DMSO stock solution to 900 μL of 20% SBE-β-CD physiological saline solution and mix evenly.
Preparation of 20% SBE-β-CD in Saline (4°C,1 week): Dissolve 2 g SBE-β-CD in 10 mL saline to obtain a clear solution.

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Solubility in Formulation 3: ≥ 2.08 mg/mL (6.62 mM) (saturation unknown) in 10% DMSO + 90% Corn Oil (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 20.8 mg/mL clear DMSO stock solution to 900 μL of corn oil and mix evenly.


Solubility in Formulation 4: 10% DMSO+90% (20% SBE-β-CD in Saline): ≥ 2.08 mg/mL (6.62 mM)

 (Please use freshly prepared in vivo formulations for optimal results.)
Preparing Stock Solutions 1 mg 5 mg 10 mg
1 mM 3.1815 mL 15.9074 mL 31.8147 mL
5 mM 0.6363 mL 3.1815 mL 6.3629 mL
10 mM 0.3181 mL 1.5907 mL 3.1815 mL

*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.

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Note: Chemical formula is case sensitive: C12H18N3O4  c12h18n3o4
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In vivo Formulation Calculator (Clear solution)
Step 1: Enter information below (Recommended: An additional animal to make allowance for loss during the experiment)
Step 2: Enter in vivo formulation (This is only a calculator, not the exact formulation for a specific product. Please contact us first if there is no in vivo formulation in the solubility section.)
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Calculation results

Working concentration mg/mL;

Method for preparing DMSO stock solution mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.

Method for preparing in vivo formulation:Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.

(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
             (2) Be sure to add the solvent(s) in order.

Clinical Trial Information
NCT Number Recruitment interventions Conditions Sponsor/Collaborators Start Date Phases
NCT05826990 RECRUITING Drug: cefepime and enmetazobactam combination Complicated Urinary Tract Infection Allecra 2023-09-11 Phase 2
NCT03775668 COMPLETED Drug: 1 µCi of 14C-AAI101 + 500 mg AAI101 Healthy Allecra 2018-11-27 Phase 1
NCT03680352 COMPLETED Drug: cefepime/AAI101 PK in Patients With Various Degrees of Renal Impairment Allecra 2017-09-01 Phase 1
NCT03680612 COMPLETED Drug: Cefepime 1G - 2G / AAI101 0.5G - 0.75G
Drug: cefepime 1 g or cefepime 2 g
Urinary Tract Infections Allecra 2017-09-05 Phase 2
NCT03687255 COMPLETED Drug: cefepime/AAI101 combination
Drug: Piperacillin/tazobactam
Urinary Tract Infections Allecra 2018-09-24 Phase 3
Biological Data
  • Free concentration-time profiles for the simulated human regimen of cefepime at 2 g every 8 h (30-min infusion) in mice compared with those in humans. Symbols represent means ± SDs.Antimicrob Agents Chemother. 2015 May;59(5):2688-94
  • Free concentration-time profiles for the simulated human regimen of cefepime-AAI101 at 2 g/0.5 g every 8 h (30-min infusion) in mice compared with those in humans. Symbols represent means ± SDs.Antimicrob Agents Chemother. 2015 May;59(5):2688-94
  • Comparative efficacy of simulated human doses of cefepime at 2 g q8h as monotherapy or in combination with AAI101 against Enterobacteriaceae in the neutropenic thigh infection model.Antimicrob Agents Chemother. 2015 May;59(5):2688-94
  • Pharmacodynamic profile of humanized cefepime-AAI101 (FEP/AAI) at 2 g/0.5 g against a distribution of Enterobacteriaceae sorted by cefepime-AAI101 MICs determined with fixed AAI101 concentrations of 1 mg/liter (A), 2 mg/liter (B), 4 mg/liter (C), 8 mg/liter (D), or 16 mg/liter (E). Symbols represent means ± SDs.Antimicrob Agents Chemother. 2015 May;59(5):2688-94
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