Tebipenem Ushers in an Era of Oral Carbapenems

Drug-resistant Enterobacterales — for which parenteral drugs are the only treatment options — cause increased burden on patients and healthcare systems alike. Tebipenem is an orally bioavailable carbapenem with an activity spectrum comparable to ertapenem. In a placebo-controlled, blinded study, investigators randomized 1372 patients hospitalized with complicated urinary tract infections (UTIs) or pyelonephritis (mean age, 58; 58% female, 24% positive for extended-spectrum β-lactamase–producing Enterobacterales) to receive oral tebipenem (600 mg every 8 hours) or intravenous ertapenem (1 g every 24 hours). The primary endpoint was a composite of clinical cure and microbiologic response (defined as reduction of bacterial count to <10³ CFU/mL…