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Introduction

Student enjoyment pertains to the sense of pleasure or satisfaction that students derive from the learning process. Enjoyment of a learning activity fosters sustained motivation, enthusiasm, and positive emotions that enhance the overall learning experience.^1,2 This aspect of education is closely intertwined with both student interest and motivation. While these three concepts share connections, they represent distinct dimensions of a student’s engagement with learning. Student interest involves the curiosity and attraction that they feel toward a particular subject or activity, whereas motivation encompasses the factors that drive students to dedicate themselves to the learning process.³ According to the Self-Determination Theory, motivation is enhanced when learners experience autonomy in learning, feeling of competence, and sense of relatedness to other students.⁴ Similarly, constructivist theory emphasizes that learning is most engaging when students actively construct knowledge through hands-on activities, real-world problem-solving, and collaborative interaction.⁵ This indicates that motivation is dependent on multiple factors that include the learner’s psychological needs, personal values, and the social context in which learning occurs. The synergy of enjoyment, interest, and motivation is crucial for the academic achievement of students, as these elements significantly influence student engagement with the overall learning experience.^2–7 This combination contributes to a positive and effective learning atmosphere, fostering not only academic success but also a genuine passion for knowledge.^4,8 While these concepts may overlap, each would play a distinctive role in shaping and enhancing the overall quality of the student’s learning experience.

Given the close relationship between motivation and positive learning experiences, student enjoyment can be seen as a complementary driver of engagement, influenced by factors such as teachers’ proficiency, students’ self-efficacy, and the complexity of the subject matter. This perception drives the ongoing search for more engaging and effective instructional formats, highlighting the need to explore and refine pedagogical strategies that address diverse learning needs. Within this context, lectures remain one of the most scrutinized instructional methods in higher education. Over the past decades, the debate about the effectiveness of didactical lectures has persisted, yielding mixed outcomes that reflect the diverse perspectives among educators and the heterogeneous opinions held by students regarding instructional methods.^9–11 Didactic lectures have often faced criticism for their perceived lack of student enjoyment, primarily stemming from their reliance on passive one-way information delivery.^12–14 In contrast to active learning methodologies such as problem-based learning (PBL) or team-based learning (TBL), students frequently perceive didactic lectures as boring or ineffective.^12–14 In response to these critiques, many educators are adopting a more interactive approach to their lectures. They seek to engage students by incorporating entertaining activities such as real-life scenarios¹⁵ games¹⁶ technology¹⁷ or problem-solving components¹⁸ during lectures. However, despite these efforts, there are no universally clear guidelines on how to organize lectures that are not only educational but also enjoyable. Practical tips and useful recommendations published in Medical Teacher offer valuable strategies to help educators transform didactic lectures into interactive, and effective sessions.¹⁹

A skilled lecturer possesses the ability to attract the attention of students and enhance their enjoyment through various innovative techniques that include incorporating personal experiences, telling jokes, and sharing relevant stories.^2,20 The impact of such engaging teaching strategies extends beyond mere enjoyment; they have the potential to significantly influence the overall motivation and performance of students. An instructor with an entertaining and effective teaching style can successfully convey information, fostering a positive and dynamic learning environment that may surpass the positive ratings of active learning.²¹ In contrast, some instructors may lack the talent to effectively engage and motivate their students, resulting in a potential adverse effect on the students’ overall academic performance. However, it is worth noting that Deslauriers et al demonstrated that while students may rate enjoyable lectures positively and even feel they learned more compared to active learning sessions, objective measures showed that actual learning was greater in active learning environments that were perceived lower, indicating that high enjoyment does not necessarily lead to better learning.²²

The ongoing debate about the effectiveness of teacher-based learning methods (or passive instruction) versus student-based learning methods (or active instruction) is persistent despite the numerous studies conducted over the past decades. The multitude of factors influencing students’ enjoyment in both types of instruction could be responsible for the variable preferences or mixed feelings of enjoyment among students. In addition to the educational environment, factors such as teachers’ varying skills and experiences and the difficulty level of certain subjects all contribute to and impact the level of enjoyment experienced during a teaching activity.^1,13,14,22 Since enjoyment influences engagement, the present study aimed to develop and validate an objective instrument for systematically measuring students’ enjoyment in different pedagogical contexts, and to apply it in evaluating the enjoyment of first-year students in Physiology lectures. This kind of tool would help teachers to examine teaching strategies, identify the origins of differences in student enjoyment, and understand how the same strategies will yield different results when used by different teachers or when applied to different contexts. We sought to apply this scale objectively to measure the enjoyment scores of didactic lectures and investigate associated factors. Through this research, we aim to contribute valuable insights into the dynamics of student enjoyment, offering a tool that explores the factors that influence students’ learning experiences.

