20.500.12556/DiRROS-27738 Temocillin a narrative review of its clinical reappraisal Background: The emergence of multidrug-resistant Gram-negative bacteria, particularly extended-spectrum β-lactamase (ESBL) and AmpC-producing Enterobacterales, has brought renewed interest in temocillin, a narrow-spectrum β-lactam antibiotic first introduced in the 1980s. Objectives: We aimed to provide a comprehensive overview of the microbiological, pharmacological, and clinical profile of temocillin. Methods: We conducted a narrative review of the literature using the PubMed database to identify relevant studies concerning the microbiology, pharmacokinetics, pharmacodynamics, clinical applications, and safety of temocillin. Results: Temocillin shows strong in vitro activity against ESBL- and AmpC-producing organisms, and partial efficacy against certain Klebsiella pneumoniae carbapenemase (KPC)-producing strains. Its pharmacokinetic and pharmacodynamic characteristics, including β-lactamase stability and low ecological impact, support its use in urinary tract infections, bloodstream infections, intra-abdominal infections, pneumonia, and central nervous system infections. Additionally, evidence supports its utility in outpatient parenteral antimicrobial therapy (OPAT), including subcutaneous administration, and in vulnerable populations such as pediatric, elderly, and immunocompromised patients. Temocillin demonstrates a favorable safety profile, minimal disruption of gut microbiota, and cost-effectiveness. It also exhibits synergistic activity with agents like fosfomycin, further enhancing its clinical value. Most of the current evidence is derived from retrospective and observational studies. Conclusions: Temocillin emerges as a promising carbapenem-sparing option for the treatment of challenging infections caused by multidrug-resistant Gram-negative bacteria. temocillin extended-spectrum β-lactamase AmpC Klebsiella pneumoniae carbapenemase carbapenem-sparing antimicrobial stewardship outpatient parenteral antimicrobial therapy Enterobacterales true false true Angleški jezik Ni določen Neznano 2026-02-23 15:12:20 2026-02-23 15:12:20 2026-02-24 04:02:03 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 28. 8. 2025; str. 1-19 iss. 9, [article no.] 859 Vol. 14 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 615.33 2079-6382 10.3390/antibiotics14090859 246894595 RAZ_Cosimi_Lavinia_2025.pdf RAZ_Cosimi_Lavinia_2025.pdf 1 B4451F29857C0B783441BAD83DF0BAF8 eb0996c50f1b50aa7bb41244807dfdba461d5c6dc57ec27b29e50b15578a5c0c cf3dfd62-10c1-11f1-9cb0-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=40753 https://doi.org/10.3390/antibiotics14090859 0 db57123c-10c1-11f1-9cb0-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=40754 Univerzitetni klinični center Ljubljana 0 0 0