Oral Gepotidacin: A Promising Antibiotic for Management of Uncomplicated Urinary Tract Infection

In two randomized, controlled trials, gepotidacin was noninferior to nitrofurantoin in the treatment of female patients with uncomplicated UTI.

Gepotidacin, a first-in-class triazaacenaphthylene antibiotic, inhibits bacterial DNA replication by inhibiting both DNA gyrase and topoisomerase IV. Gepotidacin has broad-spectrum bactericidal coverage (including Enterobacterales) without cross-resistance to fluoroquinolones; thus, it is being studied as a treatment for uncomplicated urinary tract infection (UTI). Wagenlehner et al. conducted two phase 3, randomized, double-blind noninferiority trials (EAGLE-2 and EAGLE-3) comparing gepotidacin and nitrofurantoin in female participants aged ≥12 years with nitrofurantoin-susceptible pathogens (>10⁵ CFU/mL). Therapeutic success, defined as combined symptom resolution and reduction in uropathogens to <10³ CFU/mL, was assessed at the test-of-c…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases

Oral Gepotidacin: A Promising Antibiotic for Management of Uncomplicated Urinary Tract Infection

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Reviewing Author