A Study of Oral Tebipenem Pivoxil Hydrobromide (TBP-PI-HBr) Compared to Intravenous Imipenem-cilastatin in Participants With Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP)

Last updated: March 6, 2026
Sponsor: Spero Therapeutics
Overall Status: Completed

Phase

3

Condition

Urinary Tract Infections

Gynecological Infections

Urinary Incontinence

Treatment

Dummy Tablets

TBP-PI-HBr

Dummy Infusion

Clinical Study ID

NCT06059846
SPR994-305
2023-503785-22-00
  • Ages > 18
  • All Genders

Study Summary

The primary purpose of this study is to assess the efficacy of oral TBP-PI-HBr as compared with intravenous (IV) imipenem-cilastatin with respect to the overall response (combined clinical cure plus microbiological eradication) at the Test-of-Cure (TOC) visit in hospitalized adult participants (greater than or equal to (≥)18 years of age) with cUTI or AP.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Have a diagnosis of cUTI or AP.

  2. Have an adequate urine specimen for evaluation and culture obtained within 24 hoursprior to randomization with evidence of pyuria that includes at least one of thefollowing:

  3. at least 10 white blood cells (WBCs) per high power field (HPF) in urinesediment

  4. at least 10 WBCs per millimeters cubed (mm^3) in unspun urine

  5. positive leukocyte esterase (LE) on urinalysis Note: Participants may berandomized and administered study drug prior to knowledge of urine cultureresults, but pyuria must be documented.

  6. Expectation, in the judgment of the Investigator, that the participant will survivewith effective antimicrobial therapy and appropriate supportive care for theanticipated duration of the study.

Exclusion

Exclusion Criteria:

  1. Presence of any known or suspected disease or condition that may confound theassessment of efficacy.

  2. Gross hematuria requiring intervention other than administration of study drug orremoval/placement of urinary tract instrumentation.

  3. Urinary tract surgery within 7 days prior to randomization or urinary tract surgeryplanned during the study period.

  4. Creatinine clearance (CrCl) of ≤30 milliliters per minute (mL/min), as estimated bythe Cockcroft-Gault formula.

  5. Anticipated concomitant use of non-study antimicrobial drug therapy betweenrandomization and the LFU visit that would potentially effect outcome evaluations ofcUTI/AP.

  6. Receipt of a potentially effective antimicrobial within 72 hours prior to studyrandomization.

  7. Severe hepatic impairment at Screening, as evidenced by alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >5×upper limit of normal (ULN) or totalbilirubin >3×ULN, or clinical signs of cirrhosis or end-stage hepatic disease (e.g.,ascites, hepatic encephalopathy).

  8. Pregnant or lactating women.

  9. History of epilepsy or known seizure disorder (excluding a history of childhoodfebrile seizures).

  10. History of proven or suspected Clostridioides difficile associated diarrhoea.

  11. History of human immunodeficiency virus (HIV) infection.

  12. QT interval corrected using Fridericia's formula (QTcF) >480 milliseconds (msec)based on screening ECG.

  13. History of known genetic metabolism anomaly associated with carnitine deficiency.

  14. Requirement for concomitant use of valproic acid, divalproex sodium, or probenecidbetween randomization and EOT.

Note: Other inclusion and exclusion criteria as per protocol may apply.

Study Design

Total Participants: 1690
Treatment Group(s): 4
Primary Treatment: Dummy Tablets
Phase: 3
Study Start date:
December 21, 2023
Estimated Completion Date:
February 06, 2025

Study Description

The study included a pre-planned interim analysis with stopping criteria for efficacy and futility that was performed by an independent data monitoring committee (IDMC). For full details please refer to the protocol and statistical analysis plan.

Connect with a study center

  • Medical Facility

    Buenos Aires,
    Argentina

    Site Not Available

  • Medical Facility

    Buenos Aires 3435910,
    Argentina

    Site Not Available

  • Medical Facility

    Cordoba,
    Argentina

    Site Not Available

  • Medical Facility

    Córdoba,
    Argentina

    Site Not Available

  • Medical Facility

    Córdoba 3860259,
    Argentina

    Site Not Available

  • Medical Facility

    La Plata,
    Argentina

    Site Not Available

  • Medical Facility

    La Plata 3432043,
    Argentina

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  • Medical Facility

    Mendoza,
    Argentina

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  • Medical Facility

    Mendoza 3844421,
    Argentina

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    San Miguel de Tucumán,
    Argentina

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    San Miguel de Tucumán 3836873,
    Argentina

    Site Not Available

  • Medical Facility

    Villa Regina,
    Argentina

    Site Not Available

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    Villa Regina 3832647,
    Argentina

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  • Medical Facility

    Banja Luka,
    Bosnia and Herzegovina

    Site Not Available

  • Medical Facility

    Banja Luka 3204541,
    Bosnia and Herzegovina

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  • Medical Facility

    Sarajevo,
    Bosnia and Herzegovina

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  • Medical Facility

    Sarajevo 3191281,
    Bosnia and Herzegovina

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  • Medical Facility

    Tuzla,
    Bosnia and Herzegovina

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  • Medical Facility

    Tuzla 3188582,
    Bosnia and Herzegovina

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  • Medical Facility

    Barueri,
    Brazil

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  • Medical Facility

    Barueri 3470353,
    Brazil

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  • Medical Facility

    Campinas,
    Brazil

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    Campinas 3467865,
    Brazil

