OMNIvance (xeruborbactam) / Brii Biosci, Shionogi - LARVOL DELTA

Metallo-β-lactamase-producing Pseudomonas aeruginosa: epidemiology, diagnostic challenges and therapeutic strategies in the era of MDR/XDR resistance. (PubMed, Front Microbiol) - "Among treatment, cefiderocol represents the most evidence-supported option for MBL-producing strains. Aztreonam-based combinations offer an alternative treatment option, provided susceptibility is confirmed by synergy testing. Emerging antimicrobials (e.g., taniborbactam-, xeruborbactam-, and zidebactam-containing regimens) and novel strategies such as bacteriophage therapy are regarded as promising alternatives...MBL-producing P. aeruginosa requires an integrated, mechanism-based diagnostic and therapeutic strategy incorporating local epidemiology, rapid diagnostics and optimized antimicrobial selection. Ongoing development of novel agents and precision microbiology tools is expected to further refine clinical management."

Journal • Review • Infectious Disease

Escherichia coli with penicillin-binding protein 3 insertions: implications for newer β-lactam/β-lactamase inhibitor combinations. (PubMed, Antimicrob Agents Chemother) - "Newer β-lactam/β-lactamase inhibitor combinations (ceftazidime/avibactam, aztreonam/avibactam, and cefepime/taniborbactam) and cefiderocol with affinities for PBP3 show reduced activity against E. coli with YRIN and YRIK insertions...In contrast, agents targeting PBP2, such as cefepime/zidebactam and cefiderocol-xeruborbactam, retain potent in vitro activity and will likely be important for future treatment strategies...There is an urgent need for enhanced global surveillance, along with rapid diagnostic tools capable of identifying PBP3 insertions and associated high-risk clones among carbapenemase-producing E. coli. Future strategies should prioritize agents with activities against multiple essential PBPs to preserve β-lactam efficacy."

Journal • Review

Cefiderocol-Xeruborbactam Antimicrobial Susceptibility Testing Does Not Require Iron-Depleted Media (IDWeek 2026) - No abstract available

Infectious Disease

Reproducibility of Cefiderocol-Xeruborbactam MIC Determinations in Cation Adjusted Mueller Hinton Broth and Iron Depleted CAMHB using Two Reading Endpoints (IDWeek 2026) - No abstract available

Infectious Disease

Activity of Cefiderocol-Xeruborbactam and Comparator Agents against Pseudomonas aeruginosa, Including Molecularly Characterized Isolates Recovered Globally in 2024 (IDWeek 2026) - No abstract available

Clinical • Infectious Disease

Activity of Cefiderocol-Xeruborbactam and Comparator Agents against Global Acinetobacter baumannii-calcoaceticus species complex Isolates (IDWeek 2026) - No abstract available

Clinical • Infectious Disease

Activity of Cefiderocol-Xeruborbactam and Comparator Agents against Enterobacterales, Including Molecularly Characterized Isolates Recovered Globally in 2024 (IDWeek 2026) - No abstract available

Clinical • Infectious Disease

Bactericidal Activity of Cefiderocol/Xeruborbactam in a Murine Urinary Tract Infection Model (IDWeek 2026) - No abstract available

Preclinical • Infectious Disease

Phenotypic and biochemical characterization of the class C β-lactamase, PAC-1. (PubMed, J Antimicrob Chemother) - "PAC-1 is not inhibited by avibactam and hydrolyses a broad range of β-lactams including the novel cephalosporin cefiderocol. The combination cefiderocol/zidebactam was the most active against PAC-1. Transposon-mediated dissemination across distinct lineages warrants continued epidemiological surveillance of PAC-type β-lactamases."

Journal

Boronic Acid Inhibitors of β-Lactamases: A Promising Strategy Against Antimicrobial Resistance. (PubMed, Med Res Rev) - "Clinically approved agents such as vaborbactam, as well as investigational compounds including taniborbactam, xeruborbactam, and benzoxaboroles, are discussed in the context of their therapeutic relevance and spectrum of activity. Additionally, the review explores innovative approaches such as kinetic target-guided synthesis and fragment-based design to expand the chemical space of boronic acid pharmacophores. Together, these advances underscore the potential of boronic acid-based BLIs as powerful tools in overcoming β-lactamase-mediated resistance and developing next-generation antimicrobial therapies."

