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Ceftibuten combined with avibactam, ledaborbactam, or xeruborbactam is active against serine-β-lactamase-producing Enterobacterales, while the ceftibuten/xeruborbactam combination additionally retains activity against metallo-β-lactamase (VIM and IMP) producers. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 31, 2026Antimicrobial Agents and Chemotherapy0 citationsOpen Access

Comparative activity of ceftibuten combinations with avibactam, ledaborbactam, and xeruborbactam against recombinant β-lactamase-producing Escherichia coli and contemporary WGS-characterized strains of carbapenemase-producing Enterobacterales

LSLucía Sánchez-PeñaInstituto de Investigación Biomédica de A Coruña SRSalud Rodríguez-PallaresInstituto de Salud Carlos III TBTania Blanco-MartínInstituto de Salud Carlos III

Key Points

This research aims to evaluate the effectiveness of ceftibuten combinations with avibactam, ledaborbactam, and xeruborbactam against resistant Escherichia coli and Enterobacterales.
Evaluated activity of three ceftibuten combinations against isogenic E. coli and clinical Enterobacterales isolates.
Analyzed effectiveness against various β-lactamase-producing strains including serine-β-lactamases and carbapenemase producers.
Used CLSI and EUCAST breakpoints to assess susceptibility rates.
Ceftibuten combined with avibactam and ledaborbactam improved activity against E. coli producing serine-β-lactamases.
Ceftibuten/xeruborbactam remained effective against VIM-producing clinical strains, showing activity against various resistant isolates.
Susceptibility rates for MBL producers depended on the breakpoint standards used.

Abstract

ABSTRACT We evaluated the activity of ceftibuten combinations with avibactam, ledaborbactam, and xeruborbactam against isogenic Escherichia coli and clinical Enterobacterales isolates producing broad-spectrum β-lactamases. Avibactam and ledaborbactam enhanced ceftibuten activity against transformants producing serine-β-lactamases. Ceftibuten/xeruborbactam was also active against VIM and some IMP producers. All combinations were active against OXA-48- and KPC-producing clinical isolates. Ceftibuten/xeruborbactam also retained activity against VIM-producing clinical strains. Susceptibility rates for MBL producers varied, depending on the CLSI or EUCAST breakpoints applied.

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