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Pilabactam is an experimental small-molecule serine β-lactamase inhibitor designed to restore or enhance the activity of β-lactam antibiotics against resistant Gram-negative pathogens, including carbapenem-resistant Enterobacterales and Acinetobacter baumannii. Preclinical data indicate that pilabactam potentiates the activity of partner β-lactams by inhibiting key class A/C/D serine β-lactamases, thereby preventing enzymatic hydrolysis of the antibiotic backbone and lowering MICs against multidrug-resistant isolates.[21][28] It is being developed as a parenteral adjunct to existing β-lactam regimens for severe bacterial infections, but remains in early-stage clinical development and is not yet approved for clinical use.[21][28]
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