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    Curitiba,
    Brazil

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  • Medical Facility

    Curitiba 3464975,
    Brazil

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    Porto Alegre,
    Brazil

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    Porto Alegre 3452925,
    Brazil

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    Sao Jose do Rio Preto,
    Brazil

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    Sao Jose do Rio Preto,
    Brazil

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    São José do Rio Preto,
    Brazil

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    São José do Rio Preto 3448639,
    Brazil

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    Blagoevgrad,
    Bulgaria

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    Blagoevgrad 733191,
    Bulgaria

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    Dobrich,
    Bulgaria

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    Dobrich 726418,
    Bulgaria

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    Gabrovo,
    Bulgaria

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    Gabrovo 731549,
    Bulgaria

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    Lom,
    Bulgaria

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    Lom 729581,
    Bulgaria

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    Pleven,
    Bulgaria

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    Pleven 728203,
    Bulgaria

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    Plovdiv,
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    Plovdiv 728193,
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    Rousse,
    Bulgaria

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    Rousse 727523,
    Bulgaria

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    Ruse,
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    Shumen,
    Bulgaria

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    Shumen 727233,
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    Sliven,
    Bulgaria

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    Sliven 727079,
    Bulgaria

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    Sofia,
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    Sofia 727011,
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    Varna,
    Bulgaria

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  • Medical Facility

    Varna 726050,
    Bulgaria

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    Slavonski Brod,
    Croatia

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    Slavonski Brod 3190586,
    Croatia

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    Split,
    Croatia

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    Split 3190261,
    Croatia

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    Zagreb,
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    Zagreb 3186886,
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    Čakovec,
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    Kohtla-Järve 591260,
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    Parnu,
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    Tallinn,
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    Daugavpils 460413,
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    Liepaja,
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    Liepāja,
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    Liepāja 457954,
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    Riga,
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    Riga 456172,
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    Valmiera,
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    Valmiera 453754,
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    Chisinau,
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    Chisinau 618426,
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    Chisinau,
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    Krakow,
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    Lodz 3093133,
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    Łęczna 766583,
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    Brasov 683844,
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    Bucharest 683506,
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    Craiova 680332,
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    Iași,
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    Oradea 671768,
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    Timisoara,
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    Timișoara,
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    Timișoara 665087,
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    Belgrade,
    Serbia

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  • Medical facility

    Belgrade 792680,
    Serbia

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    Kragujevac,
    Serbia

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  • Medical facility

    Kragujevac 789128,
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  • Medical facility

    Nis,
    Serbia

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  • Medical facility

    Niš,
    Serbia

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  • Medical facility

    Niš 787657,
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  • Medical facility

    Novi Sad,
    Serbia

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  • Medical facility

    Novi Sad 3194360,
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    Bratislava,
    Slovakia

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  • Medical Facility

    Bratislava 3060972,
    Slovakia

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  • Medical Facility

    Galanta,
    Slovakia

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  • Medical Facility

    Galanta 3060219,
    Slovakia

    Site Not Available

  • Medical Facility

    Lučenec,
    Slovakia

    Site Not Available

  • Medical Facility

    Lučenec 3058986,
    Slovakia

    Site Not Available

  • Medical Facility

    Malacky,
    Slovakia

    Site Not Available

  • Medical Facility

    Malacky 3058897,
    Slovakia

    Site Not Available

  • Medical Facility

    Poprad,
    Slovakia

    Site Not Available

  • Medical Facility

    Poprad 723846,
    Slovakia

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  • Medical facility

    Benoni,
    South Africa

    Site Not Available

  • Medical facility

    Benoni 1020098,
    South Africa

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  • Medical facility

    Durban,
    South Africa

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  • Medical facility

    Durban 1007311,
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  • Medical Facility

    Pretoria,
    South Africa

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  • Medical Facility

    Pretoria 964137,
    South Africa

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  • Medical Facility

    Tongaat,
    South Africa

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    Tongaat 948468,
    South Africa

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    Umhlanga,
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    Umhlanga 946164,
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    Ankara,
    Turkey

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    Diyarbakir,
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    Istanbul,
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    Izmir,
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    Samsun,
    Turkey

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    Ankara,
    Turkey (Türkiye)

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  • Medical Facility

    Ankara 323786,
    Turkey (Türkiye)

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    Diyarbakır,
    Turkey (Türkiye)

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    Diyarbakır 316541,
    Turkey (Türkiye)

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    Istanbul,
    Turkey (Türkiye)

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    Istanbul 745044,
    Turkey (Türkiye)

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  • Medical Facility

    Izmir,
    Turkey (Türkiye)

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    Izmir 311046,
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    Samsun,
    Turkey (Türkiye)

    Site Not Available

  • Medical Facility

    Samsun 740264,
    Turkey (Türkiye)

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    Miami, Florida 33176
    United States

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  • Medical facility

    Miami, Florida 33144
    United States

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  • Medical Facility

    Miami 4164138, Florida 4155751 33176
    United States

    Site Not Available

  • Medical facility

    Miami 4164138, Florida 4155751 33144
    United States

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