---
title: "In vitro activity of gepotidacin combinations against Neisseria gonorrhoeae isolates"
id: "pubmed-42390436"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42390436"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42390436/"
doi: "10.1128/aac.00059-26"
published_at: "2026-08-05T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# In vitro activity of gepotidacin combinations against Neisseria gonorrhoeae isolates
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42390436
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42390436/)
- **DOI:** [10.1128/aac.00059-26](https://doi.org/10.1128%2Faac.00059-26)
- **Published At:** 2026-08-05T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This in vitro study assessed the effect of combining **gepotidacin** with other antimicrobials against six World Health Organization (WHO) Neisseria gonorrhoeae reference strains plus QC strain ATCC 49226 using **checkerboard assays** in Graver-Wade broth. - Comparator agents included **azithromycin**, **cefixime**, **ceftriaxone**, **gemifloxacin**, **sitafloxacin**, **gentamicin**, **spectinomycin**, **doxycycline**, and **lefamulin**. - Interactions were evaluated by calculating fractional inhibitory concentration (FIC) values for each drug and the fractional inhibitory concentration index (FICI) for each combination. - FICI analysis found no **synergistic** or **antagonistic** interactions between gepotidacin and the tested agents across the panel of strains. - Analysis of individual FIC values, however, identified **strain- and agent-specific** synergistic or additive effects for certain pairings, indicating heterogeneity depending on isolate and partner drug. - The study used Graver-Wade broth for checkerboard testing; specific numerical FIC/FICI results, MICs, and which strain-agent pairs showed synergy or additivity were not reported in the abstract. - Authors and affiliations: Laboratory Specialists, Inc. (L.M. Koeth, J. DiFranco-Franco) and GSK Infectious Diseases Research Unit (J. West, N.E. Scangarella-Oman). GSK provided financial support for the study and manuscript preparation; two authors are GSK employees. - Publication details: Antimicrobial Agents and Chemotherapy. 2026 Aug 5;70(8):e0005926. DOI 10.1128/aac.00059-26. PubMed ID 42390436. - Keywords listed in the source: **N. gonorrhoeae**; antibacterial agent; antimicrobial susceptibility testing; **checkerboard assay**; gepotidacin. - The abstract summarizes methods and high-level outcomes only; full numerical data and detailed pairwise results were not reported in the source abstract.
## Clinical Analysis & Structured Key Points
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Epub 2026 Jul 2. # _In vitro_ antibacterial activity of gepotidacin in combination with other antimicrobial agents against _Neisseria gonorrhoeae_ isolates [Laura M Koeth](https://pubmed.ncbi.nlm.nih.gov/?term=Koeth+LM&cauthor_id=42390436)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#full-view-affiliation-1 "Laboratory Specialists, Inc., Westlake, Ohio, USA."), [Jeanna DiFranco-Franco](https://pubmed.ncbi.nlm.nih.gov/?term=DiFranco-Franco+J&cauthor_id=42390436)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#full-view-affiliation-1 "Laboratory Specialists, Inc., Westlake, Ohio, USA."), [Josh West](https://pubmed.ncbi.nlm.nih.gov/?term=West+J&cauthor_id=42390436)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#full-view-affiliation-2 "Infectious Diseases Research Unit, GSK, Collegeville, Pennsylvania, USA."), [Nicole E Scangarella-Oman](https://pubmed.ncbi.nlm.nih.gov/?term=Scangarella-Oman+NE&cauthor_id=42390436)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#full-view-affiliation-2 "Infectious Diseases Research Unit, GSK, Collegeville, Pennsylvania, USA.") Affiliations Expand ### Affiliations * 1 Laboratory Specialists, Inc., Westlake, Ohio, USA. * 2 Infectious Diseases Research Unit, GSK, Collegeville, Pennsylvania, USA. * PMID: **42390436** * DOI: [ 10.1128/aac.00059-26 ](https://doi.org/10.1128/aac.00059-26) Item in Clipboard # _In vitro_ antibacterial activity of gepotidacin in combination with other antimicrobial agents against _Neisseria gonorrhoeae_ isolates Laura M Koeth et al. Antimicrob Agents Chemother. 