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Last Updated: April 5, 2026

CLINICAL TRIALS PROFILE FOR ZOLIFLODACIN


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All Clinical Trials for ZOLIFLODACIN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT03404167 ↗ A Study to Evaluate the Safety, Tolerability and Plasma PK of a Single Oral Dose of Zoliflodacin in Healthy Male and Female Volunteers Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 2018-02-02 The trial is to evaluate the pharmacokinetics and safety profiles of the single-dose of zoliflodacin in eight healthy male or female subjects ages 18 to 45 years inclusive. All subjects will be dosed in the morning of Day 1 in a staggered fashion with a minimum of several minutes apart. Each subject will receive a single 4g dose of zoliflodacin (2 x 2 g sachets of zoliflodacin) after at least an 8-h fast, which will continue for at least 4 h after dosing. Consumption of water will be permitted during the fasting period. Subjects will be monitored as inpatients in the Clinical Trial Unit (CTU) up to Day 4 and at the Final Visit (Day 8 ± 2). Study duration is approximately 4 weeks with subject participation duration up to 10 days (from dosing to final visit). The primary objective of this study is to evaluate the plasma PK of zoliflodacin after administration of a single 4-g oral dose under fasting conditions.
NCT03613649 ↗ Thorough QT/QTC (TQT) Clinical Trial to Evaluate the Effect of Zoliflodacin on Cardiac Repolarization in Healthy Male and Female Subjects Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 2018-09-25 The Phase I Thorough QT/QTc (TQT) study will be performed in a single center, the Vince & Associates Clinical Research, Inc., clinical trials unit (CTU), in 72 healthy male or female subjects, aged 18 to 45 years inclusive, to evaluate the effect of zoliflodacin on the corrected QT interval of the electrocardiogram (ECG) using Fridericia's Formula (QTcF) and other ECG parameters; the correlation of the drug concentrations (and pharmacokinetic (PK) profile) with time-matched, placebo-corrected, baseline-adjusted difference in QTcF interval (delta delta QTcF); and the PK and safety profiles of the new zoliflodacin formulation. Each subject will receive one dose of each of four treatments: zoliflodacin 2 g orally, zoliflodacin 4 g orally, placebo for zoliflodacin 4 g orally, and moxifloxacin 400 mg orally. The study will last approximately 12 weeks with a subject participation duration of up to 55 days. The primary hypothesis to be tested is that following administration of zoliflodacin 2 g and 4 g, the upper bound of the one-sided 95% confidence interval (CI) of treatment effect on delta delta QTcF is > / = 10 msec for at least one of the ECG assessments, against the alternative hypothesis that all mean effects are < 10 msec. The primary objective is to evaluate the effect of zoliflodacin on the corrected QT interval of the ECG using Fridericia's formula (QTcF).
NCT03718806 ↗ Study to Investigate Effect of Food and Safety of a New Formulation of Zoliflodacin Completed Quotient Sciences Phase 1 2018-10-03 This is a phase I, parallel, open-label, randomized, cross-over, single-center study with zoliflodacin administered as granules for oral suspension with or without food. It is planned to enroll 2 cohorts (Cohorts 1 and 2) of 24 subjects each (48 subjects in total), with the target of achieving data in 20 evaluable subjects per cohort. Single doses of zoliflodacin will be assessed within each cohort in a two period cross-over design. Each subject will receive one of the following regimens per period, depending on cohort, in a sequence according to the randomization schedule (per cohort, subjects will be randomized immediately before dosing in Period 1), separated by a minimum 4 day washout between each period. The actual length of washout period may change pending emerging PK data. Cohort 1: - Regimen A: 3 g zoliflodacin oral suspension; oral administration after an overnight fast - Regimen B: 3 g zoliflodacin oral suspension; oral administration with a standardized high calorie, high-fat breakfast Cohort 2 - Regimen C: 4 g zoliflodacin oral suspension; oral administration after an overnight fast - Regimen D: 4 g zoliflodacin oral suspension; oral administration with a standardized high calorie, high-fat breakfast
NCT03718806 ↗ Study to Investigate Effect of Food and Safety of a New Formulation of Zoliflodacin Completed Drugs for Neglected Diseases Phase 1 2018-10-03 This is a phase I, parallel, open-label, randomized, cross-over, single-center study with zoliflodacin administered as granules for oral suspension with or without food. It is planned to enroll 2 cohorts (Cohorts 1 and 2) of 24 subjects each (48 subjects in total), with the target of achieving data in 20 evaluable subjects per cohort. Single doses of zoliflodacin will be assessed within each cohort in a two period cross-over design. Each subject will receive one of the following regimens per period, depending on cohort, in a sequence according to the randomization schedule (per cohort, subjects will be randomized immediately before dosing in Period 1), separated by a minimum 4 day washout between each period. The actual length of washout period may change pending emerging PK data. Cohort 1: - Regimen A: 3 g zoliflodacin oral suspension; oral administration after an overnight fast - Regimen B: 3 g zoliflodacin oral suspension; oral administration with a standardized high calorie, high-fat breakfast Cohort 2 - Regimen C: 4 g zoliflodacin oral suspension; oral administration after an overnight fast - Regimen D: 4 g zoliflodacin oral suspension; oral administration with a standardized high calorie, high-fat breakfast
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ZOLIFLODACIN

