Exblifep (cefepime/enmetazobactam) / Allecra - LARVOL DELTA

Sphingobacterium spp. as intrinsic producers of SPI Ambler class B metallo-β-lactamases. (PubMed, J Antimicrob Chemother) - "S. spiritivorum was the most prevalent species of Sphingobacterium identified in clinical samples. All S. spiritivorum-like species produced a chromosomally encoded SPI-like MBL that might be challenging for the treatment of infections caused by this bacterial species."

Journal • Infectious Disease

β-Lactam/β-Lactamase Inhibitor Combinations in Sepsis-Associated Acute Kidney Injury and Renal Replacement Therapy. (PubMed, Antibiotics (Basel)) - "This review summarizes PK/PD features, extracorporeal clearance, and practical dosing considerations about ceftolozane-tazobactam, ceftazidime-avibactam, aztreonam-avibactam, cefiderocol, meropenem-vaborbactam, imipenem-relebactam, and newer agents including sulbactam-durlobactam, cefepime-enmetazobactam, and cefepime-taniborbactam. Full-dose initiation during the first 24-48 h, followed by careful adjustment, appears prudent. Therapeutic drug monitoring should be used when available, and institution-specific protocols should be integrated into stewardship programs to improve efficacy and minimize resistance."

Journal • Review • Acute Kidney Injury • Infectious Disease • Nephrology • Pediatrics • Renal Disease • Septic Shock

Revitalizing cephalosporins: The promise of β-lactamase inhibitor combinations. (PubMed, GMS Hyg Infect Control) - "It examines β-lactam resistance mechanisms, established combinations (e.g., ticarcillin/clavulanic acid, piperacillin/tazobactam), and the clinical efficacy of newer therapies like ceftazidime/avibactam (CAZ-AVI) for carbapenem-resistant Klebsiella pneumoniae (CRKP) and ceftolozane/tazobactam (TOL-TAZ) for MDR Pseudomonas aeruginosa. Additionally, novel combinations (e.g., cefepime-enmetazobactam, cefepime-taniborbactam) are discussed for tackling extensively drug-resistant (XDR) bacteria. Through comparative analyses, this review provides key insights into efficacy, resistance, pharmacokinetics, and safety, guiding researchers in optimizing antimicrobial strategies and clinicians in managing MDR infections, while supporting antibiotic management and future research."

Journal • Infectious Disease • Pneumonia

Health Economic Assessment of Cefepime-Enmetazobactam for Treating Complicated Urinary Tract Infections: A German Payer Perspective (ISPOR-EU 2025) - "The health economic analysis as one of many aspects to consider in the clinical context shows that a higher probability of relapse after antibiotic therapy might be associated with an increase in treatment costs within the German healthcare system. However, further health economic analyses are needed to improve evidence from other health economic perspectives."

HEOR • Infectious Disease • Nephrology

Therapeutic challenges in treating ESBL- and/or AmpC-producing non-carbapenemase-producing Enterobacterales: an in vitro evaluation of novel β-lactam/β-lactamase inhibitor combinations and cefiderocol. (PubMed, J Antimicrob Chemother) - "CR non-CPE exhibit heterogeneous resistance profiles, especially in ESBL/AmpC co-producers and CTX-M-33-producing isolates. While cefepime-zidebactam, imipenem-relebactam, and cefiderocol were the most active agents, susceptibility testing remains essential to guide therapy in this emerging and neglected bacterial group."

Journal • Preclinical

How I manage patients with New Delhi metallo-beta-lactamase and OXA-48-producing Enterobacterales infections: a practical approach. (PubMed, Curr Opin Infect Dis) - "Optimal management of NDM- and OXA-48-producing Enterobacterales requires individualized approach guided by pathogen type, resistance profile, and patient characteristics. Improved diagnostics and surveillance are essential to guide early treatment, while novel agents may enhance therapeutic options in the near future."

Journal • Infectious Disease

Novel beta-lactamase inhibitors with cefepime: where do they fit in clinical practice? (PubMed, Expert Opin Pharmacother) - "We performed a literature review of articles written in English using MEDLINE, PUBMED, and EMBASE, using the search terms 'Cefepime-enmetazobactam,' 'cefepime-taniborbactam,' and 'Cefepime-zidebactam' between January of 2015 and May 2025. On balance, the in vitro activity of cefepime-zidebactam fills critical gaps for the most challenging Gram-negative pathogens, including those that harbor metallo-β-lactamases with or without mutations in penicillin-binding proteins. For each of these agents, clinical data and real-world evidence generation are needed to better define their therapeutic niche, potential for resistance selection, and potential benefits compared to currently available antibiotics."