Methods

Study Design and Participants

In this cross-sectional study, we assessed the enjoyment levels of first-year undergraduate medical and dental students during two physiology lectures. Lectures were delivered by experienced and highly rated professor, followed a didactic format with interactive discussion to encourage student participation and lasted 50 minutes. First-year medical and dental students were chosen to participate in this study because they were newcomers to university health profession education, suggesting that they were unlikely to have developed preferences for specific instructional methods at this early stage. The University Research Ethics Committee granted approval for the study under the reference number “HEC-10-2023/24-F-M.” Informed consent was obtained by first providing students with a briefing sheet detailing the study’s aims and purpose. Students were informed that their participation was entirely voluntary and would not affect their marks or academic evaluation. They were then asked to sign a consent form confirming that they had read and understood the information and agreed to participate in the study. A total of 112 (68%) students participated in the study, with 32 (out of 47) participants from the dental college and 80 (out of 118) from the medical college. The measuring instrument was distributed to all students immediately following the teaching session.

Data Collection Tool

The Learning Enjoyment Scale (LES) was developed by the investigators as a comprehensive and objective measure of students’ enjoyment in the learning process (Figure 1). A brief description of the scale with guidance on its analysis, has been previously published as a data note.^23,24 The scale items are strategically based on the major categories of Bloom’s Taxonomy, specifically focusing on cognitive knowledge and affective attitudes. The LES comprises six items: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students are requested to assess each item using a five-point Likert scale, ranging from 1 to 5 (1 = strongly disagree, 2 = disagree, 3 = unsure, 4 = agree, and 5 = strongly agree). The minimum and maximum total scores across the six items are 6 and 30, respectively. If all responses are agree (ie, Likert scale 4), the total score is 24, representing 80% of the maximum score. Conversely, if all responses are unsure (ie, Likert scale 3), the total score is 18, which accounts for 60% of the maximum score. Consequently, an excellent score is deemed to be above 80% (25–30), an acceptable score falls within the range of 60–80% (18–24), and a low score is defined as less than 60% (< 18). These thresholds facilitate clear interpretation of students’ enjoyment levels and are consistent with educational standards for assessing performance and satisfaction in academic settings.

Figure 1 The Learning Enjoyment Scale. The Learning Enjoyment Scale (LES) is a comprehensive tool developed to assess student enjoyment. (A) contains six items measuring perceived learning, confidence, interest, and overall enjoyment. (B) contains six items assessing factors influencing enjoyment, such as teacher talent, content difficulty, participation, achievement of objectives, stress levels, and skill satisfaction.

The second section of the scale (enjoyment attributes) assesses the influence of various factors on students’ enjoyment. These factors include the teacher’s talent, the complexity of the topic, student participation, fulfillment of objectives, perceived stress levels, and the development of skills. The analysis of this section provides detailed understanding of the specific elements that impact students’ enjoyment during the learning process.

Data Analysis Plan

The statistical analysis for this study was carried out using the Statistical Package for Social Sciences (SPSS), version 26. Reliability analysis was applied to determine the internal consistency of the Learning Enjoyment Scale (LES) through Cronbach’s alpha. The obtained value of Cronbach’s alpha was interpreted, with values greater than 0.7 indicating a good level of internal consistency. General tendencies of the Learning Enjoyment Scale items were analyzed using the mean ± SD. The comparisons and associations between LES items or LES attributes and the total score categories were analyzed using the Spearman correlation and the chi-square test with Fisher’s exact correction, as appropriate. A p-value of <0.05 was considered statistically significant.

