Ridinilazole for the treatment of Clostridioides difficile infection

Expert Opin Investig Drugs. 2019 Apr;28(4):303-310. doi: 10.1080/13543784.2019.1582640. Epub 2019 Feb 26.


Ridinilazole is a novel antibiotic being developed for the treatment of Clostridioides difficile infection (CDI). Ridinilazole has completed two phase II trials and phase III trials which are denoted Ri-CoDIFy 1 and 2, are planned (ClinicalTrials.gov identifiers: NCT03595553 and NCT03595566). Areas covered: This article covers the chemistry, mechanism of action, in vitro microbiology versus C. difficile and host microbiota, pre-clinical and clinical efficacy, pharmacokinetics, pharmacodynamics and safety and tolerability of ridinilazole. Expert opinion: Ridinilazole is a novel antibiotic with ideal properties for the treatment of CDI. Given the promising results from the phase II clinical trial, ridinilazole may have the capability to lower the risk for CDI recurrence thus improving sustained clinical response rates - a current unmet medical need. Assuming a positive phase III trial, ridinilazole will enter a market with heightened awareness on the importance of prevention of CDI. This along with further research into the economic consequences and decreased patient quality of life associated with recurrent CDI, should provide clinicians with further evidence for the need for therapy that limits CDI recurrence and improves sustained clinical cure.

Keywords: CDI; Clostridioides difficile; SMT19969; clostridium difficile; diarrhea; ridinilazole; vancomycin.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Benzimidazoles / adverse effects
  • Benzimidazoles / pharmacology
  • Benzimidazoles / therapeutic use*
  • Clostridioides difficile / drug effects*
  • Clostridioides difficile / isolation & purification
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / microbiology
  • Humans
  • Pyridines / adverse effects
  • Pyridines / pharmacology
  • Pyridines / therapeutic use*
  • Quality of Life


  • Anti-Bacterial Agents
  • Benzimidazoles
  • Pyridines
  • ridinilazole

Associated data

  • ClinicalTrials.gov/NCT03595553
  • ClinicalTrials.gov/NCT03595566