Williams et al.
antibiotic therapy, these new agents challenge existing
methods of synthesis. In the most convergent approach
to these compounds, construction of a carbon-sulfur bond
is made more difficult by the increased complexity of the
reaction partners and the increased steric demands on
bringing them together. The introduction of charged and
nucleophilic functionality, while important in giving the
antibiotic the desired properties, has made purification
and isolation of the product more difficult. Herein, we
describe our strategy and discoveries leading to a practi-
cal synthesis for the new antibiotic ertapenem sodium 1
allowing production on multi-kilogram scale.11
Results and Discussion
Ertapenem is an amino dicarboxylic acid and as such
can exist in four forms in solution. The zwitterionic
monocarboxylate and the dicarboxylate salts are the
predominant forms in the pH range where the best
solution stability is observed.12 The monosodium salt is
the predominant form in the range from pH 4 to 7; the
disodium salt becomes the predominant form above pH
7. Ertapenem was found to crystallize as the monosodium
salt from a concentrated aqueous solution at pH 5.5 on
addition of a specific combination of alcohol solvents.
Attempts to crystallize other salts were not successful.
The monosodium salt, therefore, became the target for
isolation of the product.
Since isolation of the product would require achieving
a concentration in excess of 100 mg/mL, we examined
the solution stability at that concentration and found that
the rate of degradation in aqueous solution at 2 °C is
about 1%/h across the pH range which affords the best
solution stability (pH 5-8). Although hydrolysis contrib-
utes to the degradation of ertapenem, the formation of
dimeric degradates accounts for most of the loss in this
pH range at high concentration.13
As with Meropenem, attack of the pyrrolidine amine
on the â-lactam is responsible for formation of dimeric
degradates.14 In the case of ertapenem, other degradates
resulting from bimolecular reactions appear to arise from
attack by the two carboxylates on the â-lactam, leading
initially to anhydrides, which can then undergo intramo-
lecular acyl transfer to give the more stable products that
are observed.15 The degradates have been characterized
by NMR analysis of samples isolated by preparative
HPLC.12
FIGURE 1.
Since imipenem was introduced in the 1980s, there has
been a substantial effort to identify carbapenem antibiot-
ics with improved pharmacokinetics while retaining a
broad spectrum of activity. The introduction of a â-methyl
substituent to the carbapenem nucleus proved to be a
key advance in achieving this goal.6 Meropenem, discov-
ered at Sumitomo Pharmaceuticals, was the first car-
bapenem antibiotic to be developed for clinical use as
single agent therapy.7 Multiple daily dosing, however,
was still required.
Ertapenem sodium8 is a new broad-spectrum carbap-
enem antibiotic that has demonstrated efficacy against
the growing number of cephalosporin-resistant bacteria.9
In clinical trials, the antibiotic showed an improved
pharmacokinetic profile in comparison with other car-
bapenems allowing single agent therapy and once-daily
dosing.10 Ertapenem sodium is the active ingredient in
INVANZ which was recently approved in the United
States as an IV or IM treatment for moderate to severe
upper and lower respiratory tract, urinary tract, skin,
obstetric, and gynecologic infections. While the â-methyl
carbapenems clearly represent a significant advance in
(5) Norrby, S. R.; Alestig, K.; Bjornegard, B.; Burman, L. A.; Ferber,
F.; Huber, J. L.; Jones, K. H.; Kahan, F. M.; Kahan, J. S.; Kropp, H.;
Meisinger, M. A.; Sundelof, J. G. Antimicrob. Agents Chemother. 1983,
23, 300-7.
(6) Shih, D. H.; Baker, F.; Cama, L.; Christensen, B. G. Heterocycles
1984, 21, 29-40.
(7) (a) Sunagawa, M.; Matsumura, H.; Inoue, T.; Fukasawa, M.;
Kato, M. J. Antibiot. (Tokyo) 1990, 43, 519-32. (b) Sunagawa, M.;
Matsumura, H.; Inoue, T.; Fukasawa, M.; Kato, M. J. Antibiot. (Tokyo)
1991, 44, 459-62. (c) Fukasawa, M.; Sumita, Y.; Harabe, E. T.; Tanio,
T.; Nouda, H.; Kohzuki, T.; Okuda, T.; Matsumura, H.; Sunagawa, M.
Antimicrob. Agents Chemother. 1992, 36, 1577-9.
(8) Ertapenem was discovered at Zeneca Pharmaceuticals (now
AstraZeneca) and was licenced by Merck. Betts, M. J.; Davies, G. M.;
Swain, M. L. Antibiotic Compounds. U.S. Patent 5,478,820, 1995.
(9) (a) Jones, R. N. J. Chemother. 2001, 13, 363-76. (b) Hilliard, N.
J.; Johnson, C. N.; Armstrong, S. H.; Quarles, S.; Waites, K. B. Int. J.
Antimicrob. Agents 2002, 20, 136-40.
Recognizing the limitations that product stability
would impose on purification and isolation of the product,
(11) For a recent review covering synthesis of carbapenems, see:
Singh, G. S. Mini-Rev. Med. Chem. 2004, 4, 69-92. A scaleable
procedure for preparation of the carbapenem doripenem, avoiding
chromatographic purification, was recently reported: Nishino, Y.;
Kobayashi, M.; Shinno, T.; Izumi, K.; Yonezawa, H.; Masui, Y.;
Takahira, M. Org. Process Res. Dev. 2003, 7, 846-850.
(12) Crocker, L. S.; Wang, Y.; McCauley, J. A. Org. Process Res. Dev.
2001, 5, 77-79.
(13) Sajonz, P.; Natishan, T. K.; Wu, Y.; Williams, J. M.; Pipik, B.;
DiMichele, L.; Novak, T.; Pitzenberger, S.; Dubost, D.; Almarsson, O¨ .
J. Liq. Chrom. Relat. Technol. 2001, 24, 2999-3015.
(14) Takeuchi, Y.; Sunagawa, M.; Isobe, Y.; Hamazume, Y.; Noguchi,
T. Chem. Pharm. Bull. 1995, 43, 689.
(10) Gill, C. J.; Jackson, J. J.; Gerckens, L. S.; Pelak, B. A.;
Thompson, R. K.; Sundelof, J. G.; Kropp, H.; Rosen, H. Antimicrob.
Agents Chemother. 1998, 42, 1996-2001. (b) Majumdar, A. K.; Musson,
D. G.; Birk, K. L.; Kitchen, C. J.; Holland, S.; McCrea, J.; Mistry, G.;
Hesney, M.; Xi, L.; Li, S. X.; Haesen, R.; Blum, R. A.; Lins, R. L.;
Greenberg, H.; Waldman, S.; Deutsch, P.; Rogers, J. D. Antimicrob.
Agents Chemother. 2002, 46, 3506-11.
(15) An anhydride has been proposed as an intermediate in the
bimolecular degradation of imipenem: (a) Smith, G. B.; Schoenewaldt,
E. F. J. Pharm. Sci. 1981, 70, 272-6. (b) Ratcliffe, R. W.; Wildonger,
K. J.; DiMichele, L.; Douglas, A. W.; Hajdu, R.; Goegelman, R. T.;
Springer, J. P.; Hirshfield, J. J. Org. Chem. 1989, 54, 653-660. (c)
Smith, G. B.; Dezeny, G. C.; Douglas, A. W. J. Pharm. Sci. 1990, 79,
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