Sulopenem Etzadroxil/Probenecid: A Comprehensive Review of an Oral Thiopenem
Abstract
Objective: To review the pharmacology, pharmacokinetics/pharmacodynamics, development, spectrum of activity, clinical trials, dosing/administration, and role of sulopenem etzadroxil/probenecid in current practice.
Data sources: PubMed, EMBASE, and ClinicalTrials.gov were queried using the terms Sulopenem, CP-70429, and CP-65207.
Study selection and data extraction: Articles written in English and published from January 1, 1989 to March 1, 2026 relating to development, clinical pharmacology, antimicrobial activity/testing, safety, and clinical trial data of sulopenem were reviewed.
Data synthesis: An oral penem prodrug coformulated with probenecid to increase exposure, sulopenem etzadroxil is active against many Enterobacterales, including extended-spectrum β-lactamase (ESBL) and AmpC producers. Sulopenem did not demonstrate noninferiority in the treatment of complicated urinary tract infections (cUTIs) compared with ertapenem followed by susceptibility-guided oral therapy, or complicated intraabdominal infections compared with ertapenem followed by either amoxicillin/clavulanate or ciprofloxacin and metronidazole. Compared with ciprofloxacin in the treatment of uncomplicated UTI (uUTI), sulopenem etzadroxil/probenecid did not demonstrate noninferiority in patients with ciprofloxacin-susceptible isolates. However, higher composite response rates were observed in infections caused by ciprofloxacin-nonsusceptible isolates. Sulopenem etzadroxil/probenecid demonstrated…
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