Recarbrio (relebactam/imepenem/cilastatin) / Merck (MSD) - LARVOL DELTA

Successful treatment of an intra-abdominal abscess caused by KPC-2-producing hypervirulent Klebsiella pneumoniae sequence type 11 with imipenem/cilastatin/relebactam in a Japanese patient. (PubMed, J Infect Chemother) - "Abscess drainage was performed, and he was initially treated with meropenem (2 g every 8 hours, prolonged infusion over 3 hours), gentamicin (5 mg/kg/day), and tigecycline (200 mg as a loading, followed by 100 mg every 12 hours). Imipenem/cilastatin/relebactam is potentially an option for treating infections caused by KPC-2-producing hypervirulent K, pneumoniae with porin mutations. Cross-border spread of pathogens that are both multidrug-resistant and hyperviirulent must be closely monitored."

Journal • Infectious Disease • Pneumonia

Activity of imipenem/relebactam against KPC-producing Klebsiella pneumoniae and the possible role of Ompk36 mutation in determining resistance: an Italian retrospective analysis. (PubMed, Ann Clin Microbiol Antimicrob) - "IMI/REL showed good in vitro activity against the KPC-Kp strains analysed. All the IMI/REL-resistant strains displayed a mutation in porin OmpK36 and produced carbapenemases, with KPC-2 and KPC-3 being equally distributed. MVB and CZA maintained good activity against IMI/REL resistant isolates."

Journal • Retrospective data • Infectious Disease • Pneumonia

Real-World Applications of Imipenem-Cilastatin-Relebactam: Insights From a Multicenter Observational Cohort Study. (PubMed, Open Forum Infect Dis) - "This study provides a comprehensive analysis of the real-world effectiveness and safety of IMI/REL. Comparative studies and investigations of specific subgroups will further enhance our understanding of IMI/REL in treating MDR infections."

Clinical • Journal • Observational data • Real-world evidence • Cardiovascular • Congestive Heart Failure • Critical care • Heart Failure • Infectious Disease • Respiratory Diseases

Single-centre real-life experience with imipenem/cilastatin/relebactam use at a tertiary care hospital in Italy, June 2022-November 2024 (ESCMID Global 2025) - No abstract available

Clinical

Efficacy and Safety of Imipenem/Cilastatin/Relebactam (IMI/REL) in Treating Complicated Intra-Abdominal Infections and Complicated Urinary Tract Infections: A Systematic Literature Review of Clinical Trials: RESOLVE (ESCMID Global 2025) - No abstract available

Clinical • Review • Infectious Disease • Nephrology

Phase 2/3, open-label, randomized, active-controlled clinical trial evaluating the safety and efficacy of imipenem/cilastatin/relebactam (IMI/REL) in paediatric patients with gram-negative bacterial infection (ESCMID Global 2025) - No abstract available

Clinical • Gram negative • P2/3 data • Infectious Disease • Pediatrics

Whole genome sequencing characterization of the new KPC-245 variant-carrying Klebsiella pneumoniae strain isolated from a transplanted patient and resistant to ceftazidime/avibactam, meropenem/vaborbactam and imipenem/relebactam. (PubMed, J Glob Antimicrob Resist) - "In our study, by using WGS analysis on a clinical isolate, we identified a new blaKPC variant inside the Tn4401 transposon. Our results confirm the important role of the continuous surveillance of MDR K. pneumoniae in the clinical context."

Journal • Infectious Disease • Pneumonia • Transplantation

Antimicrobial activity of new anti-Pseudomonas beta-lactam-beta-lactamase inhibitors against Pseudomonas aeruginosa respiratory isolates recovered during the study for Monitoring Antimicrobial Resistance Trends (SMART) program in France (2016-2022). (PubMed, Infect Dis Now) - "C/T is a reliable treatment option in RTI caused by P. aeruginosa."

Journal • Infectious Disease • Respiratory Diseases

Imipenem/Cilastatin-XNW4107 Versus Imipenem/Cilastatin/Relebactam for Treatment of Participants with Bacterial Pneumonia (XNW4107-302, REITAB-2) (clinicaltrials.gov) - P3 | N=450 | Completed | Sponsor: Evopoint Biosciences Inc. | Trial completion date: Dec 2025 ➔ Sep 2024 | Trial primary completion date: Apr 2025 ➔ Sep 2024 | Recruiting ➔ Completed

Trial completion • Trial completion date • Trial primary completion date • Infectious Disease • Pneumonia • Respiratory Diseases

ANTIMICROBIAL SUSCEPTIBILITY OF PSEUDOMONAS AERUGINOSA FROM ELDERLY PATIENTS IN THE ICU (SCCM 2025) - "We evaluated the in vitro activity of ceftazidime-avibactam (CAZ-AVI), ceftolozane-tazobactam (C-T), imipenem-relebactam (IMI-REL), and many comparator agents against contemporary PSA isolates from United States (US) medical centers...Among isolates recovered from elderly patients, lower susceptibility for ICU isolates compared to non-ICU isolates was observed for piperacillin-tazobactam (PIP-TAZ; 74.5% [ICU] vs. 84.7% [non-ICU]), meropenem (MEM; 76.7% vs. 87.7%), imipenem (77.9% vs. 86.1%), ceftazidime (78.8% vs. 87.1%), and cefepime (82.5% vs. 88.8%)... CAZ-AVI, C-T, and IMI-REL were highly active and exhibited similar coverage against a large contemporary collection of PSA isolates from elderly patients. Cross-resistance among these new β-lactamase inhibitor combinations varied markedly, indicating that all 3 should be tested in the clinical laboratory and available for clinical use."