Journal • Review

Boron-Containing Drug Candidates in Clinical Trials. (PubMed, Handb Exp Pharmacol) - "The agents reviewed include borofalan, delanzomib, flovagatran, dutogliptin, talabostat, numidargistat, OATD-02, AN0128, epetraborole, ganfeborole, acoziborole, taniborbactam, xeruborbactam, and sodium borocaptate, as well as the five FDA-approved boroncontaining drugs (bortezomib, ixazomib, crisaborole, tavaborole, vaborbactam). The review also highlights how clinical success depends on matching pharmacology with unmet need, feasible administration, competitive differentiation, and durable development partnerships. Ongoing advances in scaffold design, delivery, combination therapy, and indication selection are expected to broaden the therapeutic impact of boron-containing medicines."

Journal • Cardiovascular • Head and Neck Cancer • Hematological Disorders • Infectious Disease • Oncology • Pulmonary Disease • Respiratory Diseases • Solid Tumor • Thrombosis • Tuberculosis

Comparative evaluation of the activity of novel β-lactam antibiotics against difficult-to-treat Pseudomonas aeruginosa clinical isolates. (PubMed, JAC Antimicrob Resist) - "Among the 502 isolates, cefepime-zidebactam exhibited the highest in vitro activity (100% susceptibility), followed by cefiderocol-xeruborbactam (98%), cefiderocol (95%), ceftolozane-tazobactam (90%), cefepime-taniborbactam (86%), ceftazidime-avibactam (85%), and imipenem-relebactam (41%). While currently approved β-lactam agents retained activity against many DTR P. aeruginosa isolates, their performance was markedly compromised in the presence of carbapenemases, with the notable exceptions of cefepime-zidebactam and cefiderocol. Investigational β-lactam/β-lactamase inhibitor combinations exhibited consistently robust activity across resistance phenotypes, including carbapenemase-producing isolates, representing promising options for DTR P. aeruginosa infections."

Journal • Infectious Disease

Comparative activity of ceftibuten combinations with avibactam, ledaborbactam, and xeruborbactam against recombinant β-lactamase-producing Escherichia coli and contemporary WGS-characterized strains of carbapenemase-producing Enterobacterales. (PubMed, Antimicrob Agents Chemother) - "Ceftibuten/xeruborbactam also retained activity against VIM-producing clinical strains. Susceptibility rates for MBL producers varied, depending on the CLSI or EUCAST breakpoints applied."

Journal

A Review of β-Lactamase Inhibitors in Clinical Use and Development: Mechanisms, Spectrum, and Therapeutic Applications. (PubMed, Int J Microbiol) - "As the efficacy of conventional treatments diminishes, reliance on last-resort agents like carbapenems and colistin has increased, in turn accelerating resistance to these precious final-line options...A paramount, ongoing challenge remains the development of effective inhibitors against metallo-β-lactamases (MBLs), though promising candidates like taniborbactam and xeruborbactam are now in clinical development. This review synthesizes the current knowledge on these innovative inhibitors, from recently approved combinations like ceftazidime/avibactam and cefepime/enmetazobactam to those in advanced clinical trials, and critically examines the associated therapeutic challenges, including the emergence of resistance. By integrating mechanistic insights with clinical perspectives, this article is aimed at informing the ongoing battle against antimicrobial resistance and guiding the future development of life-saving therapeutic strategies."

Journal • Review • Infectious Disease

Impact of acquired broad-spectrum _xFFFF_-lactamases on susceptibility to oral cephalosporin (ceftibuten) and oral carbapenem (tebipenem) in combination with new _xFFFF_-lactamase inhibitors ledaborbactam and xeruborbactam in Escherichia coli (ESCMID Global 2026) - No abstract available

Combination therapy

Activity of cefiderocol/xeruborbactam against NDM-producing Escherichia coli isolates with PBP3 insertions and decreased susceptibility or resistance to aztreonam/avibactam, cefiderocol, and cefepime/taniborbactam (ESCMID Global 2026) - No abstract available

