Complicated Urinary Tract Infections Have a New Treatment Option

For most people with urinary tract infections (UTIs), a short course of antibiotics is the go-to treatment. But for complicated urinary tract infections — severe bacterial illnesses that are resistant to different forms of antibiotics — this may not be adequate.

“While the oral form of this antibiotic is not more efficacious or safe than the intravenous alternative, it is more convenient and can avoid the need for hospitalization or home intravenous administration,” says Craig Comiter, MD, the clinic chief of urologic specialties at Stanford University in Palo Alto, California. “This makes a valuable treatment option for complicated UTIs slightly easier to prescribe.”

Dr. Comiter expects that once Utebzi becomes available (by the end of this year, according to GSK), it will also lead to cost savings because it may reduce the time needed for hospitalization or missed work.

What Are Complicated UTIs?

Complicated UTIs are different. They are much more serious and harder to treat. The symptoms can extend throughout the body, and may include:

• Fever
• Chills
• Nausea
• Vomiting
• Dehydration
• Fatigue
• Lower back pain

• Male biological sex (due to having a prostate and longer urethra)
• Functional or anatomical issues involving the urinary tract and bladder
• Kidney stones
• Diabetes
• Pregnancy
• Having a catheter
• Weakened immune system
• Renal failure
• A recent hospital stay, especially if a urinary stent was placed
• Recent surgery, including kidney transplant
  

An Oral Alternative to IV Medication

Amanda Peppercorn, MD, vice president of clinical development at GSK, calls carbapenems “a backbone for the treatment of severe infections in the hospital.”

“These medications are exclusively for very serious infections caused by bacteria with a lot of resistance,” says Dr. Peppercorn. “This drug brings the first oral carbapenem to market, so it allows patients — once they’ve stabilized from a very severe infection — to be able to be treated with an oral carbapenem, so that they can go home earlier or possibly avoid hospitalization.”

Patient Trials Show Significant Effectiveness

The FDA based its approval of Utebzi on results from a study involving nearly 1,700 adults hospitalized with complicated urinary tract infections. Over the course of 7 to 10 days, patients were randomly assigned to receive 600 milligrams (mg) of Utebzi orally every six hours or 500 mg of an intravenous form of carbapenem every six hours.

Those taking the pill had an overall success rate of almost 60 percent — about the same success rate as those receiving the IV administration.

About 90 percent of patients in both groups “felt better and had no clinical symptoms,” according to Peppercorn.

While Utebzi is expected to be available to consumers by the end of 2026, Peppercorn notes that details regarding its pricing and insurance coverage are yet to be worked out.