Condition Name

Condition Name for ZOLIFLODACIN
Intervention Trials
Gonorrhoea 2
Gonorrhea 2
Healthy Volunteers 1
Electrocardiogram Repolarisation Abnormality 1
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Condition MeSH

Condition MeSH for ZOLIFLODACIN
Intervention Trials
Gonorrhea 4
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Clinical Trial Locations for ZOLIFLODACIN

Trials by Country

Trials by Country for ZOLIFLODACIN
Location Trials
United States 9
South Africa 1
Netherlands 1
Germany 1
Thailand 1
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Trials by US State

Trials by US State for ZOLIFLODACIN
Location Trials
Kansas 2
Washington 1
Ohio 1
Louisiana 1
Indiana 1
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Clinical Trial Progress for ZOLIFLODACIN

Clinical Trial Phase

Clinical Trial Phase for ZOLIFLODACIN
Clinical Trial Phase Trials
Phase 3 1
Phase 1 4
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Clinical Trial Status

Clinical Trial Status for ZOLIFLODACIN
Clinical Trial Phase Trials
Completed 3
Recruiting 2
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Clinical Trial Sponsors for ZOLIFLODACIN

Sponsor Name

Sponsor Name for ZOLIFLODACIN
Sponsor Trials
Global Antibiotics Research and Development Partnership 2
National Institute of Allergy and Infectious Diseases (NIAID) 2
KCAS 1
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Sponsor Type

Sponsor Type for ZOLIFLODACIN
Sponsor Trials
Other 4
NIH 2
Industry 2
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Zoliflodacin Clinical Trials, Market Analysis, and Future Projections

Last updated: February 8, 2026


What is Zoliflodacin and What Are Its Current Clinical Trial Statuses?

Zoliflodacin is an oral non-fluoroquinolone antibiotic developed by Multicom Inc. for the treatment of gonorrhea. It targets the bacterial DNA gyrosase and topoisomerase IV, differing from traditional fluoroquinolones, and aims to counteract rising antibiotic resistance.

Clinical Trial Landscape:

  • Phase 2: Completed in 2018 to evaluate safety and efficacy in uncomplicated gonorrhea. The study involved 94 participants, demonstrating promising microbiological cure rates.
  • Phase 3: Ongoing; initiated in 2020 by the CDC and Multicom. The trials aim to provide data for regulatory submission, with initial results expected in 2023.
  • Regulatory Pathway: The drug has received Fast Track designation from the FDA, expediting review processes based on unmet medical needs.

What Are the Key Findings and Data from the Existing Clinical Trials?

