Paromomycin

Summary

Paromomycin (CHEMBL370143) is an approved small-molecule antibacterial drug (ATC A07AA06); indicated across 4 conditions including visceral leishmaniasis and cutaneous leishmaniasis.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: A07AA06
• Indications: 4 conditions
• Clinical trials: 20
• Chemistry: 615.6 Da · C23H45N5O14

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL370143
Name	Paromomycin
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	165580
ChEBI	CHEBI:7934
ATC	A07AA06
Molecular formula	C23H45N5O14
Molecular weight	615.6
InChIKey	UOZODPSAJZTQNH-LSWIJEOBSA-N

SMILES: C1[C@H]([C@@H]([C@H]([C@@H]([C@H]1N)O[C@@H]2[C@@H]([C@H]([C@@H]([C@H](O2)CO)O)O)N)O[C@H]3[C@@H]([C@@H]([C@H](O3)CO)O[C@@H]4[C@@H]([C@H]([C@@H]([C@@H](O4)CN)O)O)N)O)O)N

IUPAC name: (2S,3S,4R,5R,6R)-5-amino-2-(aminomethyl)-6-[(2R,3S,4R,5S)-5-[(1R,2R,3S,5R,6S)-3,5-diamino-2-[(2S,3R,4R,5S,6R)-3-amino-4,5-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-6-hydroxycyclohexyl]oxy-4-hydroxy-2-(hydroxymethyl)oxolan-3-yl]oxyoxane-3,4-diol

ChEBI definition: An amino cyclitol glycoside that is the 1-O-(2-amino-2-deoxy-α-D-glucopyranoside) and the 3-O-(2,6-diamino-2,6-dideoxy-β-L-idopyranosyl)-β-D-ribofuranoside of 4,6-diamino-2,3-dihydroxycyclohexane (the 1R,2R,3S,4R,6S diastereoisomer). It is obtained from various Streptomyces species. A broad-spectrum antibiotic, it is used (generally as the sulfate salt) for the treatment of acute and chronic intestinal protozoal infections, but is not effective for extraintestinal protozoal infections. It is also used as a therapeutic against visceral leishmaniasis.

Pharmacological roles (ChEBI): antibacterial drug, antiprotozoal drug, anthelminthic drug, antiparasitic agent.

Also known as: Aminosidin, ANTIBIOTIC SF 767B, ANTIBIOTIC SF-767B, Catenulin, Crestomycin, Estomycin, Gabromycin, Hydroxymycin, Monomycin a, Neomycin e, Paromomicina, Paromomycin

Parent form; salt/anhydrous children: CHEMBL2206196

Patent coverage: 7,079 distinct patent families (26,290 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 1 (assay-derived). Sample: Bacterial 70S ribosome.

Bioactivity

ChEMBL activities: 2 potent at pChembl ≥ 5 of 2 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
P02358	7.48	IC50	33	nM	CHEMBL_ACT_24813006
P02358	7.42	IC50	38	nM	CHEMBL_ACT_19126748

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

4 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
visceral leishmaniasis	3	MONDO:0005445	EFO:0005045
cutaneous leishmaniasis	3	MONDO:0005446	EFO:0005046
leishmaniasis	2	MONDO:0011989	EFO:0005044
osteomyelitis	0	MONDO:0005246	EFO:0003102

Clinical trials

Total trials: 20.

Phase distribution

Phase	Trials
Not specified	8
PHASE3	7
PHASE2	3
PHASE2/PHASE3	1
EARLY_PHASE1	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT07463040	PHASE3	NOT_YET_RECRUITING	Study Comparing Several Drugs to Understand Which Work Against Cutaneous Leishmaniasis (CL)
NCT00255567	PHASE3	COMPLETED	Efficacy/Safety of Sodium Stibogluconate (SSG) Versus Paromomycin (PM) and SSG/PM Combination to Treat V Leishmaniasis
NCT00629031	PHASE3	COMPLETED	An Open Lable Randomised Study to Assess the Safety and Efficacy of Short Course Paromomycin in Visceral Leishmaniasis
NCT00696969	PHASE3	COMPLETED	Safety and Efficacy Study to Evaluate Different Combination Treatment Regimens for Visceral Leishmaniasis
NCT01122771	PHASE3	COMPLETED	Phase III, Study of Three Short Course Combo (Ambisome®, Miltefosine, Paromomycin) Compared With AmBisome for the Treatment of VL in Bangladesh
NCT01790659	PHASE3	COMPLETED	Phase 3 Study of Walter Reed (WR) 279,396 and Paromomycin Alone for the Treatment of Cutaneous Leishmaniasis in Panama
NCT03129646	PHASE3	COMPLETED	Miltefosine/Paromomycin Phase III Trial for Treatment of Primary Visceral Leishmaniasis (VL) Patients in Eastern Africa
NCT03829917	PHASE2/PHASE3	COMPLETED	Oral Miltefosine Plus Topical Paromomycin In American Cutaneous Leishmaniasis
NCT00657917	PHASE2	TERMINATED	Topical Treatment of Recalcitrant Ulcerative Old World Leishmaniasis With WR 279,396
NCT03399955	PHASE2	UNKNOWN	Short Course Regimens for Treatment of PKDL (Sudan)
NCT05957978	PHASE2	COMPLETED	LXE408 for Treatment of Visceral Leishmaniasis in Ethiopia, a Proof of Concept Study
NCT01050777	EARLY_PHASE1	COMPLETED	Efficacy of Topical Liposomal Form of Drugs in Cutaneous Leishmaniasis
NCT04342715	Not specified	ACTIVE_NOT_RECRUITING	A Study to Assess Immune Response Status in Patients Before and After Treatment for Visceral Leishmaniasis
NCT06907498	Not specified	RECRUITING	Paromomycin or Metronidazole for Symptomatic Dientamoeba Fragilis in Adults
NCT00004444	Not specified	COMPLETED	Pilot Randomized Study of Paromomycin (Aminosidine) vs Streptomycin for Uncomplicated Pulmonary Tuberculosis
NCT01357304	Not specified	COMPLETED	10 Prescriptions an Hour. Group Treatment and Physical Activity Referral in a Primary Health Care Setting
NCT01641796	Not specified	NO_LONGER_AVAILABLE	Paromomycin for Individuals With Uncomplicated Cutaneous Leishmaniasis
NCT01780909	Not specified	UNKNOWN	The Use of a Non-absorbable Marker for the Evaluation of the Gastrointestinal Transit
NCT03334357	Not specified	COMPLETED	Physical Fitness as Klotho Protein Stimulator.
NCT03759886	Not specified	UNKNOWN	Oral Antibiotic Prophylaxis in Colorectal Surgery

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

PharmGKB dosing guidelines (1) — CPIC / DPWG genotype-guided dosing for this drug (drug × pharmacogene):

Guideline	Source	Gene(s)	Dosing	Recommendation
Annotation of CPIC Guideline for amikacin, dibekacin, gentamicin, kana	CPIC	MT-RNR1		yes

PharmGKB also curates 0 clinical and 8 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).