Cephalosporin-based combination therapies for combating ESKAPE pathogens: a patent review

ESKAPE (namely Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter) pathogens pose a major threat to global health. The World Health Organization highlights the need for new antimicrobial strategies, including combination therapies, to address their resistance. Cephalosporins, due to their broad-spectrum activity and safety profile, are widely used in hospitals and serve as strong candidates for such regimens. While many studies explore cephalosporin combinations, there is a lack of systematic reviews focused on patent literature. This study analyses patent filings related to cephalosporin-based combination therapies targeting ESKAPE pathogens. The Espacenet database was thoroughly searched using the keywords "combination," "antibiotics," and "cephalosporin" yielding 666 patent applications filed up to June 2024. Based on the inclusion criteria, 30 patents were selected for further analysis. Notably, most patents were filed in China and the USA, accounting for up to 30% and 17%, respectively. Most patents were filed by private companies and classified under the International Patent Classification code A61K, indicating their pharmaceutical applications. Additionally, in 2022, the highest number of patents were filed in this area. However, clinical data were included in only two patents, reflecting a broader challenge: the high cost of development limits real-world validation of these combinations. Despite this, the patent landscape offers valuable insights into emerging strategies for combating ESKAPE pathogens with cephalosporin-based therapies.