Impetigo is the most common bacterial skin
infection in children. Treatment is becoming complicated due to the development of antimicrobial resistance, especially in the main pathogen, Staphylococcus aureus.
Ozenoxacin, a novel non-fluorinated topical
quinolone antimicrobial, has demonstrated efficacy in
impetigo. Areas covered: This article reviews the microbiology, pharmacodynamic and pharmacokinetic properties of
ozenoxacin, and its clinical and microbiological efficacy in
impetigo. Expert opinion: In an environment of increasing antimicrobial resistance and concurrent slowdown in antimicrobial development, the introduction of a new agent is a major event.
Ozenoxacin is characterized by simultaneous affinity for
DNA gyrase and
topoisomerase IV, appears to be impervious to certain efflux pumps that confer bacterial resistance to other
quinolones, shows low selection of resistant mutants, and has a mutant prevention concentration below its concentration in skin. These mechanisms protect
ozenoxacin against development of resistance, while the absence of a
fluorine atom in its structure confers a better safety profile versus
fluoroquinolones. In vitro studies have demonstrated high potency of
ozenoxacin against staphylococci and streptococci including resistant strains of S. aureus. Clinical trials of
ozenoxacin in patients with
impetigo reported high clinical and microbiological success rates. Preserving the activity and availability of
ozenoxacin through antimicrobial stewardship is paramount.