Imipenem-cilastatin-funobactam versus imipenem-cilastatin-relebactam in patients with hospital-acquired bacterial pneumonia or ventilator-associated bacterial pneumonia: a phase 3, double-blind, non-inferiority randomised trial.

In a phase 3 trial in HABP/VABP patients, imipenem-cilastatin-funobactam showed 14-day all-cause mortality of 3.0% versus 2.7% for imipenem-cilastatin-relebactam.

• Why it matters: HABP and VABP require new options against Gram-negative pathogens, and clinicians need evidence that a new regimen matches existing imipenem-cilastatin therapy on early survival and safety.
• What they did: In 62 hospitals (58 in China, three in the USA, one in Spain), adults with HABP/VABP were randomized 2:1 to 1·25 g imipenem-cilastatin-funobactam or 1·25 g imipenem-cilastatin-relebactam every 6 h for 7–14 days, with renal dose adjustment.
• The result: The 14-day mortality difference was 0·2% (95% CI −3·5% to 4·0%), meeting the 10% non-inferiority margin, and grade 3+ treatment-related adverse events were 7% versus 11%.

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