gamithromycin and Swine-Diseases

The aim of this study is to evaluate the safety and efficacy of gamithromycin (GAM) for the treatment of naturally occurring bacterial swine respiratory disease (SRD) administered IM. A total of 240 pigs (nine-weeks old) were selected from two sites in Heilongjiang Province of China. The pigs showed severe signs of respiratory disease. Among them, 120 pigs were randomly divided into 4 groups of low dose (3 mg/kg), middle dose (6 mg/kg), high dose (12 mg/kg) GAM IM injection and 2.5 mg/kg tulathromycin (TUL) IM injection (positive control group) for phase II clinical trial to screen effective therapeutic dose. The other 120 pigs were randomly divided into 2 groups of 6 mg/kg GAM IM injection and 2.5 mg/kg TUL IM injection (positive control group) for phase III clinical trial to further confirm the efficacy. Animals were clinically observed daily for 14 days after treatment initiation. The predominant pathogens present in pretreatment respiratory tract samples were Streptococcus suis (S. suis) and Actinobacillus pleuropneumoniae (A. pleuropneumoniae). Haemophilus parasuis (H. parasuis) and Pasteurella multocida (P. multocida) were also found in the respiratory tract. All isolates were subjected to in vitro sensitivity testing and the measured minimal inhibitory concentrations (MIC) of GAM were from 0.0625 μg/mL to 8 μg/mL. In all treatment groups, rectal temperature dropped and clinical index (mental status and respiratory symptom) significantly improved after treatment (P ≤ .05). As a result, 82.76% animals treated with the 6 mg/kg GAM injection were cured. This was significantly higher than that of 3 mg/kg GAM injection (P ≤ .05) and similar to that of 12 mg/kg GAM injection and 2.5 mg/kg TUL injection (P > .05) in phase II clinical trial. In phase III clinical trial, 80.70% of animals treated with the 6 mg/kg GAM injection were cured and the cure rate was similar to that of 2.5 mg/kg TUL injection (P > .05). In conclusion, we recommended a single dose (6 mg/kg) of GAM IM injection for the treatment of bacterial SRD.

Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; China; Disaccharides; Dose-Response Relationship, Drug; Heterocyclic Compounds; Macrolides; Respiratory Tract Infections; Swine; Swine Diseases

The immunomodulatory properties of gamithromycin (GAM), ketoprofen (KETO) and their combination (GAM-KETO) were investigated after both in vitro and in vivo lipopolysaccharide (LPS)-induced inflammation. The influence of these drugs was measured on the production of prostaglandin E2 (PGE2) and the pro-inflammatory cytokines tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1β in both LPS-stimulated porcine peripheral blood mononuclear cells (PBMCs) and LPS-challenged pigs. Additionally, effects on the production of acute phase proteins (APPs), including pig major acute phase protein (pig-MAP) and C-reactive protein (CRP), as well as on the development of fever, pulmonary symptoms and sickness behaviour were investigated. Dexamethasone was included as a positive control in the in vitro research. Following an 18h-incubation period with 1.25μg/mL LPS, the levels of TNF-α, IL-1β and IL-6 (p<0.05) measured in the PBMC supernatants were significantly increased. Incubation with a high concentration of both GAM and KETO significantly reduced the in vitro levels of all three cytokines. Maximal plasma concentrations of TNF-α and IL-6 were observed at 1h and 2.5h following LPS challenge in pigs, respectively. Neither GAM, nor KETO nor the combination GAM-KETO was able to inhibit the in vivo LPS-induced cytokine production. Furthermore, none of the drugs influenced the subsequent APPs production. In contrast, administration of KETO significantly reduced PGE2 production both in vitro and in vivo (p<0.05 and p<0.001, respectively) and prevented the development of fever and severe symptoms, including dyspnoea, anorexia, vomiting and lateral decubitus.

Topics: Acute-Phase Proteins; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Cells, Cultured; Cytokines; Dinoprostone; Drug Therapy, Combination; Gene Expression Regulation; Inflammation; Ketoprofen; Leukocytes, Mononuclear; Lipopolysaccharides; Macrolides; Male; Swine; Swine Diseases

The pharmacokinetics of gamithromycin were evaluated in 26 male castrated and female crossbred swine administered gamithromycin 15% w/v (Zactran®, Boehringer Ingelheim) intravenously at 6 mg/kg bodyweight or intramuscularly at 3, 6 or 12 mg/kg bodyweight. Blood samples were collected up to Day 10 to establish the plasma profile of gamithromycin, bioavailability and dose proportionality. When administered by intramuscular injection at 6 mg/kg BWT, pharmacokinetic parameters were as follows: area under the curve until last quantifiable plasma concentration, 5.13 ± 0.957 µg*hours/ml; maximum plasma concentration, 960 ± 153 ng/ml at 5 to 15 min; terminal half-life of 94.1 ± 20.4 hr. Absolute bioavailability was 92.2%. Increase in systemic exposure was proportional to the gamithromycin dose level over the range 3-12 mg/kg BWT. No gender-related statistically significant difference in exposure was observed. For clinical evaluation of Zactran® against swine respiratory disease, 305 pigs from six commercial farms in three countries in Europe with signs associated with Actinobacillus pleuropneumoniae and/or Haemophilus parasuis and/or Pasteurella multocida and/or Bordetella bronchiseptica were used. At each site, animals were treated once in a 1:1 ratio with a single intramuscular dose of Zactran® (6 mg gamithromycin/kg bodyweight) or Zuprevo® (4% w/v tildipirosin at 4 mg/kg bodyweight; MSD Animal Health) at the recommended dose respectively. Animals were observed and scored daily for 10 consecutive days for signs of swine respiratory disease (depression, respiration and rectal temperature), and animals presenting signs of clinical swine respiratory disease (Depression Score 3 and/or Respiratory Score 3 associated with Rectal Temperature > 40.0°C) were removed from the study and considered as treatment failure. Animals which remained in the study were individually assessed for 'treatment success' or 'treatment failure' (Depression Score ≥ 1 and Rectal Temperature > 40.0°C or Respiratory Score ≥ 1 and Rectal Temperature > 40.0°C). Using a non-inferiority hypothesis test (non-inferiority margin = 0.10), the proportion of treatment successes in the Zactran® group (97%) was equivalent to or better than that in the Zuprevo® group (93%).

Topics: Actinobacillus Infections; Actinobacillus pleuropneumoniae; Animals; Anti-Bacterial Agents; Bordetella bronchiseptica; Bordetella Infections; Female; Haemophilus Infections; Haemophilus parasuis; Macrolides; Male; Pasteurella Infections; Pasteurella multocida; Respiratory Tract Infections; Sus scrofa; Swine; Swine Diseases