The eradication of Helicobacter pylori, the etiologic agent of gastric ulcer and adenocarcinoma, is a big concern in clinics due to the increasing drug resistance phenomena and the limited number of efficacious treatment options. The exploitation of the H. pylori carbonic anhydrases (HpCAs) as promising pharmacological targets has been validated by the antibacterial activity of previously reported CA inhibitors due to the role of these enzymes in the bacterium survival in the gastric mucosa. The development of new HpCA inhibitors seems to be on the way to filling the existing antibiotics gap. Due to the recent evidence on the ability of the coumarin scaffold to inhibit microbial α‐CAs, a large library of derivatives has been developed by means of a pH‐regulated cyclization reaction of coumarin‐bearing acyl thiosemicarbazide intermediates. The obtained 1,3,4‐thiadiazoles (10–18a,b) and 1,2,4‐triazole‐3‐thiones (19–26a,b) were found to strongly and selectively inhibit HpαCA and computational studies were fundamental to gaining an understanding of the interaction networks governing the enzyme–inhibitor complex. Antibacterial evaluations on H. pylori ATCC 43504 highlighted some compounds that maintained potency on a resistant clinical isolate. Also, their combinations with metronidazole decreased both the minimal inhibitory concentration and minimal bactericidal concentration values of the antibiotic, with no synergistic effect.

Background: Bacterial resistance to antibiotics continues to rise globally, posing a significant public health challenge and incurring substantial social and economic burdens. In response, the World Health Organization (WHO) has published a list of priority pathogens for which effective treatment options are critically limited. Several antibiotics are categorized as Gram-positive-only (GPO) agents due to their lack of activity against Gram-negative species. Although these compounds often target conserved bacterial processes, their limited spectrum is largely attributed to poor penetration of the Gram-negative outer membrane (OM). Results: In this study, we designed and synthesized a series of adarotene-derived compounds to evaluate the impact of introducing positively charged groups on their interaction with the Gram-negative OM. One of the newly synthesized derivatives, SPL 207, displayed minimum inhibitory concentration (MIC) values ranging from 8 to 64 µM against a panel of Gram-positive and Gram-negative bacteria. The ability of SPL207 to disrupt outer and inner membrane permeability was evaluated using fluorescence assays and confocal microscopy, revealing that the compound compromises membrane integrity across all tested Gram-negative bacteria. Strong synergistic activity was observed in combination with colistin against three P. aeruginosa colistin-resistant strains. Atomistic details of membrane interference were elucidated by molecular dynamics (MD) simulations, with SPL207 clearly acting as a membrane destabilizer by enhancing Ca²⁺ ions diffusion and lipids destabilization. Conclusions: Although the observed MIC values remain above clinically acceptable thresholds, these findings provide a promising proof of concept. The further structural optimization of adarotene derivatives may yield novel broad-spectrum agents with improved antimicrobial potency against MDR pathogens.