In vitro activity of levonadifloxacin, the active drug of orally administered prodrug alalevonadifloxacin against bloodstream isolates of Burkholderia pseudomallei

Eradication of Burkholderia pseudomallei infections requires prolonged antibiotic treatment indicating microbiological and pharmacokinetic limitations of current options. Levonadifloxacin, a novel benzoquinolizine-fluoroquinolone available intravenously and orally, showed greater activity than ciprofloxacin (MICs, 0.25 to 2 versus 0.25–8 mg/L) and comparable to doxycycline against 50 B.pseudomallei isolates. In time-kill assay, levonadifloxacin exerted rapid ∼3 log10 reduction while doxycycline was bacteriostatic. Levonadifloxacin merits further investigations as a potential treatment option for B. pseudomallei infections.