LTX-109 is a Novel Agent for Nasal Decolonisation of Methicillin Resistant and Sensitive Staphylococcus aureus.

Nasal decolonisation has a proven effect on the prevention of severe Staphylococcus aureus infections and in the control of methicillin resistant S. aureus (MRSA). However, rising rates of resistance to antibiotics highlights the need for new substances for nasal decolonisation. LTX-109 is a broad spectrum, fast-acting bactericidal antimicrobial drug for topical treatment, which causes membrane disruption and cell lysis. This mechanism of action is not associated with cross-resistance and has a low propensity for development of resistance. In the present study persistent nasal MRSA and methicillin sensitive S. aureus carriers were treated for three days with vehicle, 1%, 2% or 5% LTX-109, respectively. A significant effect on nasal decolonisation was observed already after 2 days of LTX-109 treatment in subjects treated with 2% or 5% LTX-109 compared to vehicle (P≤0.0012, Dunnett's test). No safety issues were noted during the 9-week follow-up period. Minimal reversible epithelial lesions were observed in the nasal cavity. The systemic exposure was very low with a Cmax 1-2 h post dosing (3.72-11.7 ng/mL). One week after treatment initiation LTX-109 was not detectable in any subject. Summary: Intranasal treatment of S. aureus with LTX-109 is safe and reduces the bacterial load already after a single day of treatment. Hence, LTX-109 has the potential as a new and effective antimicrobial agent with low propensity of resistance development that can prevent infections by MSSA/MRSA during hospitalization. ClinicalTrials.gov: NCT01158235.