Oral gepotidacin versus nitrofurantoin in patients with uncomplicated urinary tract infection (EAGLE-2 and EAGLE-3): two randomised, controlled, double-blind, double-dummy, phase 3, non-inferiority trials

First-in-class triazaacenaphthylene antibiotic was non-inferior to nitrofurantoin in terms of therapeutic success in both EAGLE-2 (50.6% v 47.0%) and EAGLE-3 (58.5% v 43.6%) and superior to nitrofurantoin in EAGLE-3 (adjusted difference 14.6%, 95% CI 6.4 to 22.8).

SPS commentary:

Related editorial notes gepotidacin selectively inhibits bacterial DNA replication by interaction with the bacterial subunits of DNA gyrase and topoisomerase IV. It has shown potent activity against a wide range of uropathogens in previous non-clinical studies, including those resistant to other antibiotics. It notes these study findings provide strong evidence that it is an effective and safe oral antibiotic for the treatment of uncomplicated urinary tract infections, with the potential to be a valuable new treatment, particularly among patients who are intolerant or resistant to other treatments.

The Lancet

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