Tebipenem pivoxil

Tebipenem pivoxil
Tebipenem pivoxil
Clinical data
Trade namesOrapenem, others
Other namesTebipenem pivoxil hydrobromide (USAN US)
AHFS/Drugs.comutebzi
License data
Routes of
administration		By mouth
Drug classBeta-lactam antibiotic
ATC code
Legal status
Legal status
Identifiers
  • (4R,5S,6S)-(Pivaloyloxy)methyl 3-((1-(4,5-dihydrothiazol-2-yl)azetidin-3-yl)thio)-6-((R)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylate
CAS Number
PubChem CID
UNII
KEGG
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC22H31N3O6S2
Molar mass497.63 g·mol−1
3D model (JSmol)
  • [H][C@]12N(C(C(OCOC(C(C)(C)C)=O)=O)=C(SC3CN(C4=NCCS4)C3)[C@@H]2C)C([C@@]1([C@H](O)C)[H])=O

Tebipenem pivoxil, sold under the brand name Orapenem among others, is a beta-lactam antibiotic medication used for the treatment of complicated urinary tract infections, including pyelonephritis.[1] It is a broad-spectrum orally-administered antibiotic, from the carbapenem subgroup of beta-lactam antibiotics.[1] It was developed as a novel drug to combat bacteria that had acquired antibiotic resistance to commonly used antibiotics.[2][3] Tebipenem is the first carbapenem whose prodrug form is orally available.[4]

The most common side effects include diarrhea, headache, nausea, abdominal pain, increased liver enzymes, and Clostridioides difficile infection.[5]

Medical uses

Tebipenem pivoxil is indicated for the treatment of complicated urinary tract infections, including pyelonephritis, caused by the following susceptible microorganisms: Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex, Klebsiella oxytoca, and Enterococcus faecalis in adults who have limited or no alternative oral treatment options.[1]

In Japan, tebipenem pivoxil is approved for the treatment of haemophilus infections and streptococcal infections.[6]

Side effects

The most common side effects include diarrhea, headache, nausea, abdominal pain, increased liver enzymes, and Clostridioides difficile infection.[5]

History

The efficacy of tebipenem pivoxil was evaluated in adults with cUTI, including pyelonephritis, in a global, randomized, double-blind, double-dummy, noninferiority trial (NCT06059846).[5] In this trial, 1,690 hospitalized participants were randomly assigned to receive tebipenem pivoxil 600 mg orally every 6 hours or imipenem-cilastatin 500 mg intravenously every 6 hours for 7 to 10 days.[5] A total of 929 participants were considered the “intent-to-treat” population.[5]

Society and culture

Tebipenem pivoxil was approved for medical use in Japan in April 2009,[7] and in the United States in June 2026.[5]

Names

Tebipenem pivoxil is the international nonproprietary name.[8]

Tebipenem pivoxil is sold under the brand names Orapenem and Utebzi.[1][9]

Research

Tebipenem pivoxil is under development for the treatment of Shigella infections.[6]

References

  1. 1 2 3 4 5 "Utebzi (tebipenem pivoxil) tablets, for oral use" (PDF). U.S. Food and Drug Administration (FDA). Retrieved 14 July 2026.
  2. ↑ El-Gamal MI, Oh CH (2010). "Current status of carbapenem antibiotics". Current Topics in Medicinal Chemistry. 10 (18): 1882–97. doi:10.2174/156802610793176639. PMID 20615191.
  3. ↑ Fujimoto K, Takemoto K, Hatano K, Nakai T, Terashita S, Matsumoto M, et al. (February 2013). "Novel carbapenem antibiotics for parenteral and oral applications: in vitro and in vivo activities of 2-aryl carbapenems and their pharmacokinetics in laboratory animals". Antimicrobial Agents and Chemotherapy. 57 (2): 697–707. doi:10.1128/AAC.01051-12. PMC 3553697. PMID 23147735.{{cite journal}}: CS1 maint: overridden setting (link)
  4. ↑ Hazra S, Xu H, Blanchard JS (June 2014). "Tebipenem, a new carbapenem antibiotic, is a slow substrate that inhibits the β-lactamase from Mycobacterium tuberculosis". Biochemistry. 53 (22): 3671–8. doi:10.1021/bi500339j. PMC 4053071. PMID 24846409.
  5. 1 2 3 4 5 6 "FDA approves first oral carbapenem therapy for complicated urinary tract infections" (Press release). U.S. Food and Drug Administration (FDA). 17 June 2026. Retrieved 1 August 2026. Public Domain This article incorporates text from this source, which is in the public domain.
  6. 1 2 "GSK/Spero Therapeutics". AdisInsight. 19 June 2026. Retrieved 8 July 2026.
  7. ↑ "Tebipenem pivoxil". Inxight Drugs. 22 April 2009. Retrieved 19 June 2026.
  8. ↑ World Health Organization (2003). "International nonproprietary names for pharmaceutical substances (INN): recommended INN: list 49". WHO Drug Information. 17 (2). hdl:10665/72145.
  9. ↑ "Utebzi (tebipenem pivoxil) approved in the US for adults with complicated urinary tract infections (cUTIs)". Us.gsk.com. Retrieved 14 July 2026.

Further reading

  • Clinical trial number NCT06059846 for "A Study of Oral Tebipenem Pivoxil Hydrobromide (TBP-PI-HBr) Compared to Intravenous Imipenem-cilastatin in Participants With Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP) (PIVOT-PO)" at ClinicalTrials.gov
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