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Tebipenem pivoxil hydrobromide-No PICC, no problem!

Varun Sodhi1, Kelli A Kronsberg2, Mickayla Clark2,3

  • 1Department of Internal Medicine/Sunrise Health GME Consortium, MountainView Hospital, Las Vegas, Nevada, USA.

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|August 9, 2021
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Summary

Tebipenem pivoxil hydrobromide, an oral carbapenem, shows non-inferiority to ertapenem for complicated urinary tract infections. This novel antibiotic offers a potential outpatient treatment option for bacterial infections.

Keywords:
antibioticextended-spectrum beta-lactamaseoral carbapenemtebipenem

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Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Tebipenem pivoxil hydrobromide is an orally bioavailable prodrug of tebipenem, a carbapenem antimicrobial.
  • Carbapenems target penicillin-binding proteins, inhibiting bacterial cell wall synthesis and leading to cell lysis.

Purpose of the Study:

  • To evaluate the efficacy and safety of oral tebipenem pivoxil hydrobromide compared to intravenous ertapenem.
  • To assess tebipenem pivoxil hydrobromide as a potential oral treatment for complicated urinary tract infections (cUTI).

Main Methods:

  • A large Phase 3 clinical trial (ADAPT-PO) compared oral tebipenem pivoxil hydrobromide (600 mg every 8 h) with intravenous ertapenem (1 g every 24 h).
  • The study included patients with complicated urinary tract infections, including acute pyelonephritis.

Main Results:

  • Tebipenem pivoxil hydrobromide was non-inferior to ertapenem in overall response at test of cure (58.8% vs. 61.6%).
  • Clinical cure rates were high for both groups (93.1% vs. 93.6%), as was microbiological eradication (59.5% vs. 63.5%).
  • Common adverse reactions included diarrhea, headache, and nausea.

Conclusions:

  • Oral tebipenem pivoxil hydrobromide demonstrates comparable efficacy to intravenous ertapenem for cUTI treatment.
  • This novel oral carbapenem offers a promising alternative for outpatient management of infections, potentially reducing hospitalizations.