{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:57:38Z","timestamp":1790740658509,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004423","name":"WHO","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"name":"\u00d6rebro County Council Research Committee"},{"DOI":"10.13039\/501100002915","name":"Foundation for Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002915","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006736","name":"\u00d6rebro University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006736","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The spread of ceftriaxone-resistant Neisseria gonorrhoeae is threatening the last option for gonorrhoea treatment, ceftriaxone. Gepotidacin, the first-in-class triazaacenaphthylene bacterial topoisomerase type IIA inhibitor, recently showed non-inferiority compared to ceftriaxone-azithromycin for treatment of uncomplicated urogenital gonorrhoea in a Phase 3 randomized controlled trial. We evaluated the in vitro susceptibility to gepotidacin in clinical gonococcal isolates (n\u200a=\u200a2912), including 125 (4.3%) ceftriaxone-resistant isolates, collected 2021\u201324 in eight WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) countries in three WHO regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Isolates from Cambodia (n\u200a=\u200a474), Indonesia (n\u200a=\u200a107), Malawi (n\u200a=\u200a111), the Philippines (n\u200a=\u200a817), South Africa (n\u200a=\u200a578), Thailand (n\u200a=\u200a249), Uganda (n\u200a=\u200a342) and Vietnam (n\u200a=\u200a234) were examined. MICs of gepotidacin were determined using agar dilution. Gepotidacin target genes (gyrA and parC) were examined with Illumina sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Gepotidacin showed high in vitro activity, with MICs ranging from &amp;lt;0.016 to 4\u2005mg\/L. The modal MIC was 0.5\u2005mg\/L, MIC\u2085\u2080 0.5\u2005mg\/L and MIC\u2089\u2080 1\u2005mg\/L. Minor variations in the MIC distributions across countries were observed. ParC D86N, which in suboptimal gepotidacin concentrations predisposes for resistance development, was found in 35.5% of isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We show that the in vitro susceptibility to gepotidacin in N. gonorrhoeae isolates, including 4.3% ceftriaxone-resistant isolates, collected 2021\u201324 in eight WHO EGASP countries, including five Asian countries, is high. Our findings support gepotidacin\u2019s continued clinical development, registration and introduction as a novel oral treatment for gonorrhoea. However, as with all new novel antimicrobials, cautious and optimal introduction, and surveillance of phenotypic and genomic susceptibility to gepotidacin internationally, pre- and post-licencing, should accompany any clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf452","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:09:13Z","timestamp":1764248953000},"source":"Crossref","is-referenced-by-count":6,"title":["High\n                    <i>in vitro<\/i>\n                    activity of the novel antimicrobial gepotidacin against\n                    <i>Neisseria gonorrhoeae<\/i>\n                    isolates in eight WHO Enhanced Gonococcal Antimicrobial Surveillance Programme countries in three WHO regions, 2021\u201324"],"prefix":"10.1093","volume":"81","author":[{"given":"Josefine","family":"Ahlstrand","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine 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