zosurabalpin (RG6006) / Roche - LARVOL DELTA

In vitro activity of zosurabalpin against a global set of carbapenem-resistant-A. baumannii clinical isolates. (PubMed, Antimicrob Agents Chemother) - "We compared zosurabalpin's activity with currently available antibiotics, including colistin, cefiderocol, sulbactam-durlobactam, as well as rifabutin. Zosurabalpin MICs in CRAB isolates were generally low, including metallo-β-lactamase-producing-CRAB. The low MICs show a high potential to overcome current treatment limitations; however, mutations in lptD may contribute to resistance emergence and should be further studied."

Journal • Preclinical • Infectious Disease

Activity of the Novel Agent Zosurabalpin (RG6006) Against 1473 Clinical Isolates of Acinetobacter baumannii-calcoaceticus Complex Collected Worldwide in 2025 (IDWeek 2026) - No abstract available

Clinical • Infectious Disease

Rapid delineation of Acinetobacter baumannii dose responses to zosurabalpin based on machine learning-assisted interpretation of bacterial nanomotions. (PubMed, Microbiol Spectr) - "Together, these features provide rapid phenotypic insights that may support future development of timely, targeted therapy decisions. The findings highlight nanomotion-based antimicrobial susceptibility testing as a promising tool to accelerate diagnostic readiness for new antibiotics and improve treatment management in infections caused by multidrug-resistant A. baumannii."

Journal • Infectious Disease

In vitro evaluation of the novel antibiotic zosurabalpin against carbapenem-resistant Acinetobacter baumannii clinical isolates. (PubMed, J Glob Antimicrob Resist) - "These findings indicate that ZAB exhibits strong in vitro activity against CRAB including strains resistant to last-line commercially available antibiotics such as FDC."

Journal • Preclinical • Infectious Disease

Therapeutic challenges and emerging strategies against carbapenem-resistant Acinetobacter baumannii. (PubMed, Curr Res Microb Sci) - "Sulbactam-durlobactam has demonstrated superior clinical resolution in CRAB-induced pneumonia and meningitis compared to traditional polymyxin-based regimens. Eravacycline achieves 100% microbiological clearance in abdominal infections without promoting resistance, and cefiderocol retains activity against metallo-β-lactamase-producing strains in clinical settings. Beyond these, zosurabalpin targets LPS transport via a novel mechanism, while bacteriophage cocktails and engineered antimicrobial peptides are advancing through clinical validation. In this review, we comprehensively examine the heterogeneous resistance mechanisms underlying CRAB persistence and critically evaluate emerging antimicrobial-centered therapeutic paradigms, with emphasis on empirically validated strategies for managing invasive CRAB infections."

Journal • Review • CNS Disorders • Infectious Disease • Pneumonia • Respiratory Diseases

Activity of zosurabalpin against carbapenem-resistant Acinetobacter baumannii-calcoaceticus complex (CRABC) isolates producing NDM and/or oxacillinase enzymes (ESCMID Global 2026) - No abstract available

Antimicrobial activity of zosurabalpin against Acinetobacter baumannii-calcoaceticus complex clinical isolates in China (ESCMID Global 2026) - No abstract available

Clinical

Therapeutic milestones against multidrug resistant Acinetobacter baumannii: from legacy antibiotics to Zosurabalpin. (PubMed, Arch Microbiol) - "This review provides a chronological overview of the evolution of antimicrobial therapies used against A. baumannii, spanning the early era of penicillins and tetracyclines to contemporary agents such as eravacycline and ceftazidime-avibactam. Preclinical data and emerging clinical findings highlight its potent activity against highly resistant CRAB strains and its ability to circumvent conventional resistance pathways, marking it as a promising candidate in the antimicrobial pipeline. Finally, we evaluate the limitations of current treatment modalities and explore emerging strategies, including phage therapy, novel target discovery, and non-traditional therapeutics, offering a forward-looking perspective on restoring and sustaining effective anti-Acinetobacter interventions."

Journal • Review • Critical care • Gene Therapies • Infectious Disease • Novel Coronavirus Disease

An Overview of the Epidemiology of Multidrug Resistance and Bacterial Resistance Mechanisms: What Solutions Are Available? A Comprehensive Review. (PubMed, Microorganisms) - "This comprehensive review synthesizes global epidemiological data, insights into bacterial resistance mechanisms, and emerging therapeutic solutions, including novel antibiotics such as lasso peptides and macrocyclic peptides (e.g., zosurabalpin), naturally derived compounds (e.g., corallopyronin, clovibactin, chlorotonil A), and targeted inhibitors (e.g., Debio 1453 for Neisseria gonorrhoeae). Addressing the AMR crisis requires coordinated international efforts, accelerated drug discovery, and the integration of innovative non-antibiotic approaches to preserve the efficacy of existing therapies and ensure preparedness against future bacterial threats."

Journal • Review • Infectious Disease • Pneumococcal Infections • Pneumonia

Activity of Zosurabalpin and Comparator Antimicrobial Agents Tested Against Acinetobacter baumannii-calcoaceticus complex (ABC) Isolates Collected Worldwide in 2024. (IDWeek 2025) - No abstract available

Infectious Disease

Antibiotics and non-traditional antimicrobial agents for carbapenem-resistant Acinetobacter baumannii in Phase 1, 2, and 3 clinical trials. (PubMed, Expert Opin Investig Drugs) - "Specifically, 9 antibiotics are in Phase 1 (R-327, xeruborbactam/QPX-7728, upleganan/SPR-206, MRX-8, QPX-9003, zifanocycline/KBP-7072, apramycin/EBL-1003, zosurabalpin/RG-6006, and ANT-3310), two in Phase 2 (BV-100, OMN-6), and two in Phase 3 (zidebactam/WCK-5222, funobactam/XNW-4107) clinical trials...In particular, two monoclonal antibodies (TRL-1068, CMTX-101), a phage therapy (Phagebank), an immune-modulating agent (recombinant human plasma gelsolin/Rhu-pGSN), a microbiome-modulating agent (SER-155), and an engineered cationic antibiotic peptide (PLG-0206). Several agents with promising characteristics against CRAB infections are in clinical development (Phases 1, 2, and 3). The urgent need for therapeutic options against CRAB infections necessitates optimizing efforts and time for introducing successfully studied agents into clinical practice."

