Document:

EX-10.1

 Exhibit 10.1 

SECURITIES PURCHASE AGREEMENT 

This SECURITIES PURCHASE AGREEMENT (this “Agreement”) is dated as of January 16, 2020 (the “Agreement
Date”), by and among Iterum Therapeutics Bermuda Limited, a company formed under the laws of Bermuda (the “Company”), as issuer, Iterum Therapeutics plc, an Irish public limited company (“Iterum”), as
guarantor, Iterum Therapeutics International Limited, a company formed under the laws of Ireland, as guarantor, Iterum Therapeutics US Limited, a company formed under the laws of Delaware, as guarantor, and Iterum Therapeutics US Holding Limited, a
company formed under the laws of Delaware, as guarantor (the guarantors other than Iterum, collectively, the “Subsidiary Guarantors” and, together with Iterum, the “Guarantors”) and the Persons set forth on
Schedule 1 of this Agreement (together with their successors and assigns, the “Purchasers” and, together with the Company and Iterum, the “Parties”). 

W I T N E S S E T H: 

WHEREAS, the Company wishes to sell to the Purchasers Units (as defined below) consisting of (A) Notes (as defined below) in the
aggregate original principal amount of Fifty One Million Eight Hundred and Eighty Eight Thousand Dollars ($51,888,000) and (B) an aggregate of Two Million Five Hundred Ninety Four Thousand Four Hundred (2,594,400) RLNs (as defined below) in
accordance with Section 2.1 of this Agreement; and 
 WHEREAS, the Purchasers desire to purchase the Notes and the RLNs from the
Company. 
 NOW, THEREFORE, in consideration of the mutual covenants and agreements set forth herein, the Parties agree as follows: 

ARTICLE 1 
 DEFINITIONS

 Section 1.1 General Definitions. Wherever used in this Agreement, the Exhibits or the Schedules attached
hereto, unless the context otherwise requires, the following terms have the following meanings: 
 “Accredited Investor
Questionnaire” means a questionnaire used to determine a Purchaser’s status as an accredited investor, in a form satisfactory to the Company and Iterum. 

“Affiliate” means any Person or entity that, directly or indirectly through one or more intermediaries, controls or is
controlled by or is under common control with a person or entity, as such terms are used in and construed under Rule 144 under the Securities Act. With respect to a Purchaser that is not a Wellington Entity, any investment fund or managed account
that is managed on a discretionary basis by the same investment manager as such Purchaser will be deemed to be an Affiliate of such Purchaser. As used in this definition of “Affiliate,” the term “control” means the
possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a Person, whether through ownership of voting securities or partnership or other ownership interest, by contract, or otherwise. 

 

 “Agreement” shall have the meaning set forth in the introductory paragraph.

 “Agreement Date” shall have the meaning set forth in the introductory paragraph. 

“Applicable Laws” means all statutes, rules and regulations of Governmental Authorities in the United States or elsewhere
applicable to the Company, the Guarantors and their respective Subsidiaries. 
 “Authorized Shares Approval” means such
approvals as may be required from Iterum’s shareholders (i) to increase the authorized number of Ordinary Shares under Iterum’s Constitution such that the number of unissued Ordinary Shares that are available for issuance by Iterum,
less the number of shares that are issuable upon exercise, conversion or exchange of outstanding options, warrants or other securities or are reserved under any equity incentive plan maintained by Iterum, is greater than the total number of Ordinary
Shares that are issuable upon exchange of the then-outstanding 6.500% Exchangeable Senior Subordinated Notes issued under the Indenture (disregarding any limitations on exchange in Section 14.01(c) of the Indenture) and (ii) to amend
Article 7 of Iterum’s Articles of Association to authorize Iterum’s Board of Directors to allot and issue such newly created Ordinary Shares generally and to do so on a non pre-emptive basis as if
Section 1022 of the Irish Companies Act 2014 did not apply. 
 “Available Shares” means a number of Ordinary Shares
equal to the number of authorized but unissued Ordinary Shares that are available for issuance by Iterum (excluding any shares that are issuable upon exercise, conversion or exchange of outstanding options, warrants or other securities or are
reserved under any equity plan maintained by Iterum or reserved for exchange of any Notes issued pursuant to the Rights Offering). 

“Business Day” means any day other than a Saturday, a Sunday or a day on which the Federal Reserve Bank of New York is
authorized or required by law, regulation or executive order to close or be closed. 
 “Closing Date” shall have the
meaning set forth in Section 2.1 of this Agreement. 
 “Commission” means the United States Securities and Exchange
Commission. 
 “Dollars” and the “$” sign mean the lawful currency of the United States of America. 

“Exchange Act” means the Securities Exchange Act of 1934, as amended, including the rules and regulations promulgated
thereunder. 
 “Exchange Shares” means the Ordinary Shares issuable upon exchange of the Notes pursuant to the terms
thereof. 
 “Governmental Authority” means any government, governmental department, ministry, cabinet, commission, board,
bureau, agency, tribunal, regulatory authority, instrumentality, judicial, legislative, fiscal, or administrative body or entity, whether domestic or foreign, federal, state or local, having jurisdiction over the matter or matters and Person or
Persons in question. 

  
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 “Investment Company Act” means the Investment Company Act of 1940, as
amended, including the rules and regulations promulgated thereunder. 
 “Indenture” means the indenture, dated as of the
Closing Date, among the Company, Iterum, the Subsidiary Guarantors and U.S. Bank National Association, as trustee, under which the Notes are to be issued, substantially in the form attached hereto as Exhibit F. 

“Investor Rights Agreement” means the Investor Rights Agreement, dated as of the Closing Date, by and among the Company,
Iterum and each of the Purchasers, substantially in the form attached hereto as Exhibit A. 
 “Irish Takeover Rules”
means the Irish Takeover Panel Act, 1997, Takeover Rules 2013. 
 “Knowledge” means, with respect to the Company or any
Guarantor, the actual knowledge of Judith Matthews or Corey Fishman, in each case, after reasonable due inquiry. 
 “Material
Adverse Effect” means a material adverse effect on (i) the condition, financial or otherwise, operating results, assets, liabilities, operations or business of Iterum and its Subsidiaries, taken as a whole, or (ii) the ability of
Iterum to perform any of its material obligations under any of the Transaction Documents. 
 “Material Contract” means any
contract of Iterum or its Subsidiaries that has been filed or was required to have been filed as an exhibit to the SEC Reports pursuant to Item 601(b)(4) or Item 601(b)(10) of Regulation S-K. For the avoidance
of doubt, the Pfizer License shall at all times be deemed a Material Contract. 
 “Notes” means the 6.500% Exchangeable
Senior Subordinated Notes due 2025, fully and unconditionally guaranteed on an unsecured senior basis by the Guarantors, issued by the Company to the Purchasers under the Indenture. 

“Ordinary Shares” means the ordinary shares, $0.01 nominal value, of Iterum. 

“Organizational Documents” means the constitution, bylaws or similar documents, each as amended to date, of the Company and
the Guarantors. 
 “Parties” shall have the meaning set forth in the introductory paragraph. 

“Person” means and includes any natural person, individual, partnership, joint venture, corporation, trust, limited liability
company, limited company, joint stock company, unincorporated organization, Governmental Authority or any political subdivision or agency thereof, or any other entity. 

“Pfizer License” means that License Agreement, by and among Iterum, Iterum Therapeutics International Limited and Pfizer
Inc., dated as of November 18, 2015, as it may be amended from time to time. 
 “Placement Agent” means SVB Leerink
LLC. 

  
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 “Purchasers” shall have the meaning set forth in the introductory
paragraph. 
 “Regulation D” means Regulation D promulgated under the Securities Act. 

“Regulation S” means Regulation S promulgated under the Securities Act. 

“Required Purchasers” means, at any time, Purchasers holding (i) Notes representing more than 66 2/3% of the aggregate
principal amount of the Notes purchased under this Agreement, and (ii) RLNs representing more than 66 2/3% of the aggregate Principal Amount of the RLNs (as defined therein) purchased under this Agreement. 

“Rights Offering” means the public offering of subscription rights to purchase Units by Iterum and the Company to holders of
Ordinary Shares on a pro rata basis in accordance with their share ownership as of a record date to be determined by the Board of Directors of Iterum or a committee thereof; provided, that the Purchasers and their Affiliates shall not
purchase any Units pursuant to the Rights Offering (regardless of whether or not under Irish or other applicable law such subscription rights are required to be offered to the Purchasers). 

“RLNs” means the limited recourse royalty-linked subordinated notes issued to the Purchasers under the RLN Indenture. 

“RLN Indenture” means the Limited Recourse Royalty-Linked Subordinated Notes Indenture, dated as of the Closing Date, by and
among the Company, Iterum, the Subsidiary Guarantors, Iterum Holders’ Representative LLC, as Holders’ Representative, and Computershare Trust Company, N.A., as trustee, substantially in the form attached hereto as Exhibit G. 

“Rule 144A” means Rule 144A promulgated by the Commission pursuant to the Securities Act, as such rule may be amended from
time to time, or any similar rule or regulation hereafter adopted by the Commission having substantially the same effect as such rule. 

“Rule 9 Whitewash” means such approvals and waivers as may be required under the Takeover Rules or by the Irish Takeover
Panel to facilitate the issue of Exchange Shares without triggering a requirement for a mandatory offer under Rule 9 of the Irish Takeover Rules. 

“SEC Reports” shall have the meaning set forth in Section 3.1(a) of this Agreement. 

“Securities” means the Notes, the Exchange Shares and the RLNs. 

“Securities Act” means the Securities Act of 1933, as amended, including the rules and regulations promulgated thereunder.

 “Securityholder Questionnaire” means a questionnaire substantially in the form attached hereto as Exhibit B. 

“Shareholder Approval” means such approval as may be required from time to time by the applicable rules and regulations of
the Nasdaq Stock Market (or any successor entity) from Iterum’s shareholders with respect to the issuance of the Units (including the Notes) in 

  
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connection with the sale to the Purchasers hereunder and/or the issuance of all Ordinary Shares issuable in connection with the exchange of any Notes issued to the Purchasers hereunder. 

“Subsidiary or Subsidiaries” means, with respect to a Person, any entity of which securities or other ownership interests
having ordinary voting power to elect a majority of the board of directors or other individuals performing similar functions are at the time directly or indirectly owned or controlled by such Person. 

“SVB Facility” means that certain Loan and Security Agreement among the Subsidiary Guarantors, the Company and Silicon Valley
Bank, dated as of April 27, 2018 (as may be amended, modified, restated, replaced, or supplemented from time to time, including any deferrals, renewals, refinancings or extensions thereof). 

“Transaction Documents” means this Agreement, the Notes, the RLNs, the Indenture, the RLN Indenture and the Investor Rights
Agreement. 
 “Units” means units consisting of Notes and RLNs. 

“Wellington Entities” means Salthill Investors (Bermuda) L.P. and Salthill Partners, L.P. 

Section 1.2 Interpretation. In this Agreement, unless the context otherwise requires, all words and personal
pronouns relating thereto shall be read and construed as the number and gender of the party or parties requires and the verb shall be read and construed as agreeing with the required word and pronoun; the division of this Agreement into Articles and
Sections and the use of headings and captions is for convenience of reference only and shall not modify or affect the interpretation or construction of this Agreement or any of its provisions; the words “herein,” “hereof,”
“hereunder,” “hereinafter” and “hereto” and words of similar import refer to this Agreement as a whole and not to any particular Article or Section hereof; the words “include,” “including,” and
derivations thereof shall be deemed to have the phrase “without limitation” attached thereto unless otherwise expressly stated; references to a specified Article, Exhibit, Section or Schedule shall be construed as a reference to that
specified Article, Exhibit, Section or Schedule of this Agreement; and any reference to any of the Transaction Documents means such document as the same shall be amended, supplemented or modified and from time to time in effect. 

Section 1.3 Business Day Adjustment. If the day by which any payment or other performance is due to be made is not a
Business Day, that payment or performance shall be made by the next succeeding Business Day. 
 ARTICLE 2 

AGREEMENT FOR THE PURCHASE OF THE UNITS 

Section 2.1 Purchase and Sale of the Units. Subject to the conditions set forth in Article 4 of this Agreement, the
Company shall issue and sell to each Purchaser, and each Purchaser shall purchase from the Company, such Units as indicated opposite such Purchaser’s name on Schedule 1 hereto under the heading “Units Purchased”. Each
“Unit” shall consist of $1,000 principal amount of Notes and 50 RLNs. The closing shall occur on a date (“Closing  

  
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Date”) not more than five (5) Business Days following the Agreement Date, or such later date as mutually agreed by the Parties in writing. The purchase price per Unit shall be
$1,000, consisting of a purchase price per $1,000 principal amount of Notes of $768.73 and a purchase price per 50 RLNs of $231.27. 

Section 2.2 On the Closing Date, each Purchaser shall deliver or cause to be delivered to the Company (or to Iterum
if so directed by the Company), via wire transfer of immediately available funds pursuant to the wire instructions delivered to such Purchaser by the Company on or prior to the Closing Date, an amount equal to the purchase price to be paid by the
Purchaser for the Units to be acquired by it as set forth opposite the name of such Purchaser under the heading “Aggregate Purchase Price” on Schedule 1 attached hereto. 

Section 2.3 At or before the closing, the Company shall deliver or cause to be delivered to each Purchaser
(A) Notes representing the aggregate principal amount included in the number of Units being purchased by such Purchaser, registered in the name of the Purchaser, and (B) a number of RLNs included in the number of Units being purchased by
such Purchaser. 
 ARTICLE 3 

REPRESENTATIONS AND WARRANTIES 

Section 3.1 Representations and Warranties of the Company. Unless otherwise noted, the Company and the Guarantors
hereby represent and warrant, on a joint and several basis, as of the Agreement Date that: 
 (a) Since May 24, 2018, Iterum has timely
filed all required reports, schedules, forms, statements and other documents (including exhibits and all other information incorporated therein), and any required amendments to any of the foregoing, with the Commission (collectively, the
“SEC Reports”). As of their respective filing dates, each of the SEC Reports complied in all material respects with the requirements of the Exchange Act or the Securities Act, as applicable, and no SEC Reports, when filed, declared
effective or mailed, as applicable, contained any untrue statement of a material fact or omitted to state a material fact required to be stated therein or necessary in order to make the statements therein, in light of the circumstances under which
they were made, not misleading. There are no material open, outstanding or unresolved Commission comments to any SEC Reports. To the Knowledge of Iterum, none of the SEC Reports is the subject of any ongoing, pending or threatened, review, comment,
or investigation by the Commission or any other Governmental Authority. 
 (b) The financial statements of Iterum contained or incorporated
by reference in the SEC Reports complied as to form with the published rules and regulations of the Commission with respect thereto, were prepared in accordance with GAAP applied on a consistent basis throughout the periods involved and fairly
present in all material respects the financial position and the results of operations, changes in shareholders’ equity, and cash flows of Iterum at the respective dates of and for the periods referred to in such financial statements (except as
may be indicated in the notes thereto and for the omission of notes and audit 

  
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adjustments in the case of unaudited quarterly financial statements to the extent permitted by Regulation S-X or Regulation
S-K promulgated by the Commission, as applicable). 
 (c) Since December 31, 2018, neither
Iterum nor, to the Knowledge of Iterum, Iterum’s independent registered public accounting firm has identified or been made aware of (A) any significant deficiency or material weakness in the system of internal control over financial
reporting used by Iterum and its Subsidiaries that has not been subsequently remediated; or (B) any fraud, whether or not material, that involves Iterum’s management or other employees who have a role in the preparation of financial
statements or the internal control over financial reporting utilized by Iterum and its Subsidiaries. 
 (d) The Company, the Guarantors and
each of their respective Subsidiaries have been duly organized, are validly existing and in good standing under the laws of their respective jurisdictions of organization (to the extent that such qualification is required in the relevant
jurisdiction of organization), have the corporate power and authority to own their property and to conduct their business. The Company, the Guarantors and each of their respective Subsidiaries are duly qualified to transact business and are in good
standing in each jurisdiction in which the conduct of their business or their ownership or leasing of property requires such qualification, except to the extent that the failure to so qualify or be in good standing would not, individually or in the
aggregate, result in a Material Adverse Effect. 
 (e) Each of the Transaction Documents has been duly authorized by the Company and the
Guarantors and, when duly executed and delivered in accordance with its terms by the parties thereto, will constitute a valid and legally binding obligation of the Company and the Guarantors, enforceable against the Company and the Guarantors in
accordance with its terms, except as such enforceability may be limited by (i) applicable insolvency, bankruptcy, reorganization, moratorium or other similar laws affecting the enforcement of creditors’ rights generally, or
(ii) applicable equitable principles relating to enforceability (whether considered in a proceeding at law or in equity). 
 (f) The
authorized, issued and outstanding share capital of Iterum conforms to the description thereof contained in the SEC Reports, and since March 31, 2019, to Iterum’s Knowledge, there has been no material change to the number or percentage of
shares beneficially owned by any Person listed in the “Share Ownership of Certain Beneficial Owners and Management” section of Iterum’s 2019 proxy statement, as filed with the Commission on April 25, 2019 (other than as set forth
in any such Person’s beneficial ownership reports as filed with the Commission). All of the capital stock of the Company is owned by Iterum or a Subsidiary of Iterum. All of the issued shares of share capital of Iterum have been duly authorized
and validly issued and are fully paid and non-assessable. None of the outstanding share capital of Iterum was issued in violation of any preemptive rights, rights of first refusal or other similar rights to
subscribe for or purchase securities of, or other equity interests in, Iterum. Except as disclosed in the SEC Reports, there are no authorized or outstanding options, warrants, preemptive rights, rights of first refusal or other rights to purchase,
or securities convertible into or exchangeable or exercisable for, any capital stock of Iterum or any of its Subsidiaries (other than options or equity awards granted under Iterum’s equity incentive plans). 

  
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 (g) Assuming the valid passing of the Authorized Shares Approval by the requisite majority
of shareholders at a duly convened shareholder meeting, the Exchange Shares will be duly authorized and reserved and, when issued upon exchange of the Notes in accordance with the terms of the Notes and the Indenture, will be validly issued, fully
paid and not subject to calls for any additional payments (non-assessable), and the issuance of such Ordinary Shares will not be subject to any preemptive or similar rights. 

(h) The execution and delivery by the Company and the Guarantors of, and the performance by the Company and the Guarantors of their respective
obligations under, the Transaction Documents will not contravene any Organizational Documents of the Company or the Guarantors or any Material Contract, or any judgment, order or decree of any Governmental Authority, agency or court having
jurisdiction over the Company or the Guarantors or any of their respective Subsidiaries, and no consent, approval, authorization or order of, or qualification with, any Governmental Authority is required for the performance by the Company or the
Guarantors of its obligations under this Agreement, except those that have already been obtained or made or as may be required by the securities or Blue Sky laws of the various states in connection with the offer and sale of the Securities, or the
filing with the Commission of one or more registration statements pursuant to, and in accordance with, the Investor Rights Agreement. Neither the Company nor the Guarantors are in violation of its Organizational Documents. Neither the Company nor
the Guarantors are in breach of or otherwise in default, and no event has occurred which, with notice or lapse of time or both, would constitute such a default in the performance of any Material Contract, except (i) with respect to any Material
Contract other than the Pfizer License, for any such default that would not, individually or in the aggregate, have a Material Adverse Effect, and (ii) with respect to the Pfizer License, for any default that is immaterial and would not give
the counterparty thereto any right to terminate, amend or modify the Pfizer License or any rights or obligations of any Guarantor thereunder. 

(i) Since December 31, 2018, there have not been any changes, conditions, events or circumstances which have had, or would reasonably be
expected to have, a Material Adverse Effect, except in each case as described in the SEC Reports. 
 (j) Neither the Company nor the
Guarantors are, and immediately after issuance of the Notes and the RLNs, neither the Company nor the Guarantors will be, an “investment company” within the meaning of the Investment Company Act. 

(k) Since December 31, 2018, (i) Iterum has not incurred any material liability or obligation, direct or contingent, nor entered into any
material transaction; (ii) Iterum has not purchased any of its issued share capital (except in connection with the departure of an employee or consultant and pursuant to the terms of an existing agreement between such Person and Iterum of which
the Purchaser has been advised in writing), nor declared, paid or otherwise made any dividend or distribution of any kind on its share capital other than ordinary and customary dividends; and (iii) there has not been any material change in
Iterum’s share capital (other than options or equity awards granted under Iterum’s equity incentive plans), or the short-term debt or long-term debt of Iterum, except in each case as described in the SEC Reports. 

(l) Except as described in the SEC Reports, neither the Company nor Iterum has sold, issued or distributed any Ordinary Shares during the six-month period preceding the 

  
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Agreement Date, including any sales pursuant to (i) Rule 144A, (ii) Regulation D or (iii) Regulation S, other than Ordinary Shares issued pursuant to (1) the
Company’s or Iterum’s employee benefit plans, qualified stock option plans or other employee compensation plans, (2) outstanding options, rights or warrants or (3) transactions in connection with commercial relationships not
exceeding 5% in the aggregate of Iterum’s Ordinary Shares. 
 (m) Assuming the accuracy of the representations and warranties of the
Purchasers set forth in Section 3.2 of this Agreement and the Purchasers’ compliance with their agreements set forth therein, (i) the Notes and the RLNs will be issued in compliance with all applicable federal and state securities
laws and (ii) it is not necessary, in connection with the issuance and sale of the Notes and the RLNs to the Purchasers, to register the Securities under the Securities Act. 

(n) The issuance of the Notes, the RLNs and the Exchange Shares will not obligate the Company or Iterum to issue Ordinary Shares or any other
securities to any Person (other than the Purchasers or pursuant to the Rights Offering) and will not result in a right of any holder of the Company’s or Iterum’s securities, including the Ordinary Shares, to adjust the exercise,
conversion, exchange or reset price under any of such securities. Except (i) the Investor Rights Agreement and (ii) as otherwise disclosed in the SEC Reports, there are no stockholders’ agreements, voting agreements or other similar
agreements with respect to Iterum’s share capital, including the Ordinary Shares, to which Iterum is a party or, to Iterum’s Knowledge, between or among any of Iterum’s shareholders. 

(o) None of the Company, the Guarantors or any of their respective Affiliates (other than the Purchasers) has, directly or through any agent,
sold, offered for sale, solicited offers to buy or otherwise negotiated in respect of, any security (as defined in the Securities Act), that is or will be integrated with the sale of the Notes and the RLNs in a manner that would require registration
of the Notes or the RLNs under the Securities Act. 
 (p) None of the Company, the Guarantors or any of their respective Affiliates (other
than the Purchasers) or any other Person authorized to act on its or their behalf has (i) solicited offers for, or offered or sold, the Notes or the RLNs by means of any form of general solicitation or general advertising within the meaning of
Rule 502(c) of Regulation D or in any manner involving a public offering within the meaning of Section 4(a)(2) of the Securities Act or (ii) engaged in any directed selling efforts within the meaning of Regulation S, and all such Persons
have complied with the offering restrictions requirement of Regulation S. 
 (q) Neither the Company nor the Guarantors have taken, directly
or indirectly, without giving any effect to the activities of the Purchasers, any action designed to or that would reasonably be expected to cause or result in stabilization or manipulation of the price of any security of the Company or the
Guarantors to facilitate the sale or resale of the Notes or the RLNs. 
 (r) No Person, other than the Placement Agent and its Affiliates,
has or will have, as a result of the transactions contemplated by this Agreement or any of the other Transaction Documents, any right, interest or claim against or upon the Company or the 

  
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Guarantors for any commission, fee or other compensation as a finder or broker because of any act or omission by the Company, the Guarantors or their respective stockholders or Affiliates. 