Journal • Review • Infectious Disease

Management of infections caused by Extended-Spectrum Beta-Lactamase Enterobacterales in Indian patients. (PubMed, Indian J Med Microbiol) - "The purpose of this guidance document aims to assist clinicians in selecting not only the right antibiotics to diagnose ESBLs, but also right tests to diagnose ESBLs, for effective management of ESBL infections CONTENT: This guidance document highlights the importance of early and accurate identification of ESBL Enterobacterales, outlines clinical syndromes that may require empirical antibiotic coverage for ESBLs, and offers guidance on appropriate de-escalation strategies. Additionally, it emphasizes on the optimal use of use of newer beta-lactam/beta-lactamase inhibitor (BLBLI) combinations, such as cefepime-enmetazobactam and ceftolozane-tazobactam, and also emphasizes on avoiding important drugs like ceftazidime-avibactam for ESBL Enterobacterales."

Journal • Infectious Disease

Resistance of Gram-Negative Bacteria to Cefepime-Enmetazobactam: A Systematic Review. (PubMed, Pathogens) - "The resistance of the studied extended-spectrum β-lactamase (ESBL)-producing and ampicillin C β-lactamase (AmpC)-producing isolates was low (0-2.8% and 0%, respectively). The high activity of cefepime-enmetazobactam against Enterobacterales and selected lactose non-fermenting Gram-negative pathogens, including ESBL-producing and AmpC-producing isolates, makes it a potential carbapenem-sparing agent. The drug should be used after in vitro antimicrobial susceptibility testing in patients with infections caused by OXA-48, KPC, and MBL-producing isolates."

Journal • Review • Infectious Disease • Pneumonia

Ceftazidime-avibactam plus aztreonam for extensively drug-resistant gram-negative infections in critically ill patients. (PubMed, J Crit Care) - "Ceftazidime-avibactam plus aztreonam combination demonstrated significant in vitro synergy against XDR pathogens with promising trends toward improved clinical outcomes in critically ill patients, representing a crucial salvage therapy option warranting larger randomized controlled trials."

Journal • Critical care • Infectious Disease • Pneumonia • Septic Shock

Nephrotoxicity of New Antibiotics: A Systematic Review. (PubMed, Toxics) - "The agents assessed included aztreonam/avibactam, cefepime/enmetazobactam, cefiderocol, ceftobiprole, contezolid, gepotidacin, imipenem/cilastatin/relebactam, lascufloxacin, lefamulin, levonadifloxacin, plazomicin, and sulbactam/durlobactam. There is a need for post-marketing studies to better characterize renal safety. Clinicians should remain vigilant and continue to monitor for and report renal-related adverse events."

Journal • Review

In-vitro activity of cefepime/enmetazobactam against extended spectrum beta-lactamases and/or ampC producing Enterobacterales and Pseudomonas aeruginosa collected across India. (PubMed, Diagn Microbiol Infect Dis) - "The findings of the present study retraites that the spectrum of coverage of cefepime/enmetazobactam is superior to that of TZP and similar to that of meropenem, emphasising the importance of cefepime/enmetazobactam as a carbapenem-sparing option."

Journal • Preclinical • Infectious Disease • Nephrology • Pneumonia • Respiratory Diseases

In Vitro Activity of Cefepime-Enmetazobactam against Enterobacterales Isolated from Cancer Patients (ASM Microbe 2025) - "Isolates resistant to third-generation cephalosporins and isolates nonsusceptible to meropenem were screened for the presence of ß-lactamases. Cefepime/enmetazobactam showed excellent activity against most of the Enterobacterales isolates. Excellent activity was seen against third-generation cephalosporin resistant isolates. Cefepime/enmetazobactam exhibited higher activity than Piperacillin-tazobactam and Cefeperazone-sulbactam suggesting a good therapeutic alternative as compared with carbapenems against ESBL producers."

Preclinical • Infectious Disease • Oncology • Pneumonia

Is It Time to Finally Spare Carbapenems? In-Vitro Activity of Cefepime/Enmetazobactam Against ESBL-Producing and Cefepime Resistant Spice Organisms (ASM Microbe 2025) - "In all 110 isolates, FPE showed a 100% susceptibility to ESBL-producing and CEF resistant SPICE-organisms. This new combination demonstrated in-vitro activity against both ESBL-producing and SPICE organisms."