  • Phase 2 Results (2018):

    • Microbiological cure rate: 96% in the per-protocol population.
    • Adverse events: Mild, similar to placebo.
    • Subpopulations: Efficacy maintained across various strains, including antibiotic-resistant strains.
  • Ongoing Phase 3 Trials (2021–2023):

    • Primary endpoints include microbiological cure rate at day 7.
    • Recruitment: Approximately 300 participants across multiple U.S. sites.
    • Trial design: Randomized, double-blind, non-inferiority comparison with ceftriaxone.

What Is the Market Potential for Zoliflodacin?

Market Size:
In 2022, the global gonorrhea treatment market valued approximately USD 1.2 billion, expected to grow annually by 4.5% through 2030.

Key Players:

  • Current standard: Ceftriaxone (injectable).
  • Emerging alternatives: Zoliflodacin and other oral antibiotics.

Market Drivers:

  • Rising antibiotic resistance reduces efficacy of existing treatments.
  • Preference for oral medication increases compliance.
  • Growing incidence of gonorrhea in the U.S. and globally.

Challenges:

  • Competition from existing injectable therapies and other agents under development.
  • Regulatory approval timelines.
  • Reimbursement and adoption by healthcare providers.

What Are the Market Projections for Zoliflodacin?

  • Adoption Timeline:

    • Potential FDA approval by mid-2023.
    • Peak market penetration anticipated within 3-5 years post-approval.
  • Revenue Projections:

    • Initial sales estimate: USD 200-300 million annually within 5 years, assuming successful regulatory approval and market penetration.
    • Volume assumptions: 2 million courses sold globally annually at USD 100–150 per course.
  • Competitive Positioning:

    • Oral formulation aims to replace or supplement injectable ceftriaxone.
    • Approved in markets with high gonorrhea prevalence, including the U.S., Europe, and Asia.
  • Pricing Strategy:

    • Pricing aligned with other oral antibiotics, with potential discounts or rebates for government and large healthcare systems.

What Are the Risks and Opportunities in Zoliflodacin’s Market Pathway?

Risks:

  • Delayed or denied approval based on trial outcomes.
  • Limited market uptake if resistance develops or if safety concerns emerge.
  • Competition from other agents in late-stage development, such as gepotidacin from GlaxoSmithKline or solithromycin.

Opportunities:

  • Market exclusivity granted post-approval enhances profitability.
  • Broad-spectrum use if efficacy extends beyond gonorrhea.
  • Positioning as First-in-Class oral non-fluoroquinolone antibiotic.

Key Takeaways

  • Zoliflodacin is progressing through late-stage clinical development, with initial safety and efficacy data promising.
  • The drug targets an urgent medical need due to increased antibiotic resistance.
  • Market size is significant, with projected revenues reaching hundreds of millions annually post-approval.
  • Regulatory approval, competitive landscape, and market acceptance will determine commercial success.
  • The outlook remains positive if Phase 3 results confirm earlier data and regulatory processes are smooth.

FAQs

Q1: When is Zoliflodacin expected to receive FDA approval?
A1: Regulatory submission is anticipated in late 2023, with approval potentially granted within 6–12 months thereafter.

Q2: Will Zoliflodacin replace ceftriaxone as the standard of care?
A2: Possible if efficacy, safety, and cost-effectiveness are confirmed; its oral formulation offers a convenience advantage.

Q3: Are there other drugs competing with Zoliflodacin?
A3: Yes, agents like gepotidacin (GSK), solithromycin, and others in late-stage development target gonorrhea.

Q4: What are the barriers to market entry?
A4: Regulatory approval delays, pricing pressures, healthcare provider adoption, and resistance development.

Q5: How does Zoliflodacin’s mechanism differ from existing antibiotics?
A5: It inhibits bacterial DNA topoisomerases but is structurally distinct from fluoroquinolones, reducing cross-resistance.


Sources:
[1] Multicom Inc. Clinical trial registries.
[2] CDC Gonorrhea Surveillance Reports.
[3] MarketWatch 2022 report on STI therapeutics.
[4] FDA Fast Track designations documentation.

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