Journal • Review • Infectious Disease • GSN

Drug-resistant Acinetobacter baumannii: mortality, emerging treatments, and future pharmacological targets for a WHO priority pathogen. (PubMed, Clin Microbiol Rev) - "In addition, we discuss emerging druggable targets and the inherent challenges in their development, offering strategic insights into next-generation therapeutic programs. A deep profound understanding of the pathogen's molecular defenses is essential to guide the design of innovative therapies aimed at mitigating the escalating threat posed by A. baumannii."

Journal • Review • Infectious Disease

Targeting Lipopolysaccharides in Gram-negative Sepsis: Therapeutic Advances and Challenges. (PubMed, J Drug Target) - "Key strategies include antibiotics disrupting LPS biosynthesis and transport (e.g., zosurabalpin, darobactin), monoclonal and bispecific antibodies, extracorporeal endotoxin removal devices, and novel agents like LpxC inhibitors and nanotechnology-based platforms...Addressing scalability, regulatory hurdles, and cost-effectiveness will be critical to integrating LPS-targeted therapies into standard sepsis care. This review outlines a translational roadmap to harness these innovations and improve outcomes in Gram-negative sepsis."

Journal • Review • Infectious Disease • Inflammation • Septic Shock

Carbapenem Resistance in Acinetobacter baumannii: Mechanisms, Therapeutics, and Innovations. (PubMed, Microorganisms) - "Emerging treatment strategies are discussed, such as the use of new beta-lactam-beta-lactamase inhibitor combinations (e.g., sulbactam-durlobactam), siderophore cephalosporins, next-generation polymyxins, as well as novel agents like zosurabalpin and rifabutin (BV100). Together, these innovations represent a multifaceted strategy to overcome CRAB infections, yet their successful implementation requires further clinical validation and coordinated surveillance efforts. This analysis highlights the urgent need for continued investment in innovative treatments and effective resistance monitoring to limit the spread of CRAB and protect the effectiveness of last-line antibiotics."

Journal • Review • Critical care • Infectious Disease

Zosurabalpin, a novel antibiotic targeting lipopolysaccharide transport (ASM Microbe 2025) - "There is no abstract associated with this presentation."

Zosurabalpin: an antibiotic with a new mechanism of action against carbapenem-resistant Acinetobacter baumannii. (PubMed, Infez Med) - "With rising resistance and limited effective treatments, zosurabalpin offers a new, targeted therapeutic approach. Continued clinical development could help close a critical gap in the management of multidrug-resistant Acinetobacter baumannii."

Journal • Review • Infectious Disease

In silico analysis of zosurabalpin-LptB2FG binding in Acinetobacter spp., Klebsiella pneumoniae, and Shigella flexneri: mechanisms underlying its differential efficacy. (PubMed, In Silico Pharmacol) - "These findings underscore the need for tailored zosurabalpin derivatives to enhance efficacy against a broader spectrum of Gram-negative bacteria. The online version contains supplementary material available at 10.1007/s40203-025-00343-3."

Journal • Infectious Disease • Pneumonia

In vitro activity of zosurabalpin against carbapenem-resistant-A. baumannii (CRAB) clinical isolates from diverse origins (ESCMID Global 2025) - No abstract available

Late-breaking abstract • Preclinical

Preliminary zosurabalpin (5µg) disk diffusion quality control ranges using clinical and laboratory standards institute M23 criteria (ESCMID Global 2025) - No abstract available

Clinical

Antibacterial effect of zosurabalpin using simulated human doses against carbapenem resistant Acinetobacter baumannii studied in an in vitro model of infection (ESCMID Global 2025) - No abstract available

Preclinical • Infectious Disease

Antimicrobial activity of zosurabalpin against a diverse collection of aerobic and anaerobic bacterial and yeast isolates (ESCMID Global 2025) - No abstract available

Assessment of zosurabalpin activity in combination with other antibiotics (ESCMID Global 2025) - No abstract available

Combination therapy

Effect of zosurabalpin, a pathogen-focused antibiotic, on the gut microbiome of healthy participants (ESCMID Global 2025) - No abstract available

Clinical

Determination of optimal disk diffusion mass for zosurabalpin (ESCMID Global 2025) - No abstract available

Acinetobacter baumannii Complex Infections: New Treatment Options in the Antibiotic Pipeline. (PubMed, Microorganisms) - "Furthermore, many older agents, such as polymyxin and colistin, have limited lung penetration and are associated with significant toxicities. In order to place these newer molecules in context and to help clinicians appreciate the emerging potential drug development pipeline, we describe the in vitro activity, mechanisms of action, and clinical trial data not only for the commercially now available alternatives, such as cefiderocol and sulbactam-durlobactam, but also review these topics for molecules undergoing phase II and III clinical trials. Specifically, we discuss and analyze data related to four novel drugs from ABC: BV-100, cefepime-zidebactam, zosurabalpin, and OMN6."

Journal • Review • Infectious Disease • Pneumonia • Respiratory Diseases • Septic Shock