Cefepime/Enmetazobactam

Emery Haley, PhD, Scientific Writing Specialist

Cefepime/Enmetazobactam

Find the Latest FDA-Approved Labelling Information Here: Drugs@FDA Online Database 

Administrative Routes

Parenteral [intravenous infusion (IV)]

Other Names

Exblifep

Bacteriostatic or Bactericidal

Bactericidal [1]

Antibiotic Class

Fourth-Generation Cephalosporin/Beta-lactamase Inhibitor Combination

Mechanisms of Action

This antibiotic leverages dual mechanisms of action.   

Cefepime, a beta-lactam antibiotic, binds to penicillin-binding proteins (PBPs) on bacterial cell walls. PBPs are essential for the formation of peptidoglycan, which gives the bacterial wall strength and integrity. Binding of cefepime to PBPs leads to failure of peptidoglycan cell wall synthesis, causing bacterial cell death.    

Some bacteria develop resistance to beta-lactam antibiotics, like cefepime, by producing enzymes, called beta-lactamases, that degrade the antibiotic. Enmetazobactam helps preserve the activity of beta-lactam antibiotics by inhibiting these enzymes and allowing cefepime to then bind to PBPs and cause bacterial cell wall degradation. 

WHO AWaRe Classification

Not Listed (FDA approved in 2024 and should be included in WHO AWaRe revision in 2025)

Empiric Use Recommendations

No published guidance; However, IDSA guidelines include this class of combination antibiotic as an alternative therapy for complicated UTI with or without sepsis. [2]

Indication(s) Relevant to UTI

On label for complicated UTIs, including pyelonephritis, caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, or Enterobacter cloacae complex (part of the Enterobacter Group included in the Guidance® UTI test) in adults (patients age 18 years or older). 

Checkmarks

CLSI and/or FDA documents support the efficacy of this antibiotic against the following organisms from the Guidance® UTI test: Escherichia coli, Enterobacter Group organisms, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis.