Quinolones that act equally against DNA gyrase and topoisomerase IV are a desirable modality to decrease the selection of resistant strains. We first determined by genetic and biochemical studies in Staphylococcus aureus that the primary target enzyme of WCK-1734, a new quinolone, was DNA gyrase. A single mutation in gyrase, but not topoisomerase IV, caused a two-to fourfold increase in the MIC. Studies with purified topoisomerase IV and gyrase from S. aureus also showed that gyrase was more sensitive than topoisomerase IV to WCK-1734 (50% inhibitory concentration, 1.25 and 2.5 to 5.0 g/ml, respectively; 50% stimulation of cleavage complex formation, 0.62 and 2.5 to 5.0 g/ml, respectively). To test the effect of balanced activity of quinolones against the two target enzymes, we measured the frequency of selection of mutants with ciprofloxacin (which targets topoisomerase IV) and WCK-1734 alone and in combination. With the combination of ciprofloxacin and WCK-1734, each at its MIC, the ratio of frequency of mutants selected was significantly lower than that with each drug alone at two times their respective MICs. We further characterized resistant strains selected with the combination of ciprofloxacin and WCK-1734 and found evidence to suggest the existence of novel mutational mechanisms for low-level quinolone resistance. By use of a combination of differentially targeting quinolones, this study provides novel data in direct support of the paradigm for dual targeting of quinolone action and reduced development of resistance.Type II DNA topoisomerases, DNA gyrase and topoisomerase IV (TopoIV), are essential enzymes that regulate changes in DNA topology by catalyzing the concerted breakage and rejoining of DNA strands during normal cellular growth. They catalyze the relaxation of supercoiled DNA, catenation and decatenation of DNA rings, and knotting and unknotting of duplex DNA (37). DNA gyrase is unique in its ability to catalyze negative DNA supercoiling. Gyrase and TopoIV are heterotetramers of GyrA 2 GyrB 2 and ParC 2 ParE 2 , respectively. GyrA and ParC are the subunits responsible for DNA binding and the cleavage and religation reaction, and GyrB and ParE are responsible for ATP binding and hydrolysis (22).Quinolones act by forming ternary complexes with DNA and either DNA gyrase or TopoIV, thereby blocking DNA replication and triggering events leading to cell death (5, 12). Quinolone resistance occurs stepwise by mutations in the two topoisomerase target enzymes, with the first mutation generally occurring in the more sensitive enzyme (13). From the firststep mutants second-step double mutants can then be selected with resistance mutations in the second target enzyme, thereby conferring a high-level resistance phenotype (1,7,21). If the original sensitivities of both DNA gyrase and TopoIV were the same (i.e., dual targeting), no single mutational alteration in either enzyme would result in an increase in the MIC (11,25). Resistance would require, instead, concurrent alteration in both enzymes. Because spon...