Clinical • Infectious Disease

A NETWORK META-ANALYSIS TO DETERMINE OPTIMAL ANTIBIOTIC CHOICES FOR NOSOCOMIAL PNEUMONIA (SCCM 2025) - "Introduction: Several novel antibiotics have gained approval for the treatment of nosocomial pneumonia (both hospital-acquired and ventilator-associated) in recent years, including cefiderocol, imipenem/cilastatin/relebactam, ceftazidime/avibactam, and ceftolozane/tazobactam...In the GN network, meropenem was considered the reference treatment... All antibiotics targeting GN bacteria (except the combination of ceftazidime + aminoglycoside) had equivalent clinical efficacy and mortality in NP, including for the treatment of P. aeruginosa. Linezolid showed superior efficacy and a lower risk of acute kidney injury in presumed GP NP compared to vancomycin. These results suggest that when GN NP is suspected, empiric administration of novel antibiotics is not superior to treating with conventional anti-pseudomonal agents."

Retrospective data • Acute Kidney Injury • Infectious Disease • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases

ANTIMICROBIAL SUSCEPTIBILITY OF MULTIDRUG-RESISTANT ENTEROBACTERALES TO RECENTLY APPROVED Β-LACTAMS (SCCM 2025) - " Clinical isolates (1/patient) were consecutively collected from 82 US medical centers in 2019-2023 and tested for susceptibility at a monitoring laboratory by broth microdilution against ATM-AVI, ceftazidime-avibactam (CAZ-AVI), meropenem-vaborbactam (MEM-VAB), imipenem-relebactam (IMI-REL), cefiderocol (FDR), and comparators. ATM-AVI exhibited potent in vitro activity and spectrum against Enterobacterales from ICU and non-ICU patients, including MDR, XDR, CRE and isolates non-S to CAZ-AVI, MEM-VAB, IMI-REL, and/or FDR. In general, lower S rates were observed among ICU compared with non-ICU isolates."

Infectious Disease • Pediatrics

β-Lactam/β-Lactamase Inhibitor Combination Antibiotics Under Development. (PubMed, Pathogens) - "The incorporation of ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/cilastatin/relebactam has provided new therapeutic options in the treatment of patients with infections due to MDR pathogens. Cefiderocol along with cefepime/enmetazobactam, avibactam/aztreonam, and sulbactam/durlobactam have been recently added to these agents as therapeutic choices, particularly for metallo-β-lactamase producing Gram-negative bacteria...However, only a few have advanced through phase 1, 2, and 3 clinical trials. Among them, in this article, we focus on the most promising combinations of cefepime/zidebactam, cefepime/taniborbactam, and imipenem/cilastatin/funobactam, which are currently under investigation in phase 3 trials."

Journal • Review • Infectious Disease

The Effectiveness of Newer Beta-Lactams for the Treatment of Antimicrobial-Resistant Gram-Negative Meningitis. (PubMed, Clin Infect Dis) - "Several newer β-lactam agents with activity against DTR gram-negatives are available including cefiderocol, ceftazidime-avibactam, ceftolozane-tazobactam, imipenem-cilastatin-relebactam, meropenem-vaborbactam, and sulbactam-durlobactam. In this article, we review host and drug factors that influence an antibiotic's likely effectiveness for the treatment of bacterial meningitis. We also review the preclinical and clinical data in support of or against each of the aforementioned agents for the treatment of bacterial meningitis."

Journal • CNS Disorders • Infectious Disease

Comparison of the in vitro activities and resistance mechanisms against imipenem-relebactam and ceftazidime-avibactam in clinical KPC-producing Klebsiella pneumoniae isolated in China. (PubMed, Infection) - "In summary, this study suggested that IMI-REL may have superior inhibitory effects in vitro on KPC-Kps than CAZ-AVI, and described the differences in resistance mechanisms between the two antibiotics."

Journal • Preclinical • Infectious Disease • Pneumonia

Mutations leading to ceftolozane/tazobactam and imipenem/cilastatin/relebactam resistance during in vivo exposure to ceftazidime/avibactam in Pseudomonas aeruginosa. (PubMed, Microbiol Spectr) - "This work was undertaken to determine the mutation that caused resistance to three antibiotics for highly resistant Pseudomonas aeruginosa infection treatment while the bacteria were exposed to only one of these agents. The findings provide evidence that drug developers should endeavor to find effective antibiotics with new targets and that medical providers should utilize medications with different mechanisms of action in bacteria that have become resistant to even one of these three agents."

