Pharmacological Profile of Cefepime Plus Enmetazobactam in the Treatment of Complicated Urinary Tract Infections Including Catheter-Associated Urinary Tract Infection (CAUTI)

Abstract Cefepime plus enmetazobactam represents a breakthrough novel combination of a β-lactam antibiotic and a β-lactamase inhibitor, which demonstrates extensive antibacterial activity against a wide range of both gram-positive and gram-negative bacteria. The structural properties of cefepime confer a notable degree of resistance to hydrolysis by AmpC β-lactamases, while enmetazobactam effectively inhibits all variants of Ambler Class A extended-spectrum β-lactamases (ESBLs), thus rendering the combination remarkably resilient against degradation by numerous ESBLs. The primary prospective application of cefepime/enmetazobactam lies in its potential role as a carbapenem-sparing therapeutic agent, specifically aimed at treating infections that are caused by ESBL-producing Enterobacterales, thereby minimizing the necessity for carbapenem usage and mitigating the associated toxicities linked to non-β-lactam alternatives. Additionally, there may be promising applications for cefepime/enmetazobactam in the management of reproductive tract infections, intra-abdominal infections, and neonatal sepsis, owing to its favorable spectrum of activity and pharmacokinetic attributes. However, it is essential to emphasize that further comprehensive non-clinical and clinical investigations are required before endorsing its use in these specific clinical contexts. The incorporation of such studies will not only elucidate the full potential of cefepime/enmetazobactam but will also provide the necessary data to validate its safety and efficacy in diverse patient populations. In conclusion, while cefepime/enmetazobactam holds significant promise for broadening the therapeutic arsenal against resistant bacterial infections, careful consideration and rigorous research are essential to ensure its appropriate application in clinical practice.