(s) Neither (i) the Company, the Guarantors or, to the Company’s or the Guarantors’ Knowledge, their respective Affiliates
(other than the Purchasers) or (ii) to the Company’s or the Guarantors’ Knowledge, any of their respective directors, executive officers, other officers that may serve as a director or officer of any company in which it invests,
general partners or managing members, nor (iii) to Iterum’s Knowledge, any beneficial owner of 20% or more of Iterum’s voting equity securities (in accordance with Rule 506(d) of the Securities Act), is subject to any of the “bad
actor” disqualification events described in Rule 506(d)(1)(i) through (viii) under the Securities Act. 
 (t) There is no pending
or, to the Knowledge of the Company, threatened action, suit, proceeding or investigation that, individually or in the aggregate, would constitute or would reasonably be expected to reduce the amount of any Payment (as defined in the RLN Indenture),
including any action involving any of the Products (as defined in the RLN Indenture) or any intellectual property related to any of the Products. 

(u) Subject to the Pfizer License and the SVB Facility, the Company and the Guarantors are the exclusive owners of and hold all right, title
(legal and equitable) and interest in and to the rights in the Gross Revenues (as defined in the RLN Indenture), free and clear of all liens. 

(v) Subject to the Pfizer License and the SVB Facility, the Company and the Guarantors are the exclusive owners of the entire right, title and
interest in and to each of the Products, all data associated therewith, and all intellectual property rights covering or relating to the Products, free and clear of all liens. 

(w) All patents owned or controlled by the Company and the Guarantors covering any Product that have been issued or granted by the appropriate
patent office are valid and enforceable. 
 (x) The manufacture, use, offer for sale, sale and/or importation of any of the Products will not
infringe on any patent or other intellectual property rights of any third party. Neither Company nor Guarantor has received written or oral notice of any action, suit or proceeding that claims that the manufacture, use, marketing, sale, offer for
sale, importation or distribution of any Product infringes on any patent or other intellectual property rights of any third party or constitutes misappropriation of any third party’s trade secrets or other intellectual property rights. 

(y) The Guarantors are in compliance with all material terms of and obligations under the Pfizer License, are, the exclusive licensees of all
intellectual property rights purported to be licensed in the Pfizer License, and have not materially breached and are not in default under any material provision of the Pfizer License. To the Knowledge of the Guarantors, the Pfizer License is valid,
enforceable and in good standing. 
 (z) No event has occurred that would give Pfizer the right to unilaterally terminate the Pfizer License.
The Guarantors have not received any notice of an intention by 

  
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Pfizer to terminate the Pfizer License, and the Guarantors have not agreed with Pfizer to terminate the Pfizer License in whole or in part. 

(aa) The Guarantors are in compliance in all material respects with all applicable healthcare laws and regulations and with the codes of
conduct published by the Pharmaceutical Research and Manufacturers of America. 
 Section 3.2 Representations and
Warranties of the Purchasers. Each Purchaser, severally and not jointly, hereby represents and warrants on behalf of itself to the Company and the Guarantors as of the Agreement Date that: 

(a) Such Purchaser, if an entity, is duly organized and validly existing under the laws of the jurisdiction of its formation. 

(b) Each of the Transaction Documents to which it is a party has been duly authorized, executed and delivered by such Purchaser and constitutes
the valid and legally binding obligation of such Purchaser, enforceable against such Purchaser in accordance with its terms, except as such enforceability may be limited by (i) applicable insolvency, bankruptcy, reorganization, moratorium or
other similar laws affecting the enforcement of creditors’ rights generally, or (ii) applicable equitable principles relating to enforceability (whether considered in a proceeding at law or in equity). 

(c) Such Purchaser has full power and authority to purchase the Notes and the RLNs and to enter into and perform its other obligations under
each of the Transaction Documents and carry out the other transactions contemplated thereby. 
 (d) Each of the Notes, the RLNs and Exchange
Shares to be received by such Purchaser hereunder will be acquired for such Purchaser’s own account, and not with a view to the resale or distribution of any part thereof in violation of the Securities Act, and such Purchaser has no agreement
or understanding, directly or indirectly, or present intention of selling, granting any participation in or otherwise distributing the Notes, the RLNs or Exchange Shares in violation of applicable federal, state, European or Irish securities laws;
provided, however, nothing contained herein shall be deemed a representation or warranty by such Purchaser to hold the Securities for any period of time and such Purchaser reserves the right to dispose of the Securities at any time in
accordance with, or pursuant to, a registration statement or an applicable exemption under the Securities Act and any applicable European and Irish laws. 

(e) Such Purchaser can bear the economic risk and complete loss of its investment in the Securities and has such knowledge and experience in
financial and business matters that it is capable of evaluating the merits and risks of the investment contemplated hereby. 
 (f) Such
Purchaser understands that the Securities are characterized as “restricted securities” under the U.S. federal securities laws inasmuch as they are being acquired from the Company or Iterum in a transaction not involving a public offering
and that under such laws and applicable regulations such securities may be resold without registration under the Securities Act only in certain limited circumstances. 

  
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 (g) Such Purchaser understands that, except as provided below, certificates evidencing the
Securities may bear the following or any similar legend: 
 (i) “These securities represented hereby [and the securities issuable upon
exchange of these securities] have not been registered with the Securities and Exchange Commission or the securities commission of any State in reliance upon an exemption from registration under the Securities Act of 1933, as amended, and,
accordingly, may not be transferred unless (i) such securities have been registered for sale pursuant to the Securities Act of 1933, as amended, (ii) such securities may be sold pursuant to Rule 144, (iii) the Issuer has received
an opinion of counsel reasonably satisfactory to it that such transfer may lawfully be made without registration under the Securities Act of 1933, as amended, or (iv) the securities are transferred without consideration to an affiliate of such
holder or a custodial nominee (which for the avoidance of doubt shall require neither consent nor the delivery of an opinion).”; or 

(ii) If required by the authorities of any State in connection with the issuance of sale of the Securities, the legend required by such State
authority. 
 (h) Such Purchaser understands that the Securities are being offered and sold to it in reliance on specific exemptions from the
registration requirements of United States federal and state securities laws and that the Company and the Guarantors are relying in part upon the truth and accuracy of, and such Purchasers’ compliance with, the representations, warranties,
agreements, acknowledgments and understandings of such Purchaser set forth herein in order to determine the availability of such exemptions and the eligibility of such Purchaser to acquire the Securities. 

(i) Such Purchaser has (i) received all the information from the Company, the Guarantors and their management that the Purchaser considers
necessary or appropriate for deciding whether to purchase the Notes and the RLNs hereunder, including the SEC Reports and (ii) had an opportunity to ask questions and receive answers from the Company and the Guarantors regarding the Company and
the Guarantors, their financial condition, results of operations and prospects, and the terms and conditions of the offering of the Notes and the RLNs sufficient to enable it to evaluate its investment; provided, that the foregoing does not
limit or modify the representations and warranties made by the Company and the Guarantors in Section 3.1 of this Agreement or the right of each of the Purchasers to rely thereon. 

(j) Such Purchaser did not learn of the offering and sale of the Notes and the RLNs as a result of any general solicitation or general
advertising. 
 (k) Such Purchaser is an “accredited investor” as such term is defined in Regulation D. 

(l) Except in so far as such Purchaser is eligible to receive Ordinary Shares upon exchange of the Notes to be purchased by such Purchaser
hereunder and any seats on the Iterum Board of Directors pursuant to the Investor Rights Agreement, such Purchaser has no present intent to effect a “change of control” of the Company or Iterum as such term is understood under the rules
promulgated pursuant to Section 13(d) of the Exchange Act. 

  
 - 12 - 

 (m) Such Purchaser acknowledges that, subject to the terms of the Indenture, Iterum shall
not issue to any holder of a Note issued hereunder, and no such holder may acquire, a number of Ordinary Shares upon exchange of a Note and Iterum shall not otherwise issue any Ordinary Shares pursuant to the Indenture, to the extent that
(1) upon such issuance, the number of Ordinary Shares then beneficially owned by the holder and its affiliates and any other Persons or entities whose beneficial ownership of Ordinary Shares would be aggregated with the holder’s for
purposes of Section 13(d) of the Exchange Act (including any shares held by any “group” of which the holder is a member, but excluding shares beneficially owned by virtue of the ownership of securities or rights to acquire securities
that have limitations on the right to exchange, convert, exercise or purchase similar to the limitation set forth in the Indenture) would exceed 19.99% of the total number of Ordinary Shares issued and outstanding, (2) such issuance, when
aggregated with any other Ordinary Shares theretofore or simultaneously therewith issued to or otherwise beneficially owned by the holder and its affiliates and any other Persons or entities whose beneficial ownership of Ordinary Shares would be
aggregated with the holder’s for purposes of Section 13(d) of the Exchange Act (including any shares held by any “group” of which the holder is a member, but excluding shares beneficially owned by virtue of the ownership of
securities or rights to acquire securities that have limitations on the right to exchange, convert, exercise or purchase similar to the limitation set forth in the Indenture) would otherwise result in a “change of control” of Iterum within
the meaning of Nasdaq Listing Rule 5635(b) or (3) the issuance of such Ordinary Shares would, together with any other issuance of Ordinary Shares to any holders of Notes issued hereunder upon the exchange of all such Notes, exceed 19.99% of the
issued and outstanding Ordinary Shares immediately prior to the Closing Date (the “Aggregate Ownership Cap”), except that such limitations shall not apply in the event that Iterum (a) obtains the Shareholder Approval or
(b) with respect to the Aggregate Ownership Cap, obtains a waiver from the Nasdaq Stock Market LLC of all applicable listing rules requiring such stockholder approval. Until one of the exceptions in clauses (a) or (b) of the proceeding
sentence applies, upon an exchange of a Note to which the Aggregate Ownership Cap applies the Purchaser shall, subject to the terms of Section 14.01 and Section 14.02 of the Indenture, be entitled to receive up to a number of Ordinary
Shares equal to (x) the number of issued and outstanding Ordinary Shares immediately prior to the Closing Date (subject to adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization) multiplied by
(y) the quotient obtained by dividing the principal amount of such Note by the initial aggregate principal of all Notes issued hereunder immediately following their original issuance, and for the avoidance of doubt, such Purchaser shall retain
any portion of such Note not exchanged for Ordinary Shares as a result of the application of the foregoing formula. 
 (n) Such Purchaser
acknowledges that, subject to the terms of the Indenture, Iterum shall not issue to any holder of a Note issued hereunder, and no such holder may acquire, a number of Ordinary Shares upon exchange of a Note and Iterum shall not otherwise deliver any
Ordinary Shares pursuant hereto, to the extent that the issuance of such Ordinary Shares would, together with any other issuance of Ordinary Shares by Iterum to any holders of Notes issued hereunder upon the exchange of all such Notes, exceed the
Available Shares, except that such limitation shall not apply in the event that Iterum obtains the Authorized Shares Approval (the “Available Shares Ownership Cap”). Until the exception in the proceeding sentence applies, upon an
exchange of a Note to which the Available Shares Ownership Cap applies the Purchaser shall in no event, subject to the terms of Section 14.01 and Section 14.02 of the Indenture, be entitled to receive a number of Ordinary Shares
(determined in the aggregate for all such 

  
 - 13 - 

 
exchanges of a Specified Note by such holder) in excess of (x) the Available Shares (subject to adjustment in the event of any stock dividend, stock split, combination or other similar
recapitalization) multiplied by (y) the quotient obtained by dividing the principal amount of such Specified Note by the initial aggregate principal of all Specified Notes immediately following their original issuance 

(o) Such Purchaser acknowledges that Exchange Shares issued upon the exchange of any Note shall not be voted in connection with or counted in
support of the Shareholder Approval. 
 (p) Such Purchaser has not taken any of the actions set forth in, and is not subject to, any of the
“bad actor” disqualification events described in Rule 506(d)(1)(i) through (viii) under the Securities Act. The Purchaser’s responses in the questionnaire delivered to the Company by the Purchaser related to qualification under
Rule 506(d)(1) of the Securities Act are true and correct as of the Agreement Date and will remain true and correct as of the Closing Date. 

(q) Such Purchaser will only purchase Units pursuant to this Agreement in an amount set forth in Schedule 1 and will not purchase or
allow any of its Affiliates to purchase any Units pursuant to the Rights Offering (regardless of whether or not under Irish or other applicable law subscription rights to purchase Units are required to be offered to such Purchaser). 

(r) Such Purchaser hereby acknowledges and agrees that (a) the Placement Agent is acting solely as placement agent in connection with the
execution, delivery and performance of the Transaction Documents and is not acting as an underwriter or in any other capacity and is not and shall not be construed as a fiduciary for such Purchaser, the Company or any other person or entity in
connection with the execution, delivery and performance of the Transaction Documents, (b) the Placement Agent has not made and will not make any representation or warranty, whether express or implied, of any kind or character, and has not
provided any advice or recommendation in connection with the execution, delivery and performance of the Transaction Documents, (c) the Placement Agent will not have any responsibility with respect to (i) any representations, warranties or
agreements made by any person or entity under or in connection with the execution, delivery and performance of the Transaction Documents, or the execution, legality, validity or enforceability (with respect to any person) thereof, or (ii) the
business, affairs, financial condition, operations, properties or prospects of, or any other matter concerning the Company, and (d) the Placement Agent will not have any liability or obligation (including without limitation, for or with respect
to any losses, claims, damages, obligations, penalties, judgments, awards, liabilities, costs, expenses or disbursements incurred by such Purchaser, the Company or any other person or entity), whether in contract, tort or otherwise, to such
Purchaser, or to any person claiming through it, in respect of the execution, delivery and performance of the Transaction Documents. 

  
 - 14 - 

 ARTICLE 4 

CONDITIONS OF PURCHASE OF THE UNITS. 

Section 4.1 Conditions to the Sale of the Notes. The obligation of the Company to issue and sell the Units to each
Purchaser shall be subject to the fulfillment of the following conditions: 
 (a) The Company shall have received executed counterparts of
the Investor Rights Agreement from each Purchaser; 
 (b) The Company shall have received from each Purchaser a fully completed and duly
executed Securityholder Questionnaire and Accredited Investor Questionnaire; 
 (c) The Purchaser shall have delivered the purchase price for
the Units to the Company in accordance with this Agreement; 
 (d) The representations and warranties made by the Purchaser in
Section 3.2 hereof shall be true and correct as of the Agreement Date and as of the Closing Date as though made on and as of such Closing Date, except to the extent such representations and warranties are specifically made as of a particular
date, in which case such representations and warranties shall be true and correct as of such date; and 
 (e) The Purchasers shall have
performed or complied with all agreements and covenants required by this Agreement to be performed or complied with by them at or prior to the Closing Date. 

Section 4.2 Conditions to the Purchase of the Units. The obligation of the Purchasers to purchase the Units shall be
subject to the fulfillment of the following conditions: 
 (a) The Purchasers shall have received copies of the Investor Rights Agreement,
the RLN Indenture and the Indenture executed by the Company and the Guarantors and the applicable trustee (in the case of the RLN Indenture and the Indenture) and the Holders’ Representative (in the case of the RLN Indenture), dated as of the
Closing Date; 
 (b) No Material Adverse Effect shall have occurred following the Agreement Date; 

(c) The representations and warranties made by the Company in Section 3.1 hereof shall be true and correct as of the Agreement Date and as
of the Closing Date as though made on and as of such Closing Date, except to the extent such representations and warranties are specifically made as of a particular date, in which case such representations and warranties shall be true and correct as
of such date; 
 (d) The Company and the Guarantors shall have performed or complied with all agreements and covenants required by this
Agreement to be performed or complied with by it and them at or prior to the Closing Date; 

  
 - 15 - 

 (e) Iterum shall have requested and caused Wilmer Cutler Pickering Hale and Dorr LLP, U.S.
counsel for Iterum, to furnish to the Purchasers its opinion, dated the Closing Date and addressed to the Purchasers, in substantially the form attached hereto as Exhibit C; 

(f) Iterum shall have requested and caused A&L Goodbody, Irish counsel for Iterum, to furnish to the Purchasers its opinion, dated the
Closing Date and addressed to the Purchasers, in substantially the form attached hereto as Exhibit D; 
 (g) Iterum shall have
requested and caused Conyers Dill & Pearman, Bermuda counsel for Iterum, to furnish to the Purchasers its opinion, dated the Closing Date and addressed to the Purchasers, in substantially the form attached hereto as Exhibit E; 

(h) Iterum shall have executed and delivered the Investor Rights Agreement; 

(i) Iterum shall have obtained and delivered to Purchasers the written consent of Silicon Valley Bank (in its capacity as party to the SVB
Facility), to the execution of this Agreement by the Company and the Guarantors and the consummation of the activities and transactions contemplated by each of the Transaction Documents; 

(j) The aggregate consideration paid by the Purchasers for the purchase of Units pursuant to this Agreement, collectively, shall be at least
$10,000,000; and 
 (k) Iterum shall have delivered a statement setting forth for the Notes and the RLNs, as of the Closing Date
(i) with respect to the RLNs only, the fair market value of each RLN as determined by an independent valuation firm, (ii) with respect to the Notes, the total amount of original issue discount, and (iii) with respect to the Notes, the
yield to maturity. 
 Section 4.3 Mutual Conditions to Closing. The obligation of the Company to issue and sell
the Units to each Purchaser and the obligation of the Purchasers to purchase the Units shall be subject to the fulfillment of the following conditions: 

(a) There shall be no action, suit, proceeding or investigation by a Governmental Authority pending or currently threatened in writing against
the Company, a Guarantor or the Purchasers that questions the validity of any of the Transaction Documents, the right of the Company, a Guarantor or the Purchasers to enter into any of the Transaction Documents or to consummate the transactions
contemplated hereby or thereby or which, if determined adversely, would impose substantial monetary damages on the Company, a Guarantor or the Purchasers as a result of the consummation of the transactions contemplated by any of the Transaction
Documents; and 
 (b) No provision of any Applicable Law, and no judgment, injunction (whether preliminary or permanent), order or decree,
that prohibits, makes illegal or enjoins the consummation of the transactions contemplated by any of the Transaction Documents shall be in effect. 

  
 - 16 - 

 ARTICLE 5 

Covenants 

Section 5.1 Reservation of Ordinary Shares for Exchange. Subject to (i) the valid passing of the
Authorized Shares Approval by the requisite majority of shareholders at a duly convened shareholder meeting and (ii) the Available Shares Ownership Cap, Iterum covenants that it will at all times reserve and keep available out of its authorized
but unissued Ordinary Shares and/or Ordinary Shares then held in treasury, solely for the purpose of delivery upon exchange of the Notes as herein provided, such number of Ordinary Shares as shall then be deliverable upon the exchange of the Notes.
Assuming the valid passing of the Authorized Shares Approval by the requisite majority of shareholders at a duly convened shareholder meeting, all Ordinary Shares which shall be so deliverable shall, when issued, be duly and validly issued and fully
paid and not subject to calls for any additional payments (non-assessable). 

Section 5.2 Shareholder Approval. Iterum shall take all action reasonably necessary or appropriate in accordance
with the applicable rules and regulations of the Irish Takeover Rules, Nasdaq Stock Market (or any successor entity) to solicit the Shareholder Approval, the Authorized Shares Approval and the Rule 9 Whitewash. In furtherance (and without
limitation) of the foregoing, (i) Iterum and the Purchasers will use their commercially reasonable efforts to seek all waivers and derogations from the Irish Takeover Panel in connection with any proposed Rule 9 Whitewash and (ii) Iterum
will use its commercially reasonable efforts to hold meetings of shareholders no later than June 10, 2020, at which meetings proposals for obtaining the Shareholder Approval, the Authorized Shares Approval and the Rule 9 Whitewash shall be
considered, with, subject to compliance with its fiduciary duties, the recommendation of Iterum’s Board of Directors that such proposals be approved, and Iterum shall solicit proxies from its shareholders in connection therewith in the same
manner as any other management proposals in such proxy statement. The circular to independent shareholders of Iterum in respect of the Rule 9 Whitewash shall include all information required and requested by the Irish Takeover Panel, and the
Purchasers shall promptly provide any information reasonably requested by Iterum for this purpose. 
 Section 5.3
Registration Statement. To the extent not prohibited by any applicable law or applicable interpretations of the Commission or any other applicable governing authority, Iterum shall prepare and file with the Commission a registration statement
under the Securities Act covering the sale of securities in connection with the Rights Offering and shall use commercially reasonable efforts to make such registration statement effective and complete the Rights Offering prior to the date that is
six months following the Closing Date. 
 Section 5.4 Compliance. Each Purchaser agrees with Iterum (i) that
such Purchaser will sell any Securities only pursuant to either the registration requirements of the Securities Act and (if applicable) European and Irish securities laws, including any applicable prospectus delivery requirements, or an applicable
exemption therefrom, (ii) that if Securities are sold pursuant to a registration statement, they will be sold in compliance with the plan of distribution set forth therein and (iii) that if, after the effective date of a registration
statement covering the resale of the Securities, such registration statement ceases to be effective and the issuer has 

  
 - 17 - 

 
provided notice to such Purchaser to that effect, such Purchaser will sell the Securities only in compliance with an applicable exemption from the registration requirements of the Securities Act
unless and until such registration statement again becomes effective or another registration statement covering the resale of the Securities subsequently becomes effective. 

Section 5.5 Voting. Each Purchaser other than the Wellington Entities covenants and agrees soley with Iterum that at
any meeting of the holders of the capital stock of Iterum, however called, and in any other action by written consent of the holders of the capital stock of Iterum, such Purchaser shall vote all outstanding Ordinary Shares (other than Exchange
Shares issued upon the exchange of any Note) that are owned beneficially or of record by such Purchaser in favor of the Shareholder Approval and the Authorized Shares Approval and the Rule 9 Whitewash. Each Purchaser shall, promptly, if requested by
the Irish Takeover Panel, confirm in writing that it shall not accept any mandatory offer required under Rule 9 of the Irish Takeover Rules on the issue of any Exchange Shares. 

ARTICLE 6 

MISCELLANEOUS 

Section 6.1 Notices. Any notices required or permitted to be given under the terms hereof shall be sent by certified
or registered United States mail (return receipt requested) or delivered personally or by courier (including a recognized overnight delivery service) or by electronic mail and shall be effective five (5) days after being placed in the mail, if
mailed by certified or registered United States mail, or upon receipt, if delivered personally or by courier (including a recognized overnight delivery service), or when received by electronic mail if received during normal business hours of the
recipient on a Business Day, or if not so received, on the next Business Day, in each case addressed to a Party. All notices shall be addressed to the Party to be notified at the address as follows, or at such other address as such Party may
designate by giving the other Party written notice thereof in accordance with the terms of this Section 6.1: 
 If to the Company or the
Guarantors: 
 Iterum Therapeutics plc 

Block 2, Floor 3, Harcourt Centre, Harcourt Street 

Dublin 2, Ireland 
 Attention:
Corey N. Fishman, President and Chief Executive Officer 
 Email: 

With copies to: 
 Legal Department

 Iterum Therapeutics plc 

Block 2, Floor 3, Harcourt Centre, Harcourt Street 

Dublin 2, Ireland 
 Email: 

  
 - 18 - 

 Wilmer Cutler Pickering Hale and Dorr LLP 

7 World Trade Center 
 250
Greenwich Street 
 New York, New York 10007 

Attn: Brian Johnson, Esq. 
 Email:

 If to the Purchasers: To the address set forth immediately below such Purchaser’s name on the signature pages hereto. 

Section 6.2 Waiver of Notice. Whenever any notice is required to be given to any of the Purchasers, the Company or a
Guarantor under any provision of this Agreement, a waiver thereof in writing signed by the Person or Persons entitled to such notice, whether before or after the time stated therein, shall be deemed equivalent to the giving of such notice. 

Section 6.3 Fees and Expenses. 

(a) The Company, Iterum Therapeutics US Limited or Iterum Therapeutics US Holding Limited shall reimburse New Leaf Ventures III, L.P. and New
Leaf Biopharma Opportunities II, L.P. (together “New Leaf”) for all reasonable and documented third party legal or other advisory fees and expenses incurred by New Leaf in connection with the sale of the Units pursuant to this
Agreement, in an amount not to exceed $450,000. 
 (b) The Company, Iterum Therapeutics US Limited or Iterum Therapeutics US Holding Limited
shall reimburse Sarissa Capital Management LP for all reasonable and documented third party legal or other advisory fees and expenses incurred thereby (or by any Affiliate thereof) in connection with the sale of the Units pursuant to this Agreement,
in an amount not to exceed $260,000. 
 Section 6.4 Amendment and Waiver. Any term of this Agreement may be
amended and the observance of any term of this Agreement may be waived (either generally or in a particular instance and either retroactively or prospectively) only with the written consent of the Company, the Guarantors and the Required Purchasers.

