Efficacies of Sordarin Derivatives GM193663, GM211676, and GM237354 in a Murine Model of Systemic Coccidioidomycosis

Abstract
Sordarin derivatives (Glaxo Wellcome) are a new class of compounds that selectively inhibit fungal protein synthesis and have a broad spectrum of activity. Systemic coccidioidomycosis was established in female CD-1 mice infected with Coccidioides immitis, and therapy was begun on day 4 with either GM193663, GM211676, GM237354, fluconazole, or no treatment; compounds were given twice daily orally for 19 days at 20 or 100 mg/kg/day. The serum pharmacokinetics of the compounds were studied in uninfected mice. The MICs of GM193663, GM211676, and GM237354 for C. immitis were 1.56, 0.39, and 0.39 μg/ml, respectively, and the minimum fungicidal concentrations were 6.25, 3.13, and 0.39 μg/ml, respectively. Peak serum levels (sampled at 1 to 2 h) after a single 50-mg/kg dose were 9.8 μg/ml for GM193663, 13 μg/ml for GM211676, and 6.0 μg/ml for GM237354. No accumulation occurred after 19 days of dosing, and peak levels were lower at 3.2 μg/ml for GM193663, 4.0 μg/ml for GM211676, and t1/2 for each compound in serum is C. immitis was susceptible both in vitro and in vivo to the GM compounds, which were found to be equivalent or superior to fluconazole. These results are encouraging, indicating that further testing in other models of fungal disease is warranted.