Results

Table 1 displays the items of the Learning Enjoyment Scale (LES), the learning domain assessed by each item and the general tendency of students to respond to each item. According to the Likert scale analysis, the overall tendency of students’ responses in this study was “agree”. Reliability and validity of the scale were confirmed in this study: internal consistency was excellent, with a Cronbach’s Alpha of 0.91. Exploratory Factor Analysis (EFA) supported the theoretical six-domain structure, with the first two components explaining 80.5% of the variance. Inter-item correlations ranged from 0.57 to 0.81, indicating meaningful relationships between items. These psychometric properties demonstrate that the LES is a robust and valid instrument for measuring students’ enjoyment in learning contexts.

Table 1 General Tendencies of Students’ Responses to the Learning Enjoyment Scale Items

Table 2 shows the relationships of the six items of the LES with the three categories of the total score (Low, Acceptable and Excellent). The table shows a significant relation between the students’ responses and the LES categories, with “agree” being the most frequent response and “acceptable” being the major LES category.

Table 2 Examining Students’ Responses to Learning Enjoyment Scale Questionnaire Items in Relation to Total Score Categories

Table 3 displays the association between enjoyment attributes and the three categories of the total score. Enjoyment of a learning activity was strongly related to teachers’ talent (P< 0.001), difficulty of the topic (P< 0.001), students’ active participation during the activity (P< 0.001), fulfillment of the objectives (P< 0.001), low level of stress during the activity (P< 0.001) and self-perception of acquired skills (P< 0.001).

Table 3 Relationships Between Enjoyment Attributes and Categories According to the Total Learning Enjoyment Scale

Most dental students (97%) and medical students (95%) showed either acceptable or high enjoyment scores for the Physiology lectures. The difference between students in the two colleges was not statistically significant (Table 4).

Table 4 Comparison of the Total Learning Enjoyment Scale Scores of Dental and Medical Students

Table 5 demonstrates moderate to strong positive Spearman correlations (ρ = 0.35–0.57) between the Total LES Score and all enjoyment attributes, indicating that students with higher LES scores consistently reported more favorable perceptions. The strongest association was observed for “The teacher is talented in teaching” (ρ = 0.57, p < 0.001), suggesting that perceptions of teaching talent are closely aligned with overall enjoyment levels. Other positive correlations further indicate that attributes such as active participation, fulfillment of learning objectives, reduced stress, satisfaction with skills gained, and perceived easiness of topic content also contribute meaningfully to students’ enjoyment.

Table 5 Spearman Correlation Between Total Learning Enjoyment Score and Enjoyment Attributes

Discussion

Enjoyment can be defined as a positive emotional response to learning experiences, characterized by interest, engagement, and satisfaction, which can coexist with the pursuit of academic excellence.²⁵ Because it is a subjective feeling, there is currently no universally accepted instrument for its assessment. Researchers have employed a variety of approaches, including single-question ratings (eg, on a scale from 0 to 6),²⁶ satisfaction questionnaires with open-ended items,^27,28 adapted items from the Achievement Emotions Questionnaire,²⁹ and researcher-designed questionnaires based on enjoyment indicators.³⁰ While these methods provide useful insights, they vary widely in scope, depth, and focus, highlighting the need for a more structured and comprehensive tool that captures multiple dimensions of enjoyment and links them to specific aspects of the learning experience.

The Learning Enjoyment Scale (LES) employed in this study was developed by researchers to directly measure students’ enjoyment following various types of teaching activities. In developing this scale, a direct question about enjoyment was incorporated, alongside additional items assessing students’ perceptions of various learning domains (knowledge, comprehension, application, and analysis) which are recognized to influence enjoyment. The scale reflects students’ satisfaction and self-perception of the knowledge acquired during the completed teaching activity. The psychometric properties, including excellent internal consistency (Cronbach’s Alpha = 0.91), strong inter-item correlations (ranging from 0.57 to 0.81), and support for the theoretical six-domain structure through Exploratory Factor Analysis (explaining 80.5% of the variance), confirm that the LES is a reliable and valid tool for measuring students’ enjoyment in learning contexts. A test–retest reliability is planned for future research to further validate the scale. The LES items are grounded in the major categories of Bloom’s Taxonomy, encompassing cognitive knowledge and affective attitude, while the psychomotor domain is partially addressed in the second section of the scale. Broadly, the scale evaluates students’ perceptions of knowledge, comprehension, application, analysis, interest, and enjoyment attained during the teaching activity. The calculated total LES provides a quantitative value for comparisons across different teaching activities and is categorized as excellent, acceptable, or low. Our findings revealed a significant relationship between students’ responses to the questionnaire items and LES score categories, with “Agree” emerging as the most frequent response and “Acceptable” being the predominant category.

