Recent advances in the exploration of oxazolidinone scaffolds from compound development to antibacterial agents and other bioactivities

Bacterial infections cause a variety of life-threatening diseases, and the continuous evolution of drug-resistant bacteria poses an increasing threat to current antimicrobial regimens. Gram-positive bacteria (GPB) have a wide range of genetic capabilities that allow them to adapt to and develop resistance to practically all existing antibiotics. Oxazolidinones, a class of potent bacterial protein synthesis inhibitors with a unique mechanism of action involving inhibition of bacterial ribosomal translation, has emerged as the antibiotics of choice for the treatment of drug-resistant GPB infections. In this review, we discussed the oxazolidinone antibiotics that are currently on the market and in clinical development, as well as an updated synopsis of current advances on their analogues, with an emphasis on innovative strategies for structural optimization of linezolid, structure-activity relationship (SAR), and safety properties. We also discussed recent efforts aimed at extending the activity of oxazolidinones to gram-negative bacteria (GNB), antitumor, and coagulation factor Xa. Oxazolidinone antibiotics can accumulate in GNB by a conjugation to siderophore-mediated β-lactamase-triggered release, making them effective against GNB. [Display omitted] •Oxazolidinone antibiotics have become the treatment of choice for infections caused by Gram-positive bacteria (GPB).•Oxazolidinones 5a, 12f, 14h, 20c, 22h, 37a, and 40a exhibited potent anti-GPB activity.•Siderophore-cephalosporin-oxazolidinone conjugate 75 demonstrated excellent activity against Gram-negative bacteria.•Tricyclic fused oxazolidinone (82a) demonstrated potent anticoagulation factor Xa activity.•Antiproliferative oxazolidinone 96f demonstrated potent activity against mutant isocitrate dehydrogenase 1 (mIDH1).