Preclinical • Infectious Disease • Pneumonia

In vitro activity of Cefepime/Enmetazobactam against Klebsiella pneumoniae carrying blaKPC allelic variants conferring resistance to Ceftazidime/Avibactam. (PubMed, Int J Antimicrob Agents) - No abstract available

Journal • Preclinical • Infectious Disease • Pneumonia

New β-Lactam/β-Lactamase Inhibitor Combination Antibiotics. (PubMed, Pathogens) - "During the last 2 years from the writing of this article, cefepime/enmetazobactam, aztreonam/avibactam, and sulbactam/durlobactam were approved for use in clinical practice. Aztreonam/avibactam is indicated for the treatment of adult patients who suffer from complicated intra-abdominal infections, complicated urinary tract infections including pyelonephritis, hospital-acquired pneumonia, and ventilator-associated pneumonia due to aerobic Gram-negative infections with limited therapeutic options. Sulbactam/durlobactam, a combination of 2 β-lactamase inhibitors, is indicated for the treatment of adult patients with hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia due to the Acinetobacter baumannii-calcoaceticus complex [including carbapenem-resistant Acinetobacter baumannii (CRAB) infections]."

Journal • Review • Infectious Disease • Nephrology • Pneumonia • Respiratory Diseases

Diagnostic algorithm for the detection of carbapenemases and extended-spectrum β-lactamases in carbapenem-resistant Pseudomonas aeruginosa. (PubMed, Microbiol Spectr) - "We used the following BL-BLI combinations: ceftolozane-tazobactam (C-T), ceftazidime-avibactam, imipenem-relebactam (I-R), meropenem-vaborbactam, cefepime-enmetazobactam (C-E), and aztreonam-avibactam. This method is particularly valuable for laboratories lacking access to molecular diagnostics, as it provides a practical alternative for routine testing. By facilitating the early detection of resistant P. aeruginosa strains, this approach has the potential to improve patient outcomes, optimize antimicrobial therapy, and enhance global surveillance efforts against multidrug-resistant pathogens."

Journal • Infectious Disease

Critical reappraisal of current issues for improving the proper clinical use of the incoming beta-lactam/beta-lactamase inhibitor combinations of tomorrow. (PubMed, Expert Rev Anti Infect Ther) - "A literature search was performed on PubMed-MEDLINE (until December 2024) for retrieving available studies on cefepime-enmetazobactam, sulbactam-durlobactam, and cefepime-taniborbactam. Overall, old habits die hard and issues retrieved with licensed beta-lactams emerged also with novel BL/BLIc of tomorrow, potentially affecting their efficacy when used in real-world practice. Adopting appropriate corrective measures for overcoming these issues might increase the likelihood of preserving their efficacy in the future by minimizing the propensity risk of resistance development."

Clinical • Journal • Infectious Disease • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases

Cefepime/enmetazobactam as treatment for extended-spectrum-betalactamase producing Escherichia coli bloodstream infection in a septic patient with liver cirrhosis: a case report (ESCMID Global 2025) - No abstract available

Case report • Clinical • Fibrosis • Gastroenterology • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis

Microbiological outcome of eradication of cefepime/enmetazobactam vs piperacillin/tazobactam against most common Enterobacterales at test of cure; a posthoc analysis from the ALLIUM Phase 3 trial (ESCMID Global 2025) - No abstract available

P3 data • Retrospective data

Outcomes by MIC values for patients infected with Enterobacterales treated with cefepime/enmetazobactam or piperacillin/tazobactam for complicated urinary tract infections in the phase 3 ALLIUM trial (ESCMID Global 2025) - No abstract available

Clinical • P3 data • Infectious Disease • Nephrology

Cefepime/enmetazobactam for Gram-negative PJIs? A porcine study evaluating target tissue concentrations following intermittent short-term infusion and continuous infusion of a novel antibiotic combination (ESCMID Global 2025) - No abstract available

Gram negative • Preclinical • Infectious Disease

Impact of bacterial inoculum on the activity of cefepime and cefepime/enmetazobactam against AmpC-hyperproducing Enterobacter spp (ESCMID Global 2025) - No abstract available

Cefepime/enmetazobactam as a carbapenem-sparing alternative: activity against extended-spectrum beta-lactamase-producing Enterobacteriaceae, with or without carbapenemases (ESCMID Global 2025) - No abstract available

Effect of cefepime/enmetazobactam (FEP-META) versus ceftazidime/avibactam (CAZ-AVI) in combination with aztreonam (ATM) against clinical isolates resistant to different β-lactamase classes (ESCMID Global 2025) - No abstract available

Clinical • Combination therapy