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Utebzi (tebipenem pivoxil) is an oral carbapenem antibiotic indicated for the treatment of complicated urinary tract infections (cUTIs), including pyelonephritis, in adult patients who have limited or no alternative oral treatment options. Developed by Spero Therapeutics under a license agreement with GSK, which holds the New Drug Application sponsorship, Utebzi is the first and only oral carbapenem antibiotic approved in the United States. It is a prodrug that is rapidly converted to the active moiety, tebipenem, which exerts its antibacterial effect by binding to and inhibiting penicillin-binding proteins (PBPs) in bacterial cell walls, thereby disrupting cell wall biosynthesis and causing cell death. Utebzi is active against susceptible Gram-negative and Gram-positive pathogens, including *Escherichia coli*, *Klebsiella pneumoniae*, *Enterobacter cloacae* species complex, *Klebsiella oxytoca*, and *Enterococcus faecalis*.
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