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Zidebactam is a novel small molecule beta-lactamase inhibitor and antibiotic adjuvant developed to combat serious infections caused by highly drug-resistant Gram-negative bacteria. It belongs to the bicyclo-acyl hydrazide (BCH) group, which is derived from diazabicyclooctanes (DBOs). Zidebactam acts as a dual-action agent by binding with high affinity to Penicillin-binding protein 2 (PBP2) and inhibiting class A and C beta-lactamases. This mechanism prevents the hydrolysis of partner antibiotics such as cefepime, thereby enhancing their antimicrobial activity. Zidebactam is primarily being developed in combination with cefepime for the treatment of complicated urinary tract infections, intra-abdominal infections, respiratory tract infections, neutropenic fever, and particularly for combating carbapenem-resistant Enterobacteriaceae and *Pseudomonas aeruginosa*.
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