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Background  Tebipenem, an orally bioavailable carbapenem administered as a pro-drug, completed a phase 3 clinical trial for evaluating its safety and efficacy for the treatment of complicated urinary tract infection and acute pyelonephritis. The purpose of this study was to investigate the  in vitro  activity of tebipenem and comparator agents, including ertapenem and meropenem, against a recent collection of Gram-positive isolates associated with clinical infections.    Methods  The susceptibility of 580 Gram-positive organisms were tested, including: methicillin-susceptible  Staphylococcus aureus  (MSSA, 489 isolates), methicillin-susceptible  Staphylococcus epidermidis  (MSSE, 31), other methicillin-susceptible coagulase-negative staphylococci (MSCoNS, 29), and vancomycin-susceptible  Enterococcus faecalis  (31). The isolates were collected primarily from pneumonia in hospitalized patients (498 isolates; 85.9%), urinary tract infections (42 isolates; 7.2%), and bloodstream infections (38 isolates; 6.6%). Organisms were tested using reference broth microdilution methods in a central laboratory.Results  Tebipenem had an MIC 90  value of 0.03 mg/L against MSSA and 0.015 mg/L against MSSE isolates. Ertapenem MIC 90  values were 8-fold higher against MSSA (MIC 90 , 0.25 mg/L) and 32-fold higher against MSSE (MIC 90 , 0.5 mg/L). Tebipenem displayed an MIC 90  value of 0.03 mg/L against MSCoNS species other than  S. epidermidis . This result was 8- and 32-fold lower than those of meropenem (MIC 90 , 0.25 mg/L) and ertapenem (MIC 90 , 1 mg/L), respectively. Tebipenem inhibited all  E. faecalis  isolates at ≤1 mg/L (MIC 90 , 1 mg/L), with an MIC 90  value at least 2-fold lower than meropenem (MIC 90 , >1 mg/L) and 16-fold lower than ertapenem (MIC 90 , >8 mg/L).    Conclusion  Tebipenem displayed potent activity against methicillin susceptible staphylococci, including MSSA, MSSE, and other MSCoNS. Tebipenem  in vitro  activity was greater than meropenem and ertapenem when tested against  E. faecalis.  These data indicate that tebipenem may be an option for treating urinary tract infections caused by these organisms or as an empiric option to provide broader coverage against Gram-negative and -positive organisms.Disclosures    S J Ryan Arends, PhD ,  AbbVie (formerly Allergan ) (Research Grant or Support) GlaxoSmithKline, LLC  (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support) Nabriva Therapeutics  (Research Grant or Support) Spero Therapeutics  (Research Grant or Support)  Abby L. Klauer, n/a ,  Cidara Therapeutics, Inc.  (Research Grant or Support) Spero Therapeutics  (Research Grant or Support)  Nicole Cotroneo ,  Spero Therapeutics  (Employee, Shareholder)  Ian A. Critchley, Ph.D. ,  Spero Therapeutics  (Employee, Shareholder)  Rodrigo E. Mendes, PhD ,  AbbVie  (Research Grant or Support) AbbVie (formerly Allergan ) (Research Grant or Support) Cipla Therapeutics  (Research Grant or Support) Cipla USA Inc.  (Research Grant or Support) ContraFect Corporation  (Research Grant or Support) GlaxoSmithKline, LLC  (Research Grant or Support) Melinta Therapeutics, Inc.  (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support) Nabriva Therapeutics  (Research Grant or Support) Pfizer, Inc.  (Research Grant or Support) Shionogi  (Research Grant or Support) Spero Therapeutics  (Research Grant or Support)

1038. In Vitro Activity of Tebipenem, an Orally Available Carbapenem Agent, Against a Collection of Surveillance Gram-Positive Clinical Isolates