 Section 6.5 Governing Law; Consent to Jurisdiction; Waiver of Jury Trial. All questions concerning the
construction, validity, enforcement and interpretation of this Agreement shall be governed by and construed and enforced in accordance with the internal laws of the State of New York without regard to the choice of law principles thereof. Each Party
agrees that all legal proceedings concerning the interpretations, enforcement and defense of the transactions contemplated by this Agreement (whether brought against a Party hereto or its respective Affiliates, directors, officers, shareholders,
employees or agents) shall be commenced exclusively in the state and federal courts sitting in the City of New York. Each Party hereby irrevocably submits to the exclusive jurisdiction of the state and federal courts sitting in the City of New York,
borough of Manhattan for the adjudication of any dispute hereunder or in connection herewith or with any transaction contemplated hereby or discussed herein, and hereby irrevocably waives, and agrees not to assert in any suit, action or other
proceeding, any claim that it is not personally subject to the jurisdiction of any such court, that such suit, action or 

  
 - 19 - 

 
proceeding is improper or is an inconvenient venue for such proceeding. Each Party hereby irrevocably waives personal service of process and consents to process being served in any such suit,
action or other proceeding by mailing a copy thereof via registered or certified United States mail or overnight delivery (with evidence of delivery) to such Party at the address in effect for notices to it under this Agreement and agrees that such
service shall constitute good and sufficient service of process and notice thereof. Nothing contained herein shall be deemed to limit in any way any right to serve process in any other manner permitted by law. THE PARTIES HEREBY WAIVE ALL RIGHTS TO
A TRIAL BY JURY. 
 Section 6.6 Successors and Assigns. This Agreement shall bind and inure to the respective
successors and assigns of the Parties. The Company and the Guarantors may assign this Agreement at any time in connection with a sale or acquisition of the Company or a Guarantor, as applicable, whether by merger, consolidation, sale of all or
substantially all of the Company’s or such Guarantor’s assets, or similar transaction, without the consent of the Purchasers; provided, that, the successor or acquirer agrees in writing to assume all of the Company’s or such
Guarantor’s, as applicable, rights and obligations under this Agreement. 
 Section 6.7 Entire Agreement. The
Transaction Documents contain the entire understanding of the Parties with respect to the matters covered thereby and supersede any and all other written and oral communications, negotiations, commitments and writings with respect thereto. Except as
otherwise provided herein, the provisions of this Agreement may be waived, modified, supplemented or amended only by an instrument in writing signed by an authorized representative of each Party. 

Section 6.8 Severability. If any provision of this Agreement shall be invalid, illegal or unenforceable in any
respect under any law, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby. 

Section 6.9 Counterparts. This Agreement may be executed in several counterparts, and by each Party on separate
counterparts, each of which and any photocopies or other electronic transmission (including by PDF) thereof shall be deemed an original, but all of which together shall constitute one and the same agreement. 

Section 6.10 Survival. 

(a) This Agreement and all agreements, representations and warranties made herein, and in any document, certificate or statement delivered
pursuant thereto or in connection herewith, shall be considered to have been relied upon by the other Parties and shall survive the execution and delivery of this Agreement and the purchase of the Units hereunder regardless of any investigation made
by any such other Party or on its behalf, and shall continue in force until the applicable statute of limitations. 
 (b) The obligations of
the Company, the Guarantors and the Purchasers under this Article 6 shall survive and remain in full force and effect regardless of the consummation of the transactions contemplated hereby, the repayment of the Notes or the termination of this
Agreement or any provision hereof. 

  
 - 20 - 

 Section 6.11 No Waiver. Neither the failure of, nor any delay on
the part of, any Party in exercising any right, power or privilege under this Agreement shall operate as a waiver thereof, nor shall any single or partial exercise of any right, power or privilege under this Agreement preclude other or further
exercise thereof or the exercise of any other right, power or privilege; nor shall any waiver of any right, power or privilege under this Agreement constitute a waiver of any other right, power or privilege under this Agreement. All rights and
remedies herein provided are cumulative and not exclusive of any rights or remedies otherwise provided by law. 

Section 6.12 Several Obligations. The obligations of the Purchasers under the Transaction Documents shall be several
and not joint. 
 Section 6.13 Disclosure/Publicity. By no later than 9:00 a.m., New York City time, on the first
trading day after the date of this Agreement, Iterum shall disclose publicly, by press release or a Current Report on Form 8-K reasonably acceptable to the Purchasers, all material terms of the transactions
contemplated hereby and by the other Transaction Documents and any other material, non-public information that Iterum, the Company or any Guarantor has provided to the Purchasers in connection with their
consideration of the transactions contemplated by this Agreement or any of the other Transaction Documents. Notwithstanding the foregoing, Iterum shall not publicly disclose the name of any Purchaser or any Affiliate or investment adviser of a
Purchaser, or include the name of a Purchaser or any Affiliate or investment adviser of a Purchaser in any press release or in any filing with the Commission or any regulatory agency or trading market, without the prior written consent (including by
e-mail) of such Purchaser, except as required by the federal securities laws, rules or regulations and to the extent such disclosure is required by other laws, rules or regulations, at the request of the staff
of the Commission or regulatory agency or under Nasdaq regulations, in which case Iterum shall provide the Purchaser with prior written notice (including by e-mail) of such permitted disclosure, and shall
reasonably consult with Purchaser regarding such disclosure. 
 Section 6.14 Benefit of Agreement. The Placement
Agent is an intended third-party beneficiary of the representations and warranties of the Company and the Guarantors and of each Purchaser set forth in Section 3.1 and Section 3.2, respectively, of this Agreement. 

[Signature Page Follows] 

  
 - 21 - 

 IN WITNESS WHEREOF, the Purchasers, the Company, Iterum and the Subsidiary Guarantors have
caused this Agreement to be duly executed as of the 16th day of January, 2020. 
  

			
	COMPANY:
	
	ITERUM THERAPEUTICS BERMUDA LIMITED
		
	By:	 	 /s/ Louise Barrett

	Name: Louise Barrett
	Title: Director
	
	ITERUM:
	
	ITERUM THERAPEUTICS PLC
		
	By:	 	 /s/ David Kelly

	Name: David Kelly
	Title: Director
	
	SUBSIDIARY GUARANTOR:
	
	ITERUM THERAPEUTICS INTERNATIONAL LIMITED
		
	By:	 	 /s/ Louise Barrett

	Name: Louise Barrett
	Title: Director
	
	SUBSIDIARY GUARANTOR:
	
	ITERUM THERAPEUTICS US LIMITED
		
	By:	 	 /s/ Judy Matthews

	Name: Judy Matthews
	Title: Director

  
 - 22 - 

 
			
	SUBSIDIARY GUARANTOR:
	
	ITERUM THERAPEUTICS US HOLDING LIMITED
		
	By:	 	 /s/ Judy Matthews

	Name: Judy Matthews
	Title: Director
	
	PURCHASERS:
	
	ADVENT LIFE SCIENCES LLP
		
	By:	 	 /s/ Kaasim Mahmood

	Name: Kaasim Mahmood
	Title: Partner
	
	ADVENT LIFE SCIENCES FUND II LP
	
	By: Advent Life Sciences LLP, its General Partner
		
	By:	 	 /s/ Kaasim Mahmood

	Name: Kaasim Mahmood
	Title: Partner
	
	ARIX BIOSCIENCE HOLDINGS LIMITED
		
	By:	 	 /s/ Robert Lyne

	Name: Robert Lyne
	Title: Chief Operating Officer & General Counsel

  
 - 23 - 

 
			
	CANAAN X L.P.
	
	By: Canaan Partners X LLC, its general partner
		
	By:	 	 /s/ Brent Ahrens

	Name: Brent Ahrens
	Title: Managing Member
	
	FRAZIER HEALTHCARE VII, L.P.
	
	By: FHM VII, LP, its general partner
	By: FHM VII, LLC, its general partner
		
	By:	 	 /s/ Patrick Heron

	Name: Patrick Heron
	Title: Manager
	
	FRAZIER HEALTHCARE VII-A, L.P.
	
	By: FHM VII, LP, its general partner
	By: FHM VII, LLC, its general partner
		
	By:	 	 /s/ Patrick Heron

	Name: Patrick Heron
	Title: Manager

  
 - 24 - 

 
			
	NEW LEAF VENTURES III, L.P.
	
	By: New Leaf Venture Associates III, L.P.
	Its: General Partner
	
	By: New Leaf Venture Management III, L.L.C.
	Its: General Partner
		
	By:	 	 /s/ Craig L. Slutzkin

	Name:	 	Craig L. Slutzkin
	Title:	 	Chief Operating Officer/Chief Financial Officer
	
	NEW LEAF BIOPHARMA OPPORTUNITIES II, L.P.
	
	By: New Leaf BPO Associates II, L.P.
	Its: General Partner
	
	By: New Leaf BPO Management II, L.L.C.
	Its: General Partner
		
	By:	 	 /s/ Craig L. Slutzkin

	Name: Craig L. Slutzkin
	Title:	 	Chief Operating Officer/Chief Financial Officer
	
	SOFINNOVA VENTURE PARTNERS IX, L.P.
		
	By:	 	Sofinnova Management IX, L.L.C.
		 	its General Partner
		
	By:	 	 /s/ James I. Healy

	Name: James I. Healy
	Title: Managing Member

  
 - 25 - 

 
			
	DOMAIN PARTNERS IX, L.P.
	
	By: One Palmer Square Associates IX, L.L.C.
		
	By:	 	 /s/ Lisa A. Kraeutler

	Name:	 	Lisa A. Kraeutler
	Title:	 	Attorney-in-fact
	
	PIVOTAL BIOVENTURE PARTNERS FUND I, LP
	
	By: Pivotal bioVenture Partners Fund I GP, LP
	By: Pivotal bioVenture Partners Fund I GP U.G.P., Ltd.
		
	By:	 	 /s/ Robert Hopfner

	Name:	 	Robert Hopfner
	Title:	 	Managing Partner
	
	SALTHILL INVESTORS (BERMUDA) L.P.
		
	By:	 	Wellington Management Company LLP,
		 	as investment adviser
		
	By:	 	 /s/ Emily Babalas

	Name:	 	Emily Babalas
	Title:	 	Managing Director & Counsel
	
	SALTHILL PARTNERS, L.P.
		
	By:	 	Wellington Management Company LLP,
		 	as investment adviser
		
	By:	 	 /s/ Emily Babalas

	Name:	 	Emily Babalas
	Title:	 	Managing Director & Counsel

  
 - 26 - 

 
			
	SARISSA CAPITAL OFFSHORE MASTER FUND LP
		
	By:	 	 /s/ Patrice Bonfiglio

	Name: Patrice Bonfiglio
	Title:   Chief Financial Officer
	
	SARISSA CAPITAL CATAPULT FUND LLC
		
	By:	 	 /s/ Patrice Bonfiglio

	Name: Patrice Bonfiglio
	Title:   Chief Financial Officer
	
	SARISSA CAPITAL HAWKEYE FUND LP
		
	By:	 	 /s/ Patrice Bonfiglio

	Name: Patrice Bonfiglio
	Title:   Chief Financial Officer
	
	RA CAPITAL HEALTHCARE FUND, L.P.
	
	By: RA Capital Healthcare Fund GP, LLC
	Its General Partner
		
	By:	 	 /s/ Peter Kolchinsky

	Name: Peter Kolchinsky
	Title:   Manager

  
 - 27 - 

 
			
	BLACKWELL PARTNERS LLC – SERIES A
		
	By:	 	 /s/ Justin B. Nixon

	Name: Justin B. Nixon
	Title:   Investment Manager
		 	     DUMAC, Inc., Authorized Signatory
		
	By:	 	 /s/ Jannine M. Lall

	Name: Jannine M. Lall
	Title:   Investment Manager
		 	     DUMAC, Inc., Authorized Signatory
	
	2B LLC
	
	By: SilverArc Capital Management, LLC acting as Investment manager.
		
