Amixicile: A Concept Therapeutic for Treatment of Chronic Anaerobic Infections

Anaerobic microorganisms are often associated with chronic mucosal infections including periodontal disease, inflammatory bowel diseases, and recurrent colitis caused by Clostridioides difficile. Management of these diseases requires a long term strategy, but available antibiotics (e.g., metronidazole) can only be used short term. Conceptually, therapeutics that control chronic inflammation would lessen the risk of associated autoimmune diseases including atherosclerosis, arthritis, type II diabetes, Crohn's and ulcerative colitis and even Alzheimer's disease. To meet this need, an antibiotic must overcome inevitable antibiotic resistance, toxicity to humans or their mitochondria and limit collateral damage (dysbiosis) to gut microbiota. This review describes attributes of amixicile (AMIX), a novel systemic therapeutic, that shows efficacy in animal models for treatment of C. difficile colitis and gastric infections caused by Helicobacter pylori, while limiting collateral damage to gut microflora. Together with the apparent absence of drug resistance, toxicities, and drug metabolism, might qualify amixicile for consideration as a long term therapeutic for management of chronic and acute anaerobic infections.