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TBP-PI-HBr

Phase 3

Urinary Tract Infection | Small molecule | Nephrology |Spero Therapeutics, Inc.|Last Updated: Mar 10, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment1,690
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06059846A 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)PHASE3 COMPLETED 1,690Dec 21, 2023Feb 6, 2025Mar 10, 202685 United States, Argentina +17
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Study Endpoints
Primary Endpoints
Number of Participants With Overall Response at the Test-of-Cure (TOC) Visit in the Microbiological Intent-to-Treat (Micro-ITT) Population
At Day 17 (TOC)

Overall response includes combined clinical cure plus microbiological eradication. Clinical cure is defined as a complete resolution or significant improvement of signs and symptoms of cUTI or AP present at baseline and no new symptoms, such that no further antibacterial therapy is warranted, and participant is alive. Microbiological eradication (favorable microbiological response) is defined as a reduction of baseline uropathogens to \<10\^3 CFU/mL and negative repeated blood culture if blood culture was positive for uropathogen growth at baseline and participant is alive.

Secondary Endpoints
Number of Participants With Overall Response (Combined Per-Participant Clinical Cure and Favorable Microbiological Response) at the TOC Visit in the Microbiologically Evaluable (ME) Population
At Day 17 (TOC)
Number of Participants With Overall Response at the End-of-Treatment (EOT) and Late Follow-Up (LFU) Visits in the Micro-ITT Population
At Day 10 (EOT) and Day 28 (LFU)
Number of Participants With Overall Response at EOT and LFU Visits in the ME Population
At Day 10 (EOT) and Day 28 (LFU)
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Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
TBP-PI-HBrEXPERIMENTALParticipants received TBP-PI-HBr 600 milligrams (mg), two x 300mg film-coated tablets, orally (PO) and a dummy infusion intravenously (IV), every 6 hours (q6h) from Day 1 through Day 10. Participants with estimated baseline creatinine clearance (CrCl) greater than (\>) 30 millilitres per minute (mL/min) and less than or equal to (≤) 50 mL/min received TBP-PI-HBr 300 mg q6h.
Imipenem-cilastatinACTIVE_COMPARATORParticipants received imipenem-cilastatin 500 mg, IV and matched dummy tablets, PO, q6h from Day 1 through Day 10. Dose adjustments for imipenem-cilastatin were made for participants with estimated baseline CrCl less than (\<) 90mL/min per approved imipenem-cilastatin package insert. Participants with baseline CrCl levels greater than or equal to (≥) 60 to \< 90 mL/min were administered imipenem-cilastatin, 400 mg IV q6h and participants with baseline CrCl levels \>30 to \<60 mL/min, were administered 300mg IV, q6h.
Interventions
NameTypeDescription
TBP-PI-HBrDRUGTBP-PI-HBr film-coated immediate-release tablets.
Imipenem-cilastatinDRUGSterile powder for reconstitution administered as IV.
Dummy InfusionDRUG0.9% sodium chloride administered as IV infusion.
Dummy TabletsDRUGTBP-PI-HBr matching dummy tablets.
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites85

Inclusion Criteria: 1. Have a diagnosis of cUTI or AP. 2. Have an adequate urine specimen for evaluation and culture obtained within 24 hours prior to randomization with evidence of pyuria that includes at least one of the following: 1. at least 10 white blood cells (WBCs) per high power field ...

Countries:United StatesArgentinaBosnia and HerzegovinaBrazilBulgariaCroatiaEstoniaGeorgiaGreeceHungaryIndiaLatviaMoldovaPolandRomaniaSerbiaSlovakiaSouth AfricaTurkey (Türkiye)
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Competitive Landscape -Urinary Tract Infections 5 trials
Recent Changes (Last 90 Days)
MEDIUMMay 21, 2026NCT06059846TRIAL_REMOVED: changed
MEDIUMMay 21, 2026NCT06059846TRIAL_REMOVED: changed