Novel bacterial topoisomerase inhibitors
(NBTIs) are among the
most promising new antibiotics in preclinical/clinical development.
We previously reported dioxane-linked NBTIs with potent antistaphylococcal
activity and reduced hERG inhibition, a key safety liability. Herein,
polarity-focused optimization enabled the delineation of clear structure–property
relationships for both microsomal metabolic stability and hERG inhibition,
resulting in the identification of lead compound 79.
This molecule demonstrates potent antibacterial activity against diverse
Gram-positive pathogens, inhibition of both DNA gyrase and topoisomerase
IV, a low frequency of resistance, a favorable in vitro cardiovascular safety profile, and in vivo efficacy
in a murine model of methicillin-resistant Staphylococcus
aureus infection.