Lefamulin inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome. Specifically, it binds to the peptidyl transferase center of the ribosome and inhibits the transfer of amino acids to growing polypeptide chains, which leads to the inhibition of bacterial protein synthesis and bacterial death. Lefamulin is active against a wide range of Gram-positive bacteria, including Streptococcus pneumoniae, Staphylococcus aureus, and methicillin-resistant S. aureus (MRSA), as well as some atypical bacteria such as Legionella species. It has also been shown to have activity against some Gram-negative bacteria, including Haemophilus influenzae and Moraxella catarrhalis.