Impact of acquired broad-spectrum β-lactamases on susceptibility to oral cephalosporin (ceftibuten) and oral carbapenem (tebipenem) in combination with new β-lactamase inhibitors ledaborbactam and xeruborbactam in Escherichia coli (ESCMID Global 2026) - No abstract available

Combination therapy

Activity of cefiderocol/xeruborbactam against NDM-producing Escherichia coli isolates with PBP3 insertions and decreased susceptibility or resistance to aztreonam/avibactam, cefiderocol, and cefepime/taniborbactam (ESCMID Global 2026) - No abstract available

Comparative activity of cefepime/taniborbactam and cefiderocol/xeruborbactam against producers of KPC variants conferring resistance to ceftazidime/avibactam and cefiderocol (ESCMID Global 2026) - No abstract available

Ceftibuten in combination with avibactam, ledaborbactam and xeruborbactam: comparative activity against isogenic E. coli strains and a nationwide collection of carbapenemase-producing Enterobacterales (ESCMID Global 2026) - No abstract available

Combination therapy

New-generation antibiotics and non-antibiotic strategies against carbapenemase-producing Enterobacterales: More focus on metallo-β-lactamase producers. (PubMed, Int J Antimicrob Agents) - "Continued monitoring of resistance trends and the development of innovative therapeutic strategies is warranted in the ongoing battle against CPE harboring blaMBL."

Journal • Review • Infectious Disease

Activity of novel antibiotics against dual metallo-Beta-lactamase producing Enterobacter hormaechei clinical isolates. (PubMed, JAC Antimicrob Resist) - "Our findings indicate that E. hormaechei clinical isolates co-producing NDM and VIM metallo-carbapenemases exhibited susceptibility to all tested novel BL/BLIs, including aztreonam/avibactam, cefepime/taniborbactam and cefepime/zidebactam. The combination of cefiderocol and xeruborbactam restored the activity of cefiderocol."

Journal • Infectious Disease

P1, DDI & MAD PK and Safety Study of Xeruborbactam Oral Prodrug in Combo With Ceftibuten in Healthy Participants (clinicaltrials.gov) - P1 | N=53 | Completed | Sponsor: Qpex Biopharma, Inc. | Recruiting ➔ Completed | Trial completion date: Dec 2025 ➔ Jan 2025 | Trial primary completion date: Dec 2025 ➔ Jan 2025

Trial completion • Trial completion date • Trial primary completion date • Infectious Disease

Tricyclic boronic acids as broad-spectrum serine and metallo-β-lactamase inhibitors with in vitro activity against acinetobacter baumannii: a patent evaluation (us 2025/0223303). (PubMed, Expert Opin Ther Pat) - "This article concisely reviews structurally novel xeruborbactam-inspired tricyclic boronates (reported in US 2025/0223303) with promising inhibitory activities in vitro. By introducing novel thioether-based C5 sidechains onto the previously optimized bicyclic boronate core, the inventors explored novel chemical space yielding SBL/MBL inhibitors with seemingly improved activities against carbapenem-resistant (CR) Escherichia coli, Klebsiella pneumoniae, and, importantly, Acinetobacter baumannii, when used in combination with meropenem and/or biapenem (at least with respect to taniborbactam, i.e. boronate inhibitor in late-stage clinical development). Due to the major societal importance of β-lactams for modern medicine, and the clearly demonstrated clinical potential of functionalized cyclic boronates as potent dual-acting SBL/MBL inhibitors when used in combination therapies, there is ample opportunity and scope for continued investigation of this pharmacophore,..."

Journal • Preclinical • Review • Infectious Disease • Pneumonia

Susceptibilities of cefiderocol, meropenem-xeruborbactam, cefepime-taniborbactam, aztreonam-avibactam, and sulbactam-durlobactam against imipenem-non-susceptible Gram-negative bacilli in Taiwan. (PubMed, Int J Infect Dis) - " Cefiderocol was highly effective, whereas novel β-lactam/β-lactamase inhibitors activity varied by species and carbapenemase types. PBP3 alterations reduced FTB and AZA activity in INS-EC."

Journal • Infectious Disease • Pneumonia