	By:	 	 /s/ Andrew Timpson

	Name: Andrew Timpson
	Title:   Chief Operating Officer
	
	683 CAPITAL PARTNERS, LP
		
	By:	 	 /s/ Joseph Patt

	Name: Joseph Patt
	Title:   Member of the General Partner
	
	CVI INVESTMENTS, INC.
	
	By: Heights Capital Management, Inc., its authorized signatory
		
	By:	 	 /s/ Martin Kobinger

	
	Name: Martin Kobinger
	Title:   Investment Manager

  
 - 28 - 

 
			
	EMPERY MASTER ONSHORE, LLC
	
	By: Empery Asset Management LP, its authorized agent
		
	By:	 	 /s/ Brett Director

	Name: Brett Director
	Title:   General Counsel
	
	EMPERY TAX EFFICIENT, LP
	
	By: Empery Asset Management LP, its authorized agent
		
	By:	 	 /s/ Brett Director

	Name: Brett Director
	Title:   General Counsel
	
	EMPERY TAX EFFICIENT II, LP
	
	By: Empery Asset Management LP, its authorized agent
		
	By:	 	 /s/ Brett Director

	Name: Brett Director
	Title:   General Counsel
	
	NORTH SOUND TRADING, LP
		
	By:	 	 /s/ Brian Miller

	Name: Brian Miller
	Title:   President of the General Partner

  
 - 29 - 

 
			
	LINCOLN PARK CAPITAL FUND, LLC
	
	By: Lincoln Park Capital, LLC
	By: Rockledge Capital Corporation
		
	By:	 	 /s/ Joshua Scheinfeld

	Name: Joshua Scheinfeld
	Title:   President
	
	S.H.N FINANCIAL INVESTMENTS LTD
		
	By:	 	 /s/ Nir Shamir

	Name: Nir Shamir
	Title:   Owner
	
	SABBY VOLATILITY WARRANT MASTER FUND, LTD. 
		
	By:	 	 /s/ Robert Grundstein

	Name: Robert Grundstein
	Title:   COO of Investment Manager
	
	SILVERARC CAPITAL ALPHA FUND I, L.P.
	
	By: SilverArc Capital Management, LLC acting as Investment manager.
		
	By:	 	 /s/ Andrew Timpson

	Name: Andrew Timpson
	Title:   Chief Operating Officer

  
 - 30 - 

 
			
	SILVERARC CAPITAL ALPHA FUND II, L.P.
	
	By: SilverArc Capital Management, LLC acting as Investment manager.
		
	By:	 	 /s/ Andrew Timpson

	Name:	 	Andrew Timpson
	Title:	 	Chief Operating Officer
	
	GARY D. COHN
		
	By:	 	 /s/ Gary D. Cohn

	Name:	 	Gary D. Cohn

  
 - 31 - 

 SCHEDULE 1 
  

									
	 PURCHASER
	  	UNITS
PURCHASED	 	  	AGGREGATE
PURCHASE
PRICE	 
	 Advent Life Sciences LLP
	  	 	53	 	  	$	53,000	 
	 Advent Life Sciences Fund II LP
	  	 	1,495	 	  	$	1,495,000	 
	 Arix Bioscience Holdings Limited
	  	 	1,900	 	  	$	1,900,000	 
	 Canaan X L.P.
	  	 	2,000	 	  	$	2,000,000	 
	 Frazier Healthcare VII, L.P.
	  	 	1,167	 	  	$	1,167,000	 
	 Frazier Healthcare VII-A, L.P.
	  	 	333	 	  	$	333,000	 
	 New Leaf Ventures III, L.P.
	  	 	2,208	 	  	$	2,208,000	 
	 New Leaf Biopharma Opportunities II, L.P.
	  	 	792	 	  	$	792,000	 
	 Sofinnova Venture Partners IX, L.P.
	  	 	1,750	 	  	$	1,750,000	 
	 Domain Partners IX, L.P.
	  	 	1,000	 	  	$	1,000,000	 
	 Pivotal bioVenture Partners Fund I, LP
	  	 	1,000	 	  	$	1,000,000	 
	 Sarissa Capital Offshore Master Fund LP
	  	 	9,000	 	  	$	9,000,000	 
	 Sarissa Capital Catapult Fund LLC
	  	 	3,439	 	  	$	3,439,000	 
	 Sarissa Capital Hawkeye Fund LP
	  	 	2,561	 	  	$	2,561,000	 
	 RA Capital Healthcare Fund, L.P.
	  	 	8,486	 	  	$	8,486,000	 
	 Blackwell Partners LLC – Series A
	  	 	1,514	 	  	$	1,514,000	 
	 Empery Master Onshore, LLC
	  	 	361	 	  	$	361,000	 
	 Empery Tax Efficient, LP
	  	 	55	 	  	$	55,000	 
	 Empery Tax Efficient II, LP
	  	 	334	 	  	$	334,000	 
	 Lincoln Park Capital Fund, LLC
	  	 	250	 	  	$	250,000	 
	 683 Capital Partners, LP
	  	 	1,000	 	  	$	1,000,000	 
	 SilverArc Capital Alpha Fund I, L.P.
	  	 	19	 	  	$	19,000	 
	 SilverArc Capital Alpha Fund II, L.P.
	  	 	165	 	  	$	165,000	 
	 2b LLC
	  	 	16	 	  	$	16,000	 
	 Sabby Volatility Warrant Master Fund, Ltd.
	  	 	1,500	 	  	$	1,500,000	 
	 S.H.N Financial investments ltd
	  	 	500	 	  	$	500,000	 
	 North Sound Trading, LP
	  	 	4,000	 	  	$	4,000,000	 
	 CVI Investments, Inc.
	  	 	2,000	 	  	$	2,000,000	 
	 Salthill Investors (Bermuda) L.P.
	  	 	920	 	  	$	920,000	 
	 Salthill Partners, L.P.
	  	 	570	 	  	$	570,000	 
	 Gary D. Cohn
	  	 	1,500	 	  	$	1,500,000	 
	 Total
	  	 	51,888	 	  	$	51,888,000EX-10.2

 Exhibit 10.2 

INVESTOR RIGHTS AGREEMENT 

This INVESTOR RIGHTS AGREEMENT (this “Agreement”) is made and entered into as of January [●], 2020 by and among Iterum
Therapeutics Bermuda Limited, a company formed under the laws of Bermuda (the “Company”), Iterum Therapeutics plc, an Irish public limited company (“Iterum”), including as guarantor, Iterum Therapeutics
International Limited, a company formed under the laws of Ireland, as guarantor, Iterum Therapeutics US Limited, a company formed under the laws of Delaware, as guarantor, and Iterum Therapeutics US Holding Limited, a company formed under the laws
of Delaware, as guarantor (the guarantors other than Iterum, collectively, the “Subsidiary Guarantors” and, together with Iterum, the “Guarantors”) and the “Purchasers” named in that certain
Securities Purchase Agreement by and among the Company, the Guarantors and the Purchasers dated as of January 16, 2020 (the “Purchase Agreement”). Capitalized terms used herein have the respective meanings ascribed thereto in
the Purchase Agreement unless otherwise defined herein. 
 The parties hereby agree as follows: 

1. Certain Definitions. 

As used in this Agreement, the following terms shall have the following meanings: 

“Applicable Percentage” means, with respect to any person on any date of determination, the quotient, expressed as a
percentage, determined by dividing (i) the number of Ordinary Shares owned (directly or indirectly) by such person determined on a Fully Diluted Basis by (ii) the total number of Ordinary Shares that are issued and outstanding determined
on a Fully Diluted Basis. 
 “Board” means the board of directors of Iterum. 

“Closing Date” means the date of the purchase and sale of Units consisting of the Notes and the RLNs pursuant to the Purchase
Agreement. 
 “Exchange Act” means the Securities Exchange Act of 1934, as amended, including the rules and regulations
promulgated thereunder. 
 “Exchange Shares” means Ordinary Shares issued or issuable upon the exchange of the Notes
pursuant to the terms thereof. 
 “Exempted Securities” means 

(i) Ordinary Shares (or options or other rights to acquire Ordinary Shares or securities convertible or exchangeable into or exercisable for
Ordinary Shares) issued pursuant to the Rights Offering; 
 (ii) Ordinary Shares (or options or other rights to acquire Ordinary Shares or
securities convertible or exchangeable into or exercisable for Ordinary Shares) issued as a dividend or distribution on the Notes; 

 (iii) Ordinary Shares (or options or other rights to acquire Ordinary Shares or securities
convertible or exchangeable into or exercisable for Ordinary Shares) issued by reason of a dividend, stock split, split-up or other distribution of Ordinary Shares, subject to compliance with the terms of the
Indenture; 
 (iv) Ordinary Shares or options or other rights to acquire Ordinary Shares issued to employees or directors of, or consultants
or advisors to Iterum or any of its Subsidiaries pursuant to a plan, agreement or arrangement approved by the Board or an authorized committee thereof (including, for the avoidance of doubt and without limitation, any Ordinary Shares or options or
other rights to acquire Ordinary Shares issued pursuant to Iterum’s 2015 Equity Incentive Plan and 2018 Equity Incentive Plan and any inducement grants made by Iterum pursuant to Nasdaq Listing Rule 5635(c)(4)); 

(v) Ordinary Shares (or options or other rights to acquire Ordinary Shares or securities convertible or exchangeable into or exercisable for
Ordinary Shares) actually issued upon the exercise of options or other rights or upon the conversion or exchange of securities convertible or exchangeable into Ordinary Shares (including the Notes), in each case provided such issuance is pursuant to
the terms of such option, right or other security; 
 (vi) Ordinary Shares (or options or other rights to acquire Ordinary Shares or
securities convertible or exchangeable into or exercisable for Ordinary Shares) issued to banks, equipment lessors or other financial institutions, or to real property lessors, pursuant to a debt financing, equipment leasing or real property leasing
transaction; 
 (vii) Ordinary Shares (or options or other rights to acquire Ordinary Shares or securities convertible or exchangeable into
or exercisable for Ordinary Shares) issued to suppliers or third-party service providers in connection with the provision of goods or services pursuant to transactions with such third parties or their Affiliates; 

(viii) Ordinary Shares (or options or other rights to acquire Ordinary Shares or securities convertible or exchangeable into or exercisable for
Ordinary Shares) issued in connection with sponsored research, collaboration, technology license, development, manufacturing, supply, distribution, marketing or other similar commercial agreements or strategic partnerships; or 

(ix) Ordinary Shares (or options or other rights to acquire Ordinary Shares or securities convertible or exchangeable into or exercisable for
Ordinary Shares) issued as acquisition consideration (but not in connection with a financing) pursuant to the acquisition of another entity by Iterum or any Guarantor by merger or the purchase of substantially all of the assets, the acquisition of
assets of another entity by Iterum or any Guarantor, or other reorganization or to a joint venture agreement, provided that such issuances are approved by the Board and made in compliance with the Indenture. 

“Force Majeure” means any unusual event arising from causes reasonably beyond the control of the Company or the Guarantors
(or any person acting on their behalf), which by its nature could not have been foreseen by the Company or the Guarantors, or, if it could have been foreseen, was unavoidable, and which causes a delay in or prevents the performance of any

  
 - 2 - 

 
obligation of the Company and the Guarantors under this Agreement, including but not limited to, acts of God, fire, war, explosions, lightning, extreme weather conditions, power failure or
surges, government shutdown, terrorism, insurrection, civil disturbance, strikes or other labor disputes, or restraint by court order or order of public authority or any other cause similar to the foregoing. 

“Fully Diluted Basis” means the number of Ordinary Shares outstanding or held (as the case may be), assuming the conversion,
exchange or exercise of all securities or other instruments or rights that are convertible into or exercisable or exchangeable for Ordinary Shares that are outstanding. For purposes of this definition, all Notes shall be deemed exchanged on the date
of determination using the Physical Settlement (as defined in the Indenture). 
 “Governmental Entity” means any federal,
state, local, foreign, international or multinational entity or authority exercising executive, legislative, judicial, regulatory, administrative or taxing functions of or pertaining to government. 

