Gepotidacin: A Novel Antibiotic for the Treatment of Uncomplicated Urinary Tract Infections.

This article reviews the efficacy and safety of gepotidacin, a first-in-class triazaacenaphthylene antibiotic with a novel mechanism of action, for treating uncomplicated urinary tract infections (uUTIs). Gepotidacin has demonstrated non-inferiority to nitrofurantoin in clinical trials involving non-pregnant females aged 12 and older, showing potent activity against common uropathogens including multidrug-resistant and extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli strains. Gastrointestinal adverse effects are the most common side effects, which can be mitigated by administering the drug with food, and potential drug interactions exist due to its metabolism via CYP3A4. Approved for oral use at 1500 mg twice daily for five days, gepotidacin offers a promising alternative for uUTIs caused by resistant organisms, though its role relative to other antibiotics beyond nitrofurantoin requires further study.