. Author manuscript; available in PMC: 2021 Apr 12.

Published in final edited form as: Lancet Infect Dis. 2020 Jun 19;20(8):e181–e191. doi: 10.1016/S1473-3099(20)30171-7

Table:

Potential future antimicrobials for Neisseria gonorrhoeae, Mycoplasma genitalium, or Trichomonas vaginalis

	Class	Validated activity	Resistance mutations	Clinical study	Availability
Zoliflodacin^66,67	Spiropyrimidinetrione (topoisomerase II inhibitor)	N gonorrhoeae, M genitalium, C trachomatis	GyrB Asp429Ala^, Asp429Asn^, Asp450Asn^, Asp 450Thr^	Phase 3 clinical trial initiated in 2019 (gonorrhoea)	Not yet available
Gepotidacin^68-70	Triazaacenaphthylene (topoisomerase II inhibitor)	N gonorrhoeae, M genitalium	ParC Asp86Asn^† GyrA Ala92Thr^†	Phase 2 clinical trial finished (gonorrhoea)	Not yet available
Solithromycin^71,72	Fluoroketolide	N gonorrhoeae, M genitalium, C trachomatis	Ala2058Gly^†, Ala2059Gly^† in 23S rRNA	Phase 3 clinical trial finished (gonorrhoea)	Not yet available
Lefamulin^73,74	Pleuromutilin	N gonorrhoeae, M genitalium, C trachomatis	None reported	In vitro only	Not yet available
Pristinamycin^75,76	Streptogramin	M genitalium	None reported	Prospective cohort	Europe, Australia (special access)
Sitafloxacin^77,78	Fourth-generation fluoroquinolone	M genitalium, N gonorrhoeae, C trachomatis	Affected by conventional fluoroquinolone resistance mutations	Prospective cohort	Japan
Secnidazole⁷⁹	Nitroimidazole	T vaginalis	None reported	Phase 3 clinical trial ongoing (trichomoniasis)	Not yet available

Induced or selected in laboratory strains.

^†

Identified in clinical strains.