2026. Show details Display options Display options Format Abstract PubMed PMID Antimicrob Agents Chemother Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antimicrob+Agents+Chemother%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Antimicrob+Agents+Chemother%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42390436/) . 2026 Aug 5;70(8):e0005926. doi: 10.1128/aac.00059-26. Epub 2026 Jul 2. ### Authors [Laura M Koeth](https://pubmed.ncbi.nlm.nih.gov/?term=Koeth+LM&cauthor_id=42390436)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#short-view-affiliation-1 "Laboratory Specialists, Inc., Westlake, Ohio, USA."), [Jeanna DiFranco-Franco](https://pubmed.ncbi.nlm.nih.gov/?term=DiFranco-Franco+J&cauthor_id=42390436)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#short-view-affiliation-1 "Laboratory Specialists, Inc., Westlake, Ohio, USA."), [Josh West](https://pubmed.ncbi.nlm.nih.gov/?term=West+J&cauthor_id=42390436)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#short-view-affiliation-2 "Infectious Diseases Research Unit, GSK, Collegeville, Pennsylvania, USA."), [Nicole E Scangarella-Oman](https://pubmed.ncbi.nlm.nih.gov/?term=Scangarella-Oman+NE&cauthor_id=42390436)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42390436/#short-view-affiliation-2 "Infectious Diseases Research Unit, GSK, Collegeville, Pennsylvania, USA.") ### Affiliations * 1 Laboratory Specialists, Inc., Westlake, Ohio, USA. * 2 Infectious Diseases Research Unit, GSK, Collegeville, Pennsylvania, USA. * PMID: **42390436** * DOI: [ 10.1128/aac.00059-26 ](https://doi.org/10.1128/aac.00059-26) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract This study was conducted to determine the potential effect of other antimicrobial agents on the in vitro activity of gepotidacin against six WHO _N. gonorrhoeae and_ QC strain ATCC 49226 by checkerboard assays using Graver-Wade broth. Synergy and antagonism were evaluated using fractional inhibitory concentration (FIC) and FIC index (FICI) results for gepotidacin and comparator agents (azithromycin, cefixime, ceftriaxone, gemifloxacin, sitafloxacin, gentamicin, spectinomycin, doxycycline, and lefamulin). The evaluation of FICI showed no antagonistic or synergistic interactions, while the evaluation of individual FIC values revealed strain- and agent-specific synergistic or additive effects. **Keywords:** N. gonorrhoeae; antibacterial agent; antimicrobial susceptibility testing; checkerboard assay; gepotidacin. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement N.E.S.-O. and J.W. are employees of the GSK group of companies. L.M.K. and J.D.-F. are employees of Laboratory Specialists, Inc., Laboratory Specialists, Inc. received financial support from GSK for the conduct of the study and manuscript preparation. ## Similar articles * [ In vitro efficacy of 21 dual antimicrobial combinations comprising novel and currently recommended combinations for treatment of drug resistant gonorrhoea in future era. ](https://pubmed.ncbi.nlm.nih.gov/29509792/) Singh V, Bala M, Bhargava A, Kakran M, Bhatnagar R.Singh V, et al.PLoS One. 2018 Mar 6;13(3):e0193678. doi: 10.1371/journal.pone.0193678. eCollection 2018.PLoS One. 2018.PMID: 29509792Free PMC article. * [_In Vitro_ Efficacy of Gentamicin Alone and in Combination with Ceftriaxone, Ertapenem, and Azithromycin against Multidrug-Resistant Neisseria gonorrhoeae. ](https://pubmed.ncbi.nlm.nih.gov/34668731/) Li X, Le W, Lou X, Wang B, Genco CA, Rice PA, Su X.Li X, et al.Microbiol Spectr. 2021 Oct 31;9(2):e0018121. doi: 10.1128/Spectrum.00181-21. Epub 2021 Oct 20.Microbiol Spectr. 2021.PMID: 34668731Free PMC article. * [_In Vitro_ Activity of Gepotidacin (GSK2140944) against Neisseria gonorrhoeae. ](https://pubmed.ncbi.nlm.nih.gov/28069643/) Farrell DJ, Sader HS, Rhomberg PR, Scangarella-Oman NE, Flamm RK.Farrell DJ, et al.Antimicrob Agents Chemother. 2017 Feb 23;61(3):e02047-16. doi: 10.1128/AAC.02047-16. Print 2017 Mar.Antimicrob Agents Chemother. 2017.PMID: 28069643Free PMC article. * [ In vitro activity of tigecycline alone and antimicrobial combinations against clinical Neisseria gonorrhoeae isolates. ](https://pubmed.ncbi.nlm.nih.gov/27890419/) Lee H, Kim H, Seo YH, Yong D, Jeong SH, Lee K, Chong Y.Lee H, et al.Diagn Microbiol Infect Dis. 2017 Feb;87(2):160-162. doi: 10.1016/j.diagmicrobio.2016.10.022. 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