The second section of the LES is excluded from the score calculation but plays a crucial role in assessing specific factors known to influence the overall enjoyment score. This section evaluates key elements impacting enjoyment, including the teacher’s proficiency, the complexity of the topic, active student participation, alignment with learning objectives, perceived stress during the teaching activity, and skill development. Our study demonstrated a significant association between these enjoyment attributes and the total LES score for Physiology lectures. The findings affirm that these factors collectively contribute to the study’s acceptable LES score. Notably, didactic lectures are well received by students when these factors are effectively considered and addressed. It is essential to highlight that these factors, such as teachers’ talent and skills in teaching, are often overlooked in comparisons of teaching methods’ effectiveness, including a large number of studies that praise problem-based learning and team-based learning pedagogy for being superior to lectures in many educational aspects, including enjoyment.^12–14 It is obvious that lectures can be engaging and enjoyable when presented by a talented faculty member and, conversely, uninteresting and ineffective when delivered by a faculty member lacking in presentation skills.

It is not surprising that the conclusion asserting that lectures are old teaching methods focused solely on simple transfer of information to passive listeners has been controversial for decades, as it overlooks the outcomes of interesting lectures delivered by expert talented professors who know how to draw the attention of their students through various interventions, such as stories, past experiences, gestures, a sense of humor, facial expressions, stimulating questions and purposeful movements.^13,31,32 In the absence of an objective tool for evaluation, we can claim that lectures described as ineffective might be just boring due to lack of experience or deficient skills of the presenting instructors. This perception often leads educators to undermine the role of lectures in efficiently conveying vital information to a large audience within a limited timeframe, thus favoring student-centered teaching methods that require minimal instructor input. Our assumption is supported by numerous studies indicating that didactic lectures are effective, or even superior to, alternative teaching methods.^12–14 Additionally, lectures delivered with a sense of humor and teacher’s enthusiasm are not only enjoyable but also more likely to be attended by students.^31,32 This underscores the importance of our proposed Learning Enjoyment Scale and its attributes, providing an objective means of measuring students’ enjoyment and facilitating comparisons across various teaching activities.

Given that the majority of our students expressed agreement and satisfaction with all the enjoyment attributes outlined in the questionnaire, especially the teacher’s talent, the anticipated significant relationship with an acceptable total LES score was validated. However, a previous study showed that although students reported a high enjoyment level of lectures delivered by experienced and highly appraised professors, the actual learning was less than expected.²² Similarly, while activities such as academic games can be more enjoyable and motivating than didactic lectures,³³ evidence indicates that knowledge retention from such games is often comparable to, or even lower than, that achieved through traditional lectures.^34,35 These findings suggest that factors other than enjoyment may play a more significant role in promoting effective learning.

Students might find enjoyment in didactic lectures because they can passively absorb information without the stress of demonstrating their understanding or skills. It is widely recognized that students may shy away from active participation in class due to anxiety or fear of judgment from their peers or instructors. Encouraging student participation without inducing stress fosters active engagement and promotes effective learning.³⁶ Even seemingly simple interventions, such as incorporating games, problems or humor, have been shown to reduce stress and enhance enjoyment.^16,18,37 Our findings align with this perspective, revealing a low perceived stress level during Physiology lectures. In contrast to more challenging subjects which may be less enjoyable, subjects such as Physiology, which are perceived as easier, are associated with lower stress levels. This is likely due to clarity, organization, and reduced demand for intense attention and deep thinking, which are factors that may contribute to a more conducive learning environment.

Several limitations must be considered when interpreting the results of this study. First, the study focused exclusively on first-year students, whose perceptions may differ from those of students in later years. Additionally, with a response rate of 68%, the impact of nonparticipating students’ perspectives on the results remains uncertain. Furthermore, the self-reported measure introduces the possibility of response bias. Moreover, the evaluation of enjoyment was conducted immediately after lectures, without assessing long-term knowledge retention. Finally, the developed LES was specifically applied to Physiology lectures within a single university in the UAE. Its generalizability and effectiveness should be further explored by applying it to other subjects, different teaching methods, and diverse geographic locations. This broader application would enhance the scale’s validity and provide a more comprehensive understanding of its utility in various educational contexts.

