In vitro activity of gepotidacin against urine isolates of Escherichia coli from outpatient departments in Germany.

This article focuses on the in vitro activity of gepotidacin, a novel oral antibiotic, against Escherichia coli urine isolates from outpatients in Germany, including strains resistant to standard oral antibiotics. Gepotidacin, a first-in-class triazaacenaphthylene bacterial type II topoisomerase inhibitor, demonstrated consistent minimum inhibitory concentration (MIC) values (MIC50/90 of 2/4 mg/L) across ciprofloxacin-resistant, extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant (MDR), and other resistant E. coli subsets. The study tested 460 isolates collected from 23 laboratories, finding that gepotidacin's activity was unaffected by resistance to commonly used oral antibiotics such as fosfomycin, mecillinam, and nitrofurantoin. These findings suggest gepotidacin may offer a promising oral treatment option for uncomplicated urinary tract infections, particularly in cases involving antibiotic-resistant E. coli.