A Dual-Mechanism Antibiotic Kills Gram-Negative Bacteria and Avoids Drug Resistance. Author James Martin, Joseph Sheehan, Benjamin Bratton, Gabriel Moore, André Mateus, Sophia Li, Hahn Kim, Joshua Rabinowitz, Athanasios Typas, Mikhail Savitski, Maxwell Wilson, Zemer Gitai Publication Year 2020 Type Journal Article Abstract The rise of antibiotic resistance and declining discovery of new antibiotics has created a global health crisis. Of particular concern, no new antibiotic classes have been approved for treating Gram-negative pathogens in decades. Here, we characterize a compound, SCH-79797, that kills both Gram-negative and Gram-positive bacteria through a unique dual-targeting mechanism of action (MoA) with undetectably low resistance frequencies. To characterize its MoA, we combined quantitative imaging, proteomic, genetic, metabolomic, and cell-based assays. This pipeline demonstrates that SCH-79797 has two independent cellular targets, folate metabolism and bacterial membrane integrity, and outperforms combination treatments in killing methicillin-resistant Staphylococcus aureus (MRSA) persisters. Building on the molecular core of SCH-79797, we developed a derivative, Irresistin-16, with increased potency and showed its efficacy against Neisseria gonorrhoeae in a mouse vaginal infection model. This promising antibiotic lead suggests that combining multiple MoAs onto a single chemical scaffold may be an underappreciated approach to targeting challenging bacterial pathogens. Keywords Animals, Mice, Pseudomonas aeruginosa, Anti-Bacterial Agents, Microbial Sensitivity Tests, Humans, Cell Membrane, Gram-Negative Bacteria, Gram-Positive Bacteria, Female, Male, HEK293 Cells, Proteomics, Folic Acid, Drug Resistance, Bacterial, Mice, Inbred BALB C, Quinazolines, Pyrroles, Methicillin-Resistant Staphylococcus aureus, Ovariectomy Journal Cell Volume 181 Issue 7 Pages 1518-1532.e14 Date Published 2020 Jun 25 ISSN Number 1097-4172 DOI 10.1016/j.cell.2020.05.005 Alternate Journal Cell PMCID PMC7780349 PMID 32497502 PubMedPubMed CentralGoogle ScholarBibTeXEndNote X3 XML