Conclusions

This study confirms that the Learning Enjoyment Scale (LES) is a reliable and valid tool for assessing students’ enjoyment across didactic lectures, demonstrating excellent internal consistency (Cronbach’s α = 0.91) and strong construct validity. Applied to undergraduate physiology lectures, the LES revealed that most students reported acceptable or high enjoyment levels, with no significant differences between medical and dental students. Enjoyment was most strongly associated with perceptions of the teacher’s talent, followed by active participation, fulfillment of learning objectives, reduced stress, satisfaction with skills gained, and perceived ease of content. Future research should explore the application of the LES in evaluating different instructional methods, its potential to predict learning outcomes, and its applicability across diverse disciplines and learning environments.

Data Sharing Statement

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

This study was approved by the Ethics Committee of RAK Medical and Health Sciences University, UAE (Approval No. HEC-10-2023/24-F-M), and followed the guidelines of the Declaration of Helsinki of the World Medical Association. Informed consent was obtained from all participants involved in the study.

Acknowledgments

The authors express their thanks to the students who participated in this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

The authors declare that they did not receive any funding towards this study.

Disclosure

The authors declare no competing interests.

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• Data presented at IDWeek 2025 after study stopped early for efficacy
• Primary endpoint met, demonstrating non-inferiority of oral tebipenem HBr compared to intravenous treatment¹
• A new oral option may reduce the need for cUTI treatment in hospital setting
• Data will be shared with regulatory authorities to support regulatory filings

GSK plc (LSE/NYSE: GSK) and Spero Therapeutics (Nasdaq: SPRO) today announced full results of the positive pivotal phase III PIVOT-PO trial evaluating tebipenem HBr, an investigational oral treatment for complicated urinary tract infections (cUTIs), including pyelonephritis (NCT06059846). These results were presented on 20 October 2025 in a late-breaking oral abstract session at ID Week 2025 in Atlanta, USA. 

Complicated UTIs represent an important health issue, with an estimated 2.9 million cases treated annually in the US alone.² These infections are often caused by multidrug-resistant pathogens³ and carry serious risks including organ failure, sepsis, and even death.^3-5 They also result in significant emergency department visits and hospitalisations, contributing to over $6 billion per year in healthcare costs.⁶ Current standard of care includes carbapenem antibiotics in cases of sepsis or resistance to other antibiotics but they are only available for intravenous administration typically occurring in hospital setting.^7,8 

The trial, which was stopped early for efficacy in May, demonstrated non-inferiority of tebipenem HBr compared to intravenous imipenem-cilastatin in hospitalised patients with cUTI, including pyelonephritis, based on the overall response (composite of clinical cure plus microbiological eradication of the bacteria causing the infection) at the test of cure visit. Tebipenem HBr (oral, 600 mg) achieved a 58.5% overall success rate (261/446 participants) compared to 60.2% overall success rate (291/483 participants) for imipenem-cilastatin (intravenous, 500 mg) (adjusted treatment difference: −1.3%; 95% CI: −7.5%, 4.8%). The safety profile of tebipenem HBr was generally similar to that of imipenem-cilastatin and other carbapenem antibiotics. The most frequently reported adverse events (in ≥3% of patients who received tebipenem HBr) were diarrhea and headache; these events were all mild or moderate and non-serious. 

Tony Wood, Chief Scientific Officer, GSK, said: “Complicated UTIs can have serious consequences for patients, including organ failure and sepsis, and oral options for drug-resistant infections are limited. These ground-breaking data show for the first time that cUTIs, including pyelonephritis, can be treated with an oral carbapenem antibiotic as effectively as with an intravenous one. We have a long-standing commitment to delivering novel anti-infectives and are delighted to offer the potential of tebipenem HBr as an effective oral alternative that could be taken at home”. 

Esther Rajavelu, Chief Executive Officer, Spero Therapeutics, said: “These data presented at IDWeek represent the culmination of years of dedicated work by our team in close collaboration with GSK. We are deeply grateful to the physicians, researchers, support staff, and, most importantly, to the patients who made this study, and the ones before it, possible. Along with GSK, we are now focused on advancing tebipenem HBr toward FDA submission and bringing this important therapy to patients in need.”

