SQ641 is a chemically-modified analog of nucleoside-based Capuramycin (CM) with a unique mechanism of action and a unique target, the TL-1 enzyme. ATTRIBUTES OF SQ641: It is bactericidal and kills Mtb faster than any existing antitubercular drugs, including isoniazid and rifampin. It is fast-acting, disintegrating even slow-growing bacteria in 24 hours. Is active against all strains of multidrug-resistant clinical strains of Mtb tested to date. Has an exceptional 55 hr post antibiotic effect against Mtb. Shows strong synergy in TB with Ethambutol, Streptomycin, and SQ109. Is highly effective in preventing development of drug resistant mutants in Mtb. Has excellent in vitro activity against NTM: M. avium complex (MAC), M. abscessus, and M. kansasii and M. avium subspecies paratuberculosis. Acts synergistically with a variety of anti-mycobacterial agents with activity against NTM. Demonstrates efficacy in a mouse model of chronic TB by reducing CFU in lungs of infected mice by 1.0 to 1.5 log. New formulations to improve efficacy of SQ641 have now been explored. Sequella licensed the Capuramycin class of antibacterials from Daiichi-Sankyo in 2004, and has exclusive worldwide rights, excluding the Middle East, for all indications. SQ641 is being formulated for planned studies in M. ulcerans (Buruli ulcer), M. avium paratuberculosis (MAP), and Clostridum difficile infection (CDI).