“Indenture” means the indenture, dated as of the Closing Date, among the Company, Iterum, the Subsidiary Guarantors and U.S.
Bank National Association, as trustee, under which the Notes are to be issued. 
 “Major Investors” means Sarissa Capital
Offshore Master Fund LP, Sarissa Capital Catapult Fund LLC and Sarissa Capital Hawkeye Fund LP, and their respective successors. 

“New Securities” means, collectively, equity securities of Iterum (including Ordinary Shares), whether or not currently
authorized, as well as rights, options, or warrants to purchase such equity securities, or securities of any type whatsoever that are, or may become, convertible or exchangeable into or exercisable for such equity securities. 

“Note” or “Notes” means the 6.500% Exchangeable Senior Subordinated Notes due 2025, fully and
unconditionally guaranteed on an unsecured senior basis by Iterum, issued by the Company pursuant to the Purchase Agreement. 

“Ordinary Shares” means the ordinary shares, $0.01 nominal value, of Iterum. 

“Principal Amount” means, for any RLN, the Principal Amount set forth in such RLN (which shall be a Permitted Denomination
(as defined in the RLN Indenture)). 
 “Principal Amount Multiple” means for any RLN, the product of the Principal Amount
and 100. 
 “Prospectus” means (i) the prospectus included in any Registration Statement, as amended or supplemented
by any prospectus supplement, with respect to the terms of the offering of any portion of the Registrable Securities covered by such Registration Statement and by all other amendments and supplements to the prospectus, including post-effective
amendments and all material incorporated by reference in such prospectus, and (ii) any “free writing prospectus” as defined in Rule 405 under the Securities Act. 

  
 - 3 - 

 “Purchasers” means (i) the Purchasers identified in the Purchase
Agreement and (ii) any permitted transferee of any Purchaser who is a subsequent holder of Registrable Securities. 

“Register,” “registered” and “registration” refer to a registration made by preparing and
filing a Registration Statement or similar document in compliance with the Securities Act, and the declaration or ordering of effectiveness of such Registration Statement or document. 

“Registration Default” shall mean, subject to the third sentence of Section 2(a), the occurrence of
any of the following: (i) the Company and the Guarantors fail to file and/or make effective a Registration Statement covering the resale of all of the Registrable Securities in accordance with the timing and other requirements set forth in
Section 2(a) or (ii) if a Registration Statement filed pursuant to Section 2(a) has been declared effective and such Registration Statement ceases to be effective or the prospectus contained
therein ceases to be usable for resales of Registrable Securities (a) for more than sixty (60) consecutive days during the required effectiveness period or (b) for more than one hundred twenty (120) days (whether or not
consecutive) in any 12-month period during the required effectiveness period. Notwithstanding the foregoing, any day on which a Force Majeure has occurred or is continuing shall not count toward the timing
requirements for the filing of a Registration Statement under clause (i) above or the calculation of the number of days in clauses (ii)(a) and (b) above. 

“Registrable Securities” means (A) in the case of a Registration Statement on Form
S-1 (i) the Notes, (ii) the Exchange Shares, (iii) the RLNs, and (iv) any other securities issued or issuable with respect to or in exchange for the Notes, the Exchange Shares or the RLNs,
whether by merger, charter amendment or otherwise and (B) in the case of a Registration Statement on Form S-3, the Exchange Shares; provided that a security shall cease to be a Registrable Security upon
the earlier of (A) a sale pursuant to a Registration Statement, and (B) such security becoming eligible for sale without restriction by a Purchaser pursuant to Rule 144 and without the requirement to be in compliance with Rule
144(c)(1) (or any successor thereto) promulgated under the Securities Act. 
 “Registration Statement” means any
registration statement of Iterum, the Company and the Subsidiary Guarantors under the Securities Act that covers the resale of any of the Registrable Securities pursuant to the provisions of this Agreement, amendments and supplements to such
Registration Statement, including post-effective amendments, all exhibits and all material incorporated by reference in such Registration Statement. 

“Registration Trigger” means the later of (i) the earlier of (x) the consummation of the Rights Offering and
(y) the date that is one year following the Closing Date and (ii) the date on which the number of unissued Ordinary Shares that are available for issuance by Iterum, less the number of shares that are issuable upon exercise, conversion or
exchange of outstanding options, warrants or other securities or that are reserved under any equity incentive plan maintained by Iterum or reserved for exchange of any Notes issued pursuant to the Rights Offering, is greater than the total number of
Ordinary Shares that are issuable upon exchange of the then-outstanding Notes that were issued to the Purchasers pursuant to the Purchase Agreement on the Closing Date (disregarding any limitations on exchange in Section 14.01(c) of the
Indenture). 

  
 - 4 - 

 “Required Purchasers” means, at any time, Purchasers holding Registrable
Securities representing more than (a) 66 2/3% of the aggregate principal amount of Notes that constitute Registrable Securities, and (b) 66 2/3% of the aggregate Principal Amount of RLNs that constitute Registrable Securities. 

“Rights Offering” means any public offering of subscription rights to purchase Units consisting of Notes and RLNs by Iterum
and the Company to holders of Ordinary Shares on a pro rata basis in accordance with their share ownership as of a record date to be determined by the board of directors of Iterum or a committee thereof. The Purchasers and their Affiliates shall not
be entitled to purchase any Units pursuant to the Rights Offering (regardless of whether or not under Irish or other applicable law such subscription rights are required to be offered to the Purchasers). 

“RLNs” means the limited recourse royalty-linked notes issued by the Company pursuant to the Purchase Agreement. 

“RLN Indenture” means the Limited Recourse Royalty-Linked Notes Indenture, dated as of the Closing Date, by and among the
Company, Iterum, the Subsidiary Guarantors, Iterum Holders’ Representative LLC, as Holders’ Representative, and Computershare Trust Company, N.A., as trustee. 

“SEC” means the U.S. Securities and Exchange Commission. 

“Securities Act” means the Securities Act of 1933, as amended, including the rules and regulations promulgated thereunder.

 “Securityholder Questionnaire” has the meaning ascribed to such term in the Purchase Agreement. 

“Shareholder Approval” means such approval as may be required from time to time by the applicable rules and regulations of
the Nasdaq Stock Market (or any successor entity) from Iterum’s shareholders with respect to the issuance of the Units (including the Notes) in connection with the sale to the Purchasers pursuant to the Purchase Agreement and/or the issuance of
all Ordinary Shares issuable in connection with the exchange of any Notes issued to the Purchasers pursuant to the Purchase Agreement. 
 2.
Registration. 
 (a) Registration Statement. The Company and the Guarantors shall use their best efforts to (i) promptly
prepare and file with the SEC an initial Registration Statement on Form S-1 covering the resale of all of the Registrable Securities within ten (10) Business Days after the Registration Trigger and make
such Registration Statement become effective with the SEC within sixty (60) days after the Registration Trigger (or as soon as practicable thereafter), and (ii) prepare, file and make become effective a Registration Statement on Form S-3 for the resale of Registrable Securities to replace the initial Registration Statement required in clause (i) prior to the time that Iterum is no longer eligible to forward incorporate by reference into a
Registration Statement on Form S-1, provided that Iterum satisfies the eligibility requirements of Form S-3 at such time. In the event that Iterum again becomes eligible
to forward incorporate by 

  
 - 5 - 

 
reference into a Registration Statement on Form S-1 at any time, Iterum shall promptly prepare and file with the SEC a Registration Statement on Form S-1 covering the resale of any Registrable Securities that are not otherwise registered pursuant to an effective Registration Statement within thirty (30) Business Days of becoming eligible. For the avoidance
of doubt (I) at any time there is an effective Registration Statement on Form S-3 and Iterum is not eligible to forward incorporate by reference on Form S-1, Iterum
shall not be obligated to prepare, file, make effective or maintain the effectiveness of a Registration Statement on Form S-1 and (II) at any time there is an effective Registration Statement on Form S-1 and Iterum is eligible to forward incorporate by reference into such Registration Statement, Iterum shall not be obligated to prepare, file, make effective or maintain the effectiveness of a Registration
Statement on Form S-3. Subject to any SEC comments, such Registration Statements shall include the plan of distribution attached hereto as Exhibit A; provided, however, that no
Purchaser shall be named as an “underwriter” in such Registration Statement without the Purchaser’s prior written consent. Such Registration Statements also shall cover, to the extent allowable under the Securities Act and the rules
promulgated thereunder (including Rule 416), such indeterminate number of additional Ordinary Shares resulting from share splits, bonus issue of shares or similar transactions with respect to the Registrable Securities. Such Registration
Statements (and each amendment or supplement thereto, and each request for acceleration of effectiveness thereof) shall be provided in accordance with Section 3(c) hereof to the Purchasers prior to its filing or other
submission. 
 (b) Expenses. The Company, Iterum and the Subsidiary Guarantors, other than Iterum Therapeutics International Limited,
will pay all expenses associated with each Registration Statement, including (i) filing and printing fees, (ii) the Company’s and the Guarantors’ counsel and accounting fees and expenses, (iii) costs associated with clearing
the Registrable Securities for sale under applicable state securities laws and listing fees, and (iv) all rating agency fees incurred by the Company or the Guarantors (including with respect to maintaining ratings of the Notes and/or the RLNs),
but excluding discounts, commissions, fees of underwriters, selling brokers, dealer managers or similar securities industry professionals with respect to the Registrable Securities being sold. 

(c) Effectiveness. 
 (i)
The Company and the Guarantors shall use their best efforts to have each Registration Statement declared effective as soon as practicable after such Registration Statement is filed with the SEC. The Company or a Guarantor shall notify the Purchasers
by facsimile or e-mail as promptly as practicable, and in any event, within twenty-four (24) hours, after any Registration Statement is declared effective and shall simultaneously provide the Purchasers
with copies of any related Prospectus to be used in connection with the sale or other disposition of the securities covered thereby. 
 (ii)
For not more than sixty (60) consecutive days or for a total of not more than one hundred twenty (120) days in any twelve (12) month period, the Company or Iterum may suspend the use of any Prospectus included in any Registration
Statement contemplated by this Section 2 in the event that the Company or Iterum determines in good faith that such suspension is necessary to (A) delay the disclosure of material non-public
information concerning the Company or Iterum, the disclosure of which at the time is not, in the good faith 

  
 - 6 - 

 
opinion of the Company or Iterum, in the best interests of the Company or Iterum, (B) amend or supplement the affected Registration Statement or the related Prospectus so that such
Registration Statement or Prospectus shall not include an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein, in the case of the Prospectus in light of the
circumstances under which they were made, not misleading, (C) permit the Company or Iterum to conduct a sale of securities or other financing that is not a sale of Registrable Securities or (D) file a replacement Registration Statement
covering the resale of Registrable Securities in connection with the expiration or anticipated expiration of an effective Registration Statement (an “Allowed Delay”); provided that the Company or Iterum shall promptly
(a) notify each Purchaser in writing of the commencement of an Allowed Delay, but shall not (without the prior written consent of a Purchaser) disclose to such Purchaser any material non-public
information giving rise to an Allowed Delay, (b) advise the Purchasers in writing to cease all sales under such Registration Statement until the end of the Allowed Delay and (c) use best efforts to terminate an Allowed Delay as promptly as
practicable. 
 (d) Rule 415; Cutback. If at any time the SEC takes the position that the offering of some or all
of the Registrable Securities in a Registration Statement is not eligible to be made on a delayed or continuous basis under the provisions of Rule 415 under the Securities Act or requires any Purchaser to be named as an “underwriter,”
the Company and the Guarantors shall use their best efforts to persuade the SEC that the offering contemplated by such Registration Statement is a valid secondary offering and not an offering “by or on behalf of the issuer” as defined in
Rule 415 and that none of the Purchasers is an “underwriter.” The Purchasers shall have the right to select one legal counsel to review and oversee any registration or matters pursuant to this Section 2(d),
including participation in any meetings or discussions with the SEC regarding the SEC’s position and to comment on any written submission made to the SEC with respect thereto, which counsel shall be designated by the Required Purchasers. In the
event that, despite the Company’s and the Guarantors’ best efforts and compliance with the terms of this Section 2(d), the SEC does not alter its position, the Company and the Guarantors shall (i) remove from
such Registration Statement such portion of the Registrable Securities (the “Cut Back Securities”) and/or (ii) agree to such restrictions and limitations on the registration and resale of the Registrable Securities as the SEC
may require to assure the Company’s and the Guarantors’ compliance with the requirements of Rule 415 (collectively, the “SEC Restrictions”); provided, however, that the Company and the Guarantors shall not agree to
name any Purchaser as an “underwriter” in such Registration Statement without the prior written consent of such Purchaser. Any cut-back imposed on the Purchasers pursuant to this Section 2(d)
shall be allocated among the Purchasers on a pro rata basis and shall be applied first to any of the Registrable Securities of such Purchaser as such Purchaser shall designate, unless the SEC Restrictions otherwise require or provide or the
Purchasers otherwise agree. From and after such date as the Company and the Guarantors are able to effect the registration of such Cut Back Securities, the Company and the Guarantors shall use their best efforts to file a Registration Statement
relating to such Cut Back Securities and to have such Registration Statement declared effective by the SEC. 

