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Current therapy is pathogen-specific and weakened by antimicrobial resistance: ceftriaxone treats gonorrhea but lacks activity against C. trachomatis, while azithromycin or doxycycline target chlamydia but gonorrhea has developed resistance. Drug repurposing identified epetraborole as a potent inhibitor against both pathogens, including multidrug-resistant N. gonorrhoeae, anti-intracellular activity, limited impact on normal vaginal microbiota, and strong efficacy in a mouse genital-tract infection model.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/repurposing-epetraborole-to-combat-neisseria-gonorrhoeae-and-chlamydia-trachomatis-infections/455944/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/repurposing-epetraborole-to-combat-neisseria-gonorrhoeae-and-chlamydia-trachomatis-infections/455944.png","ImageObject",300,407,{"name":92,"@type":93},"Angel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why are current treatments for gonorrhea and chlamydia inadequate?","Question",{"text":113,"@type":114},"No single drug effectively treats both pathogens. Ceftriaxone is recommended for gonorrhea but lacks activity against C. trachomatis, while standard chlamydia drugs face resistance in N. gonorrhoeae.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is epetraborole (EBO) and how was it evaluated?",{"text":118,"@type":114},"EBO is a boron-containing compound in clinical trials for non-tuberculous mycobacterial infections. The document reports potent in vitro activity against N. gonorrhoeae and C. trachomatis, including intracellular burden reduction, and in vivo testing in a mouse model.",{"name":120,"@type":111,"acceptedAnswer":121},"What results did EBO show in comparison with current treatments?",{"text":122,"@type":114},"EBO demonstrated potent activity against multidrug-resistant N. gonorrhoeae and anti-C. trachomatis activity, eliminated intracellular burdens surpassing ceftriaxone and azithromycin, and showed limited activity against normal vaginal microbiota. In mice, EBO produced a 99.95% reduction in bacterial burden after 2 days against CRO-resistant N. gonorrhoeae.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},455944,1791033727,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},687207412472,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","| Antimicrobial Chemotherapy | Full-Length Text  \nRepurposing epetraborole to combat Neisseria gonorrhoeae and Chlamydia trachomatis infections  \nAbdallah S. Abdelsattar,1,2 Babatomiwa Kikiowo,1,2 Nader S. Abutaleb,1,2 Autumn S. Dove,1,2 Mohamed N. Seleem1,2 AUTHOR AFFILIATIONS See affiliation list on p. 16.  \nABSTRACT Neisseria gonorrhoeae and Chlamydia trachomatis are the most common bacterial sexually transmitted infections. The World Health Organization (WHO) estimates that there were approximately 211 million cases of chlamydia and gonorrhea in 2020. Currently, no single drug is effective against both pathogens. Ceftriaxone (CRO) is the only recommended treatment for gonococcal infections but has no activity against C. trachomatis. Azithromycin (AZM) or doxycycline (DOX) is recommended for C. trachomatis infections; however, N. gonorrhoeae has developed resistance to both agents. Without new therapeutic options, these infections risk becoming untreatable. Utilizing a drug repurposing approach, we identified epetraborole (EBO) as a potent inhibitor for N. gonorrhoeae and C. trachomatis. EBO is a boron-containing compound currently in clinical trials for the treatment of non-tuberculous mycobacterial infections. EBO demonstrated potent activity against multidrug-resistant N. gonorrhoeae with MIC ranging from 0.125 to 0.25 µg/mL. Additionally, EBO exhibited anti-C. trachomatis activity at concentrations of ≤ 1 µg/mL. Furthermore, EBO was capable of eliminating the intracellular burden of both N. gonorrhoeae and C. trachomatis, surpassing the activity of CRO and AZM. Moreover, unlike CRO and AZM, EBO showed limited activity against the normal vaginal microbiota. Finally, in an in vivo mouse model of CRO-resistant N. gonorrhoeae genital tract infection, EBO exhibited a 99.95% reduction in bacterial burden after 2 days of treatment. Collectively, our findings highlight EBO as a promising candidate for the treatment of sexually transmitted infections that warrants further investigation.  \nKEYWORDS epetraborole, sexually transmitted infections, antibacterial resistance, inclusion bodies, bacterial intracellular clearance, In vivo mouse model  \nS exually transmitted infections (STIs) significantly affect sexual and reproductive  \nhealth worldwide and can lead to severe complications, such as genital ulcers, maternal death, infertility, endocarditis, lower abdominal pain, arthritis, pelvic inflammatory disease, and urethral, vaginal, or anorectal discharge (1–5) . According to the World Health Organization (WHO), more than 1 million people aged 15 to 49 years require treatment for STIs every day (6) . Chlamydia trachomatis and Neisseria gonorrhoeae are the most prevalent bacterial STIs, with an estimated 129 and 82 million new cases, respectively, in 2020 (7, 8) .  \nC. trachomatis is an obligate intracellular bacterium with two established phases, non-replicating elementary bodies that attach and initiate the infection, and reticulate bodies that replicate and form inclusions (9–11) . Once internalized, the elementary body differentiates into the reticulate body, which then replicates inside the host cell, forming an inclusion. These new reticulate bodies will eventually undergo secondary differentiation into elementary bodies, which can infect other cells (12, 13) . C. trachomatis infections are often treated with the broad-spectrum antibiotics doxycycline (DOX), azithromycin (AZM), and levofloxacin. Yet, reports of treatment failures have increased,  \nEditor Vincent H. Tam, University of Houston, Houston, Texas, USA  \nAddress correspondence to Mohamed N. Seleem, [naguieb@vt.edu](naguieb@vt.edu).  \nincluding reports of repeated infections (14–19) . For instance, the efficacy rate of AZM against rectal Chlamydia infections in men is only 74%(20), and the re-infection rate for C. trachomatis-infected women treated with AZM ranges from 18% to 34%(21, 22) . Furthermore, C. trachomatis can develop mutations in the 23S rRNA, inducing re","cbCaivwmksCrBBUT","https://ap.wps.com/l/cbCaivwmksCrBBUT","pdf",947942,"English","# Abstract\n# Background on sexually transmitted infections\n## Chlamydia trachomatis biology and treatment challenges\n## Neisseria gonorrhoeae biology and treatment challenges\n## Co-infections and persistence-like states","[{\"question\":\"Why are current treatments for gonorrhea and chlamydia inadequate?\",\"answer\":\"No single drug effectively treats both pathogens. Ceftriaxone is recommended for gonorrhea but lacks activity against C. trachomatis, while standard chlamydia drugs face resistance in N. gonorrhoeae.\"},{\"question\":\"What is epetraborole (EBO) and how was it evaluated?\",\"answer\":\"EBO is a boron-containing compound in clinical trials for non-tuberculous mycobacterial infections. The document reports potent in vitro activity against N. gonorrhoeae and C. trachomatis, including intracellular burden reduction, and in vivo testing in a mouse model.\"},{\"question\":\"What results did EBO show in comparison with current treatments?\",\"answer\":\"EBO demonstrated potent activity against multidrug-resistant N. gonorrhoeae and anti-C. trachomatis activity, eliminated intracellular burdens surpassing ceftriaxone and azithromycin, and showed limited activity against normal vaginal microbiota. In mice, EBO produced a 99.95% reduction in bacterial burden after 2 days against CRO-resistant N. gonorrhoeae.\"}]","Repurposing epetraborole to combat Neisseria gonorrhoeae and Chlamydia trachomatis infections | PDF",1790744742,48]