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

Objective: To review the efficacy and safety of gepotidacin for the treatment of uncomplicated urinary tract infections (uUTIs).

Data sources: A literature search was performed using PubMed and Google Scholar (both January 2010 to March 2025) with the search terms gepotidacin and GSK2140944. Other resources included conference abstracts, the manufacturer's web site, and prescribing information.

Study selection and data extraction: All relevant English-language studies assessing gepotidacin efficacy and safety for the treatment of uUTIs were included.

Data synthesis: Gepotidacin is a first-in-class triazaacenaphthylene antibiotic with a novel mechanism of action that is active against strains of Escherichia coli resistant to other classes of antibiotics, including the fluoroquinolones. Gepotidacin was non-inferior to nitrofurantoin in the treatment of healthy, non-pregnant females aged 12 years and older with uUTIs. Gastrointestinal effects are the most common adverse effects, and it has several potential drug-drug interactions. Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs Gepotidacin has been directly compared to nitrofurantoin for the treatment of uUTIs, but not to other commonly used drugs, such as trimethoprim/sulfamethoxazole, fosfomycin, beta-lactams, and fluoroquinolones. However, it may be active against organisms resistant to these traditionally used agents due to its novel mechanism of action, making it an attractive option for patients with UTIs due to multidrug-resistant organisms. It should be administered with food to help decrease gastrointestinal-related adverse effects.

Conclusions: Gepotidacin is an antibiotic with a novel mechanism of action that is efficacious in the treatment of women with uUTIs caused by common uropathogens, including resistant strains.