  
 - 7 - 

 (e) Registration Default. 

(i) If a Registration Default occurs, then (i) with respect to Registrable Securities that constitute Notes, the interest rate on such
Notes will be increased by (A) 0.25% per annum for the first 90-day period beginning on the day immediately following such Registration Default and (B) an additional 0.25% per annum with respect to each
subsequent 90-day period, in each case until and including the date such Registration Default ends, up to a maximum increase of 1.00% per annum and (ii) with respect to Registrable Securities that
constitute RLNs, interest will accrue at (A) 0.25% per annum on the Principal Amount Multiple of such RLNs for the first 90-day period beginning on the day immediately following such Registration Default and
(B) an additional 0.25% per annum with respect to each subsequent 90-day period, in each case until and including the date such Registration Default ends, up to a maximum of 1.00% per annum, and such
interest shall become due and payable on the first Interest Payment Date (as such term is defined in the RLN Indenture) to occur after the occurrence of such Registration Default, and on each Interest Payment Date thereafter that corresponds to any
Interest Measuring Period (as such term is defined in the RLN Indenture) during which such Registration Default shall be continuing. A Registration Default ends with respect to any security when such security ceases to be a Registrable Security or,
if earlier, (1) in the case of a Registration Default under clause (i) of the definition thereof, when a Registration Statement filed pursuant to Section 2(a) becomes effective or (2) in the case of a
Registration Default under clause (ii) of the definition thereof, when such Registration Statement again becomes effective or such Prospectus again becomes usable. If at any time more than one Registration Default has occurred and is
continuing, then, until the next date that there is no Registration Default, the increase in interest rate provided for by this paragraph shall apply as if there occurred a single Registration Default that begins on the date that the earliest such
Registration Default occurred and ends on the next date that there is no Registration Default. 
 (ii) Without limiting the remedies
available to the Purchasers, the Company and the Guarantors acknowledge that any failure by the Company or the Guarantors to comply with their obligations under Section 2 hereof would result in material irreparable injury
to the Purchasers for which there is no adequate remedy at law, that it will not be possible to measure damages for such injuries precisely and that, in the event of any such failure, the Purchasers may specifically enforce the Company’s and
the Guarantors’ obligations under this Section 2 without the need to show actual damages and without the need to post a bond or other security. 

3. Company and Guarantor Obligations. The Company and the Guarantors will use their best efforts to effect the registration of the
Registrable Securities in accordance with the terms hereof, and pursuant thereto the Company and the Guarantors will: 
 (a) subject to the
third sentence in Section 2(a), use their best efforts to cause such Registration Statement (including any additional or replacement Registration Statement) to remain continuously effective for a period that will terminate
upon the earlier of (i) the date on which all Registrable Securities that are covered by such Registration Statement, as amended from time to time, and actually issued or issuable upon exchange of the Notes have been sold, (ii) the date on
which all Registrable Securities that are covered by such Registration Statement and actually issued or issuable upon exchange of the Notes may be sold without restriction 

  
 - 8 - 

 
pursuant to Rule 144 and without the requirement to be in compliance with Rule 144(c)(1) (or any successor thereto) promulgated under the Securities Act and (iii) the date that is six
years following the date the initial Registration Statement initially becomes effective (the “Effectiveness Period”), and advise the Purchasers promptly in writing when the Effectiveness Period has expired; 

(b) use their best efforts to prepare and file with the SEC such amendments and post-effective amendments to each such Registration Statement
and the related Prospectus as may be necessary to keep such Registration Statement effective for the Effectiveness Period and to comply with the provisions of the Securities Act and the Exchange Act with respect to the distribution of all of the
Registrable Securities covered thereby; 
 (c) provide copies to and permit any counsel designated by the Required Purchasers to review each
Registration Statement and all amendments and supplements thereto (but excluding any documents incorporated by reference in such Registration Statement, amendments or supplements that are available on the SEC’s Electronic Data Gathering,
Analysis, and Retrieval system (or any successor system)) no fewer than three (3) Business Days prior to their filing with the SEC and not file any document to which such counsel reasonably objects; 

(d) furnish to each Purchaser whose Registrable Securities are included in any Registration Statement (i) promptly after the same is
prepared and filed with the SEC, if requested by the Purchaser, one (1) copy of any Registration Statement and any amendment thereto, each preliminary prospectus and Prospectus and each amendment or supplement thereto, and each letter written
by or on behalf of the Company or the Guarantors to the SEC or the staff of the SEC, and each item of correspondence from the SEC or the staff of the SEC, in each case relating to such Registration Statement (other than any portion of any of the
foregoing which contains information for which the Company or the Guarantors have sought confidential treatment), and (ii) such number of copies of a Prospectus, including a preliminary prospectus, and all amendments and supplements thereto and
such other documents as each Purchaser may reasonably request in order to facilitate the disposition of the Registrable Securities owned by such Purchaser that are covered by such Registration Statement; 

(e) use commercially reasonable efforts to (i) prevent the issuance of any stop order or other suspension of effectiveness and,
(ii) if such order is issued, obtain the withdrawal of any such order at the earliest practical moment; 
 (f) prior to any public
offering of Registrable Securities, use commercially reasonable efforts to register or qualify or cooperate with the Purchasers and their counsel in connection with the registration or qualification of such Registrable Securities for the offer and
sale under the securities or blue sky laws of such jurisdictions requested by the Purchasers and do any and all other commercially reasonable acts or things necessary or advisable to enable the distribution in such jurisdictions of the Registrable
Securities covered by the Registration Statement; provided, however, that the Company and the Guarantors shall not be required in connection therewith or as a condition thereto to (i) qualify to do business in any jurisdiction where it would
not otherwise be required to qualify but for this Section 3(f), (ii) subject itself to general taxation in any jurisdiction where it would not otherwise be so subject but for this
Section 3(f), or (iii) file a general consent to service of process in any such jurisdiction; 

  
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 (g) use their best efforts to cause all Registrable Securities covered by a Registration
Statement to be listed on each securities exchange, interdealer quotation system or other market on which similar securities issued by the Company or Iterum are then listed; 

(h) promptly notify the Purchasers, at any time prior to the end of the Effectiveness Period, upon discovery that, or upon the happening of any
event as a result of which, the Prospectus includes an untrue statement of a material fact or omits to state any material fact required to be stated therein or necessary to make the statements therein not misleading in light of the circumstances
then existing, but shall not (without the prior written consent of a Purchaser) disclose to such Purchaser any other material non-public information, and promptly prepare, file with the SEC and furnish to such
holder a supplement to or an amendment of such Prospectus as may be necessary so that such Prospectus shall not include an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the
statements therein not misleading in light of the circumstances then existing; 
 (i) otherwise use their best efforts to comply with all
applicable rules and regulations of the SEC under the Securities Act and the Exchange Act, including, without limitation, Rule 172 under the Securities Act, file any final Prospectus, including any supplement or amendment thereof, with the SEC
pursuant to Rule 424 under the Securities Act, promptly inform the Purchasers in writing if, at any time during the Effectiveness Period, Iterum does not satisfy the conditions specified in Rule 172 and, as a result thereof, the Purchasers
are required to deliver a Prospectus in connection with any disposition of Registrable Securities and take such other actions as may be reasonably necessary to facilitate the registration of the Registrable Securities hereunder; and make available
to its security holders, as soon as reasonably practicable, an earnings statement covering a period of at least twelve (12) months, beginning after the effective date of each Registration Statement, which earnings statement shall satisfy the
provisions of Section 11(a) of the Securities Act, including Rule 158 promulgated thereunder; 
 (j) with a view to making
available to the Purchasers the benefits of Rule 144 (or its successor rule) and any other rule or regulation of the SEC that may at any time permit the Purchasers to sell securities to the public without registration, Iterum covenants and
agrees to: (i) make and keep adequate current public information available, as those terms are understood and defined in Rule 144, until the earlier of (A) six months after such date as all of the Registrable Securities may be sold
without restriction by the holders thereof pursuant to Rule 144 and without the requirement to be in compliance with Rule 144(c)(1) (or any successor thereto) promulgated under the Securities Act or any other rule of similar effect or
(B) such date as all of the Registrable Securities shall have been resold; (ii) file with the SEC in a timely manner all reports and other documents required of Iterum under the Exchange Act; and (iii) furnish to each Purchaser upon
request, as long as such Purchaser owns any Registrable Securities, (A) a written statement by Iterum that it has complied with the reporting requirements of the Exchange Act, (B) a copy of Iterum’s most recent Annual Report on Form 10-K or Quarterly Report on Form 10-Q, and (C) such other information as may be reasonably requested in order to avail such Purchaser of any rule or regulation of the SEC
that permits the selling of any such Registrable Securities without registration; 

  
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 (k) make available at reasonable times at the Company or the Guarantors’ principal
place of business or such other reasonable place for inspection by the Purchasers, and any attorney or accountant retained by such Purchaser, all pertinent financial and other records and pertinent corporate documents of each of the Company and the
Guarantors as may be reasonably necessary for the purpose of review as reasonably requested by the Purchasers and cause the Company’s and the Guarantors’ officers, directors and employees to supply within a reasonable time period all
information reasonably requested by any such Purchaser, attorney or accountant in connection with any Registration Statement or any post-effective amendment thereto subsequent to the filing thereof and prior to its effectiveness, as shall be
reasonably necessary for the sole purpose of enabling such Persons to conduct an investigation within the meaning of Section 11 of the Securities Act; provided, however, that the conduct of the foregoing inspection shall be subject to the
execution by all Persons party to such inspection of a reasonable confidentiality and non-use undertaking in customary form with respect to confidential and propriety information of the Company and the
Guarantors; and 
 (l) not later than ten (10) Business Days following the date on which Shareholder Approval is obtained, provide a
CUSIP number for all Registrable Securities. 
 4. Obligations of the Purchasers. 

(a) It shall be a condition precedent to the obligations of the Company and the Guarantors to take any action pursuant to
Section 2 hereof with respect to the Registrable Securities of any Purchaser that such Purchaser furnish in writing to the Company and the Guarantors a Securityholder Questionnaire and any other information regarding
itself, the Registrable Securities held by it and the intended method of disposition of the Registrable Securities held by it, as shall be reasonably required to effect the registration of such Registrable Securities, and such Purchaser shall
execute such documents in connection with such registration as the Company and the Guarantors may reasonably request. At least five (5) Business Days prior to the first anticipated filing date of any Registration Statement, the Company or the
Guarantors shall notify each Purchaser of the information the Company and the Guarantors require from such Purchaser if such Purchaser elects to have any of the Registrable Securities included in such Registration Statement. A Purchaser shall
provide such information to the Company and the Guarantors at least three (3) Business Days prior to the first anticipated filing date of such Registration Statement if such Purchaser elects to have any of the Registrable Securities included in
such Registration Statement. 
 (b) Each Purchaser, by its acceptance of the Registrable Securities, agrees to cooperate with the Company and
the Guarantors as reasonably requested by the Company and the Guarantors in connection with the preparation and filing of a Registration Statement hereunder, unless such Purchaser has notified the Company and the Guarantors in writing of its
