High In Vitro Susceptibility To The First-In-Class Spiropyrimidinetrione Zoliflodacin Among Consecutive Clinical Neisseria Gonorrhoeae Isolates From Thailand And South Africa

We evaluated the in vitro susceptibility to the first-in-class spiropyrimidinetrione zoliflodacin among recent consecutive clinical Neisseria gonorrhoeae isolates cultured in Thailand (n = 99) (in 2018) and South Africa (n = 100) (in 2015 to 2017). Zoliflodacin was highly active in vitro against all tested isolates (MIC range, 0.004 to 0.25 mu g/ml; MIC50 0.064 mu g/ml; MIC90, 0.125 mu g/ml), with no cross-resistance to any of the seven comparator antimicrobials. Our data support the initiation of the global phase 3 randomized controlled clinical trial of zoliflodacin for uncomplicated gonorrhea.