Expression
of β-lactamase is the single most prevalent determinant
of antibiotic resistance, rendering bacteria resistant to β-lactam
antibiotics. In this article, we describe the development of an antibiotic
prodrug that combines ciprofloxacin with a β-lactamase-cleavable
motif. The prodrug is only bactericidal after activation by β-lactamase.
Bactericidal activity comparable to ciprofloxacin is demonstrated
against clinically relevant E. coli isolates expressing
diverse β-lactamases; bactericidal activity was not observed
in strains without β-lactamase. These findings demonstrate that
it is possible to exploit antibiotic resistance to selectively target
β-lactamase-producing bacteria using our prodrug approach, without
adversely affecting bacteria that do not produce β-lactamase.
This paves the way for selective targeting of drug-resistant pathogens
without disrupting or selecting for resistance within the microbiota,
reducing the rate of secondary infections and subsequent antibiotic
use.