Chemistry:Ciclacillin

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Short description: Chemical compound
Ciclacillin
Ciclacillin.svg
Clinical data
AHFS/Drugs.comInternational Drug Names
Routes of
administration
Oral
ATC code
  • none
Pharmacokinetic data
BioavailabilityModerate
Protein binding<25%
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC15H23N3O4S
Molar mass341.43 g·mol−1
3D model (JSmol)
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Ciclacillin (INN) or cyclacillin (USAN), trade names Cyclapen, Cyclapen-W, Vastcillin, and others, is an aminopenicillin antibiotic. Its spectrum of activity is similar to that of ampicillin, although it is less susceptible to beta-lactamases than ampicillin and has much higher bioavailability.[1] A large randomized, double-blind clinical trial published in 1978 also showed that ciclacillin is associated with significantly fewer and milder adverse effects than ampicillin;[2] later studies seemed to confirm this improved tolerability, at least in children.[3][4]

Ciclacillin has been superseded by newer antibiotics and is no longer in clinical use, at least in the United States.[5]

Synthesis

In an attempt to form orally active penicillins unrelated to ampicillin, use was made of the fact that certain spiro α-amino acids, such as Cycloleucine, are well absorbed orally and transported like normal amino acids.

Cyclacillin synthesis:[6]

Reaction of cyclohexanone with ammonium carbonate and KCN under the conditions of the Bucherer-Bergs reaction led to hydantoin 1. On acid hydrolysis, α-amino acid 2 resulted. Treatment with phosgene both protected the amino group and activated the carboxyl group toward amide formation (as 3) and reaction with 6-aminopenicillanic acid (6-APA) gave cyclacillin (4).

This artifice seems to have worked, since cyclacillin is more active in vivo than its in vitro spectrum suggests.[citation needed]

References

  1. "Cyclacillin: microbiological and pharmacological properties and use in chemotherapy of infection - a critical appraisal". Chemotherapy 22 (3–4): 154–182. 1976. doi:10.1159/000221924. PMID 773605. 
  2. "Double-blind clinical trials of oral cyclacillin and ampicillin". Antimicrobial Agents and Chemotherapy 15 (1): 55–58. January 1979. doi:10.1128/aac.15.1.55. PMID 371540. 
  3. "Double-blind multicenter comparison of cyclacillin and amoxicillin for the treatment of acute otitis media". The Journal of Pediatrics 101 (4): 617–621. October 1982. doi:10.1016/S0022-3476(82)80724-5. PMID 6750067. 
  4. "Multicenter comparison of cyclacillin and amoxicillin in the treatment of acute streptococcal pharyngitis". Clinical Therapeutics 5 (3): 299–304. 1983. PMID 6342785. 
  5. Infectious diseases (3rd ed.). Hagerstown, MD: Lippincott Williams & Wilkins. 2004. pp. 186. ISBN 0-7817-3371-5. https://books.google.com/books?id=_eHyE9lRw7oC.  Retrieved on September 7, 2008 through Google Book Search.
  6. "Synthesis of new broad-spectrum aminoalicyclic penicillins". Antimicrobial Agents and Chemotherapy 7: 586–589. 1967. PMID 5596194. 

Further reading