Dr George Sakoulas, Adjunct Professor Department of Pediatrics, UCSD School of Medicine and Chief Infectious Diseases Sharp Rees Stealy Medical Group, commented: “Increasing antibiotic resistance among community-acquired bacteria that cause cUTIs is greatly amplifying the burden of treatment for patients, clinicians, and payers. The therapeutic flexibility of a new oral antibiotic may reduce the need for intravenous antibiotics to treat cUTI, providing benefit to patients and improving treatment options.”

Secondary endpoints also show:

• Clinical cure (i.e. absence of symptoms) rates at test of cure visit were 93.5% in the tebipenem HBr group (417/446) compared to 95.2% in the imipenem-cilastatin group (460/483) with adjusted treatment difference: −1.6% (95% CI: −4.7%, 1.4%)
• Microbiological response rates at test of cure visit were 60.3% in the tebipenem HBr group (269/446) compared to 61.3% in the imipenem-cilastatin group (296/483) with adjusted treatment difference: −0.8% (95% CI: −6.9%, 5.3%)
• Overall, clinical and microbiological response rates at test of cure in participants with infections caused by antimicrobial-resistant Enterobacterales were consistent with the respective response rates in the primary analysis population. 

GSK plans to work with US regulatory authorities to include the data as part of a filing in Q4 2025. If approved, tebipenem HBr would be the first oral carbapenem antibiotic in the US for patients who suffer from cUTIs, adding to GSK’s growing anti-infectives portfolio and helping address the challenges of antimicrobial resistance (AMR). 

The development of tebipenem HBr is supported in part with federal funds from the U.S. Department of Health and Human Services; Administration for Strategic Preparedness and Response; Biomedical Advanced Research and Development Authority (BARDA), under contract number HHSO100201800015C.  

About tebipenem HBr

Tebipenem pivoxil as hydrobromide salt (Tebipenem HBr) is a late-stage development asset developed in collaboration with Spero Therapeutics. Tebipenem HBr is being developed to treat cUTIs, including pyelonephritis. In September 2022, GSK entered into an exclusive license agreement with Spero Therapeutics for the development and commercialisation of tebipenem HBr in all markets, except certain Asian territories. Under this agreement GSK has sub-licensed back to Spero Therapeutics the rights and responsibility to conduct certain development work including the PIVOT-PO Phase III study, after which sponsorship of the new drug application (NDA) will be transferred to GSK from Spero Therapeutics. Tebipenem HBr has received Qualified Infectious Disease Product (QIDP) and Fast Track designations from the US FDA.

About the PIVOT-PO trial

PIVOT-PO was a global, randomised, double-blind, pivotal, non-inferiority (NI margin: -10%) Phase III clinical trial of oral tebipenem HBr compared to IV imipenem-cilastatin, in hospitalised adult patients with cUTI including pyelonephritis. Patients were randomised 1:1 to receive tebipenem pivoxil (600 mg) orally every six hours, or imipenem-cilastatin (500 mg) IV every six hours, for a total of seven to ten days. Matching placebos were used to maintain blinding. The primary efficacy endpoint was overall response (composite of clinical cure plus microbiological eradication) at the test-of-cure visit (about 17 days from first dose administration of study drug) in patients with qualifying pathogens susceptible to imipenem. The trial enrolled a total of 1,690 patients, with randomisation stratified by age, baseline diagnosis (cUTI or pyelonephritis), and the presence or absence of urinary tract instrumentation. For further details on the trial, refer to clinicaltrials.gov identifier NCT06059846.

