Background

In this phase 2 study, we evaluated the efficacy and safety of oral gepotidacin, a novel triazaacenaphthylene bacterial type II topoisomerase inhibitor, for the treatment of uncomplicated urogenital gonorrhea.

Methods

Adult participants with suspected urogenital gonorrhea were enrolled and completed baseline (day 1) and test-of-cure (days 4-8) visits. Pretreatment and posttreatment urogenital swabs were collected for Neisseria gonorrhoeae (NG) culture and susceptibility testing. Pharyngeal and rectal swab specimens were collected if there were known exposures. Participants were stratified by gender and randomized 1:1 to receive a 1500-mg or 3000-mg single oral dose of gepotidacin.

Results

The microbiologically evaluable population consisted of 69 participants, with NG isolated from 69 (100%) urogenital, 2 (3%) pharyngeal, and 3 (4%) rectal specimens. Microbiological eradication of NG was achieved by 97%, 95%, and 96% of participants (lower 1-sided exact 95% confidence interval bound, 85.1%, 84.7%, and 89.1%, respectively) for the 1500-mg, 3000-mg, and combined dose groups, respectively. Microbiological cure was achieved in 66/69 (96%) urogenital infections. All 3 failures were NG isolates that demonstrated the highest observed gepotidacin minimum inhibitory concentration of 1 µg/mL and a common gene mutation. At the pharyngeal and rectal sites, 1/2 and 3/3 NG isolates, respectively, demonstrated microbiological cure. There were no treatment-limiting adverse events for either dose.

Conclusions

This study demonstrated that single, oral doses of gepotidacin were ≥95% effective for bacterial eradication of NG in adult participants with uncomplicated urogenital gonorrhea.

Clinical trials registration

NCT02294682.

The ATLAS trigger reduces the rate of interesting events to be recorded for off-line analysis in three successive levels from 40 MHz to ∼ 100 kHz, ∼ 2 kHz and ∼ 200 Hz. The high level triggers and data acquisition system are designed to profit from commodity computing and networking components to achieve the required performance. In this paper, we discuss data flow aspects of the design of the second level trigger (LVL2) and present results of performance measurements.

This paper presents a summary of beam-induced backgrounds observed in the ATLAS detector and discusses methods to tag and remove background contaminated events in data. Triggerrate based monitoring of beam-related backgrounds is presented. The correlations of backgrounds with machine conditions, such as residual pressure in the beam-pipe, are discussed. Results from dedicated beam-background simulations are shown, and their qualitative agreement with data is evaluated. Data taken during the passage of unpaired, i.e. non-colliding, proton bunches is used to obtain background-enriched data samples. These are used to identify characteristic features of beam-induced backgrounds, which then are exploited to develop dedicated background tagging tools. These tools, based on observables in the Pixel detector, the muon spectrometer and the calorimeters, are described in detail and their efficiencies are evaluated. Finally an example of an application of these techniques to a monojet analysis is given, which demonstrates the importance of such event cleaning techniques for some new physics searches.