Journal • Preclinical • Infectious Disease

Suggested Dosing of Select Beta-lactam Agents for the Treatment of Antimicrobial-Resistant Gram-Negative Infections in Children. (PubMed, J Pediatric Infect Dis Soc) - "Optimizing antibiotic dosing is critical to improving the outcomes of children with AMR infections."

Journal • Infectious Disease • Pediatrics

Antimicrobial activity of imipenem/relebactam and comparator agents against Gram-negative isolates collected from pediatric patients: SMART 2018-2022 Global Surveillance. (PubMed, J Pediatric Infect Dis Soc) - "Based on in vitro data, IMI/REL represents a good therapeutic option for most hospitalized pediatric patients infected with common Gram-negative pathogens."

Journal • Infectious Disease • Pediatrics

Imipenem/Cilastatin/Relebactam Pharmacokinetics, Safety, and Outcomes in Adults and Adolescents With Cystic Fibrosis (clinicaltrials.gov) - P4 | N=4 | Terminated | Sponsor: Hartford Hospital | N=16 ➔ 4 | Recruiting ➔ Terminated; Difficulty enrolling

Enrollment change • Trial termination • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

A phase III randomized controlled non-inferiority trial to study the efficacy and safety of imipenem/cilastatin/relebactam (IMI/REL) versus piperacillin/tazobactam (PIP/TAZ) in patients with hospital-acquired bacterial pneumonia (HABP) or ventilator-associated bacterial pneumonia (VABP). (PubMed, Int J Infect Dis) - P3 | "IMI/REL met non-inferiority criteria versus PIP/TAZ for 28-day ACM, and safety profiles were comparable. This trial could support the use of IMI/REL to treat adults with HABP/VABP, including regional use in China."

Head-to-Head • Journal • P3 data • Infectious Disease • Pneumonia • Respiratory Diseases

Real-World Experience of Imipenem-Relebactam Treatment as Salvage Therapy in Difficult-to-Treat Pseudomonas aeruginosa Infections (IMRECOR Study). (PubMed, Infect Dis Ther) - "Imipenem/cilastatin/relebactam may represent a treatment option for patients with DTR-P. aeruginosa infections, which should be validated in prospective clinical trials."

Journal • Real-world • Real-world evidence • Critical care • Infectious Disease • Pneumonia • Respiratory Diseases • Septic Shock

First case report of a vertebral osteomyelitis caused by carbapenem-resistant Enterobacter cloacae treated with imipenem/cilastatin/relebactam prolonged infusion then meropenem/vaborbactam in continuous infusion. (PubMed, Front Pharmacol) - "Therapeutic drug monitoring confirmed that extended-infusion of I-R and continuous infusion of MVB achieved serum concentrations up to 12 mg/L of imipenem and 19 mg/L of meropenem, respectively. The favourable outcome of this patient treated for a vertebral osteomyelitis caused by carbapenem-resistant E. cloacae suggest that extended- and continuous infusions of I-R and MVB, are promising regimens for treatment of BJIs caused by carbapenem-resistant Enterobacterales."

Journal • Infectious Disease • Inflammation

Impact of Obesity on the Pharmacokinetics of Imipenem-Relebactam in ICU Patients (clinicaltrials.gov) - P4 | N=0 | Withdrawn | Sponsor: University of Illinois at Chicago | N=12 ➔ 0 | Enrolling by invitation ➔ Withdrawn

Enrollment change • Trial withdrawal • Genetic Disorders • Obesity

In vivo development of resistance to novel β-lactam/β-lactamase inhibitor combinations in KPC-producing Klebsiella pneumoniae infections: a case series. (PubMed, Eur J Clin Microbiol Infect Dis) - "Therapy with novel βL/βLICs or cefiderocol may lead to the selection of resistant mutants in the presence of factors influencing the achievement of PK/PD targets. KPC variants are mainly associated with resistance to ceftazidime/avibactam, and some of them (e.g. KPC-14) may also be associated with reduced susceptibility to aztreonam/avibactam and/or cefiderocol. Loss of function of the OmpK35 and OmpK36 porins appears to play a role in the development of resistance to meropenem/vaborbactam and/or imipenem/relebactam, but other mechanisms may also be involved."

Journal • Preclinical • Acute Kidney Injury • Cardiovascular • Genetic Disorders • Infectious Disease • Nephrology • Obesity • Pneumonia • Renal Disease • Respiratory Diseases • Septic Shock

Evaluation of Imipenem-cilastatin-relebactam for the Treatment of Infections Caused by Pseudomonas aeruginosa (IDWeek 2024) - No abstract available

Infectious Disease