About complicated urinary tract infections (cUTIs)

cUTIs are broadly described as any UTI that carries an increased risk of morbidity and mortality.³ Definitions of cUTIs are not currently uniform among international societies and regulatory agencies.^{5, 9} cUTIs encompass a heterogeneous patient population due to the wide range of host factors, comorbidities and urological abnormalities associated with cUTIs.^{5, 9} Risk factors for cUTI include indwelling catheters, ureteric stents, neurogenic bladder, obstructive uropathy, urinary retention, urinary diversion, kidney stones, diabetes mellitus, immune deficiency, urinary tract modification, and UTIs in renal transplant patients.^{3, 10-13}

GSK in infectious diseases

GSK has pioneered innovation in infectious diseases for over 70 years, and the Company’s pipeline of medicines and vaccines is one of the largest and most diverse in the industry, with a goal of developing preventive and therapeutic treatments for multiple disease areas or diseases with high unmet needs globally. Our expertise and capabilities in infectious disease strongly position us to help prevent and treat disease, and potentially mitigate the challenge of antimicrobial resistance (AMR).

About Spero Therapeutics

Spero Therapeutics, headquartered in Cambridge, Massachusetts, is a clinical-stage biopharmaceutical company focused on identifying and developing novel treatments for rare diseases and multi-drug resistant (MDR) bacterial infections with high unmet need. For more information, visit www.sperotherapeutics.com

About GSK

GSK is a global biopharma company with a purpose to unite science, technology, and talent to get ahead of disease together. Find out more at gsk.com.

Cautionary statement regarding forward-looking statements

GSK cautions investors that any forward-looking statements or projections made by GSK, including those made in this announcement, are subject to risks and uncertainties that may cause actual results to differ materially from those projected. Such factors include, but are not limited to, those described in the “Risk Factors” section in GSK’s Annual Report on Form 20-F for 2024, and GSK’s Q2 Results for 2025.

References

1. Hong D. et al, Oral Tebipenem Pivoxil Hydrobromide vs Intravenous Imipenem-Cilastatin in Patients with Complicated Urinary Tract Infections or Acute Pyelonephritis: Efficacy and Safety Results from the Phase 3 PIVOT-PO study, Oral presentation at ID Week 2025, 20 October 2025. 
2. Carreno JJ, et al. Longitudinal, Nationwide, Cohort Study to Assess Incidence, Outcomes, and Costs Associated With Complicated Urinary Tract Infection. Open Forum Infect Dis. 2019;6:ofz446.
3. Sabih A, Leslie SW. Complicated urinary tract infections. In: StatPearls. 2023. StatPearls Publishing: Treasure Island, FL, USA.
4. Vallejo-Torres L, et al. Cost of hospitalised patients due to complicated urinary tract infections: a retrospective observational study in countries with high prevalence of multidrug-resistant Gram-negative bacteria: the COMBACTE-MAGNET, RESCUING study. BMJ Open. 2018;8:e020251.
5. Marantidis J, Sussman RD. Unmet Needs in Complicated Urinary Tract Infections: Challenges, Recommendations, and Emerging Treatment Pathways. Infect Drug Resist. 2023:16:1391-1405.
6. Lodise TP, et al. Hospital admission patterns of adult patients with complicated urinary tract infections who present to the hospital by disease acuity and comorbid conditions: How many admissions are potentially avoidable? Am J Infect Control. 2021;49(12):1528-1534.
7. Cotroneo, N., et al. In Vitro and In Vivo Characterization of Tebipenem, an Oral Carbapenem. Antimicrobial agents and chemotherapy. 2020. 64(8), e02240-19.
8. Maeda M, et al. Efficacy of carbapenems versus alternative antimicrobials for treating complicated urinary tract infections caused by antimicrobial-resistant Gram-negative bacteria: protocol for a systematic review and meta-analysis. BMJ Open. 2023 Apr 21;13(4):e069166.
9. Fernandez MM, et al. Poster presented at ESCMID Global, 27–30 April 2024, Barcelona, Spain. Poster P1023.
10. Bonkat G, et al. Keep it Simple: A Proposal for a New Definition of Uncomplicated and Complicated Urinary Tract Infections from the EAU Urological Infections Guidelines Panel. Eur Urol. 2024;86(3):195-197.
11. Wagenlehner FME, et al. Epidemiology, definition and treatment of complicated urinary tract infections. Nat Rev Urol. 2020;17(10):586-600.
12. Gomila A, et al. Predictive factors for multidrug-resistant gram-negative bacteria among hospitalised patients with complicated urinary tract infections. Antimicrob Resist Infect Control. 2018;7:111.
13. Altunal N, et al. Ureteral stent infections: a prospective study. Braz J Infect Dis. 2017;21(3):361-364.