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

Susceptibility and molecular characterization of isolates from a Phase 2/3, open-label, randomized, active-controlled clinical trial evaluating the safety and efficacy of imipenem/cilastatin/relebactam (IMI/REL) in pediatric participants with gram-negative (GN) bacterial infection (IDWeek 2025) - No abstract available

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

Efficacy and Safety of Imipenem/Cilastatin/Relebactam (IMI/REL) in Treating Hospital-Acquired and Ventilator-Associated Bacterial Pneumonia: A Systematic Literature Review of Randomized Control Trials (IDWeek 2025) - No abstract available

Clinical • Review • Infectious Disease

How do I manage Difficult-to-Treat Pseudomonas aeruginosa infections?: Key Questions for Today's Clinicians. (PubMed, Clin Microbiol Infect) - "Ceftolozane-tazobactam, ceftazidime-avibactam, imipenem-cilastatin-relebactam and cefiderocol are newer options, but resistance and lack of relevant data from randomised clinical trials hampers knowledge of the best way to use them. Ceftolozane-tazobactam and ceftazidime-avibactam are initially preferred when susceptible because they enter the market first and there is more published evidence about them. Ceftolozane-tazobactam is preferred in P. aeruginosa pneumonia instead of ceftazidime-avibactam. Both can be equally used in other P. aeruginosa infection types. Imipenem-relebactam and cefiderocol may retain susceptibility when there is resistance to ceftolozane-tazobactam and ceftazidime-avibactam, and when metallo-beta-lactamases are not present. However, there are no head-to-head comparative studies to support a preference for one over the other. In the presence of metallo-beta-lactamases, cefiderocol is the preferred agent. Other options in this situation are..."

Journal • Review • Infectious Disease • Pneumonia • Respiratory Diseases

In Vitro Activity of Novel β-Lactam/β-Lactamase Inhibitors Against Carbapenem-Resistant Pseudomonas aeruginosa and Enterobacterales in Korea. (PubMed, Antibiotics (Basel)) - "This study evaluated the in vitro susceptibility of CRE and CRPA blood isolates from Korea to novel β-lactam/β-lactamase inhibitor combinations: ceftolozane/tazobactam (C/T), ceftazidime/avibactam (CZA), imipenem/cilastatin/relebactam (IMR), and meropenem/vaborbactam (MEV). CZA, IMR, and MEV showed promising activity against KPC-producing CRE. These findings can inform empirical therapy and stewardship efforts in Korea."

Journal • Preclinical • Hematological Disorders • Hematological Malignancies • Infectious Disease • Oncology

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

Activity of Imipenem and Imipenem/Relebactam Against Clinical Anaerobe Isolates (ASM Microbe 2025) - "Imipenem/relebactam maintains the activity of imipenem against Bacteroides spp., with 82.9-100% susceptible at the breakpoint of ≤4 μg/mL. The addition of relebactam to imipenem did not demonstrably increase activity against these isolates. IMI/REL could be an important option for situations where mixed infections including anaerobes are present."

Clinical • Infectious Disease

Tackling multidrug-resistant gram-negative infections in Children globally: current therapeutic options and perspectives. (PubMed, Expert Opin Pharmacother) - "New β-lactam antibiotics, alone or in combination with β-lactamase inhibitors - such as ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam, and cefiderocol - have emerged as preferred options for treating carbapenem-resistant and difficult-to-treat Gram-negative infections. Therapy should be guided by pathogen identification and resistance mechanisms, as susceptibility profiles vary widely based on the resistance-mechanism. Older agents like colistin, fosfomycin, nitrofurantoin, and aminoglycosides remain important, particularly in resource-limited settings, despite concerns over toxicity and safety."

Journal • Review • Infectious Disease • Pediatrics

Breaking Through Resistance: A Comparative Review of New Beta-Lactamase Inhibitors (Avibactam, Vaborbactam, Relebactam) Against Multidrug-Resistant Superbugs. (PubMed, Antibiotics (Basel)) - "The introduction of new β-lactam-β-lactamase inhibitors (BLBLIs), such as ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/cilastatin/relebactam, expands our therapeutic options against carbapenem-resistant Gram-negative bacteria, including those pathogens for which therapeutic options are limited...The recent introduction of aztreonam/avibactam marks a significant advancement in our therapeutic armamentarium against metallo-β-lactamase-producing pathogens...The present review aims to provide clinicians with a detailed understanding of each BLBLI treatment option to guide the optimal use of these new agents for the effective treatment of difficult infections caused by carbapenemase-producing Enterobacterales infections. This review is based on literature retrieved from PubMed, Scopus, Web of Science, and the Cochrane Library."

Journal • Review • Infectious Disease

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