Zoliflodacin show promise against drug resistant infection urogenital gonorrhoea

Luckey et al., 2025(The Lancet): An international, randomised, controlled, open-label, phase 3, non-inferiority clinical trial was conducted. The study evaluated the efficacy and safety of zoliflodacin versus ceftriaxone plus azithromycin in patients aged 12 years and older with clinical suspicion of uncomplicated urogenital gonorrhoea. Eligible participants were randomly assigned (2:1) to receive a single dose of zoliflodacin 3 g (oral) or ceftriaxone 500 mg (intramuscular) plus azithromycin 1 g (oral). Microbiological cure rates at test of cure in the microbiological intention-to-treat (urogenital) population were 460 of 506 participants for zoliflodacin and 229 of 238 participants for comparator. The estimated difference between groups was 5·3% and the upper confidence interval limit were within the prespecified non-inferiority margin of less than 12%. Zoliflodacin was generally well tolerated and adverse events were similar between treatment groups. No serious adverse events were reported. Data suggest a potential role for zoliflodacin as an effective oral treatment option for uncomplicated urogenital gonorrhoea.