Emerging treatments
Cefepime/enmetazobactam
A combination of the fourth-generation cephalosporin, cefepime, with the beta-lactamase inhibitor enmetazobactam. Cefepime/enmetazobactam is approved in the US and Europe for the treatment of complicated urinary tract infections (UTIs), including pyelonephritis, caused by designated susceptible microorganisms. In one double-blind phase 3 trial of patients with complicated UTI (including acute pyelonephritis), complete resolution of baseline signs and symptoms (at day 14) was greater among patients randomised to cefepime/enmetazobactam than patients randomised to piperacillin/tazobactam (79.1% vs. 58.9%, respectively).[60]
Aztreonam/avibactam
Aztreonam/avibactam (a combination of the monobactam antibiotic aztreonam with the beta-lactamase inhibitor avibactam) is approved in Europe for the treatment of complicated UTIs, including pyelonephritis. Aztreonam/avibactam is available in the US, but is not currently approved for the treatment of UTIs.
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