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**Rifasutenizol** is an orally administered, investigational small-molecule antibacterial developed by TenNor Therapeutics for *Helicobacter pylori* infection. It is a stable, non-cleavable conjugate of rifamycin and nitroimidazole pharmacophores that produces synergistic antibacterial activity through inhibition of bacterial DNA-directed RNA polymerase and nitroreductase-dependent generation of reactive intermediates that damage bacterial DNA. The rifamycin component occupies the rifamycin-binding site of bacterial RNA polymerase, while the nitroimidazole component interacts with the DNA template strand within the RNA-polymerase active-center cleft. Rifasutenizol has completed a Phase 3 *H. pylori* program in China; its Chinese NDA was accepted in August 2025 and had entered NMPA supplementary review by August 26, 2026. ([pubs.acs.org](https://pubs.acs.org/doi/pdf/10.1021/acs.jmedchem.1c02045))
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