What does this research mean for the field?

Cefepime-enmetazobactam demonstrates superior in vitro activity compared to ceftazidime-avibactam and piperacillin-tazobactam against ESBL-producing, carbapenem-susceptible Enterobacterales, but lacks significant activity against carbapenem-resistant strains. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the in vitro susceptibility and potential carbapenem-sparing utility of cefepime–enmetazobactam compared to ceftazidime–avibactam and piperacillin–tazobactam against resistant Enterobacterales isolates.

September 2, 2026Japanese Journal of Infectious DiseasesOpen Access

Superior in vitro Activity of Cefepime–Enmetazobactam Over Ceftazidime–Avibactam and Piperacillin–Tazobactam Against 3rd Generation cephalosporin resistant Enterobacterales

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Authors

PAPrabhav AggarwalMaulana Azad Medical College SSSonal SaxenaMaulana Azad Medical College AAAnugula AmrithaMaulana Azad Medical College

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Implication

In vitro susceptibility study demonstrates high cefepime–enmetazobactam efficacy against cephalosporin-resistant Enterobacterales isolates, highlighting its potential as a carbapenem-sparing agent.

Key Points

To assess the in vitro susceptibility and potential carbapenem-sparing utility of cefepime–enmetazobactam compared to ceftazidime–avibactam and piperacillin–tazobactam against resistant Enterobacterales isolates.
Evaluated 383 non-duplicate resistant clinical isolates of Escherichia coli and Klebsiella pneumoniae subsp. pneumoniae collected from January 2023 to December 2024 at a tertiary-care centre in New Delhi, India.
Stratified isolates into third-generation cephalosporin-resistant but carbapenem-susceptible (Group A, n=258) and carbapenem-resistant (Group B, n=125).
Determined antimicrobial susceptibility via CLSI disc diffusion, evaluated synergy with aztreonam, and characterized ESBL and carbapenemase resistance genes.
In Group A, cefepime–enmetazobactam demonstrated higher susceptibility rates (95.4% for E. coli, 97.4% for K. pneumoniae) than ceftazidime–avibactam (88.1% and 84.6%) and piperacillin–tazobactam (5.4% and 10.2%).
In Group B (carbapenem-resistant Enterobacterales), cefepime–enmetazobactam susceptibility was low (13% in E. coli, 14.3% in K. pneumoniae), with ceftazidime–avibactam at 31.9% and 7.1%, and piperacillin–tazobactam at 0%.
ESBL production occurred in 88% of Group A isolates (94% blaCTX-M), whereas all Group B isolates harbored blaNDM and blaOXA-48 genes, with cefepime–enmetazobactam plus aztreonam synergy observed in ≤4% of strains.

Cite This Study

Aggarwal et al. (2026) studied this question.

synapsesocial.com/papers/6a97e237c562ede874ec6348 https://doi.org/10.7883/yoken.jjid.2025.245

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Implication

In vitro susceptibility study demonstrates high cefepime–enmetazobactam efficacy against cephalosporin-resistant Enterobacterales isolates, highlighting its potential as a carbapenem-sparing agent.

Superior in vitro Activity of Cefepime–Enmetazobactam Over Ceftazidime–Avibactam and Piperacillin–Tazobactam Against 3rd Generation cephalosporin resistant Enterobacterales

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Cite This Study

Superior in vitro Activity of Cefepime–Enmetazobactam Over Ceftazidime–Avibactam and Piperacillin–Tazobactam Against 3rd Generation cephalosporin resistant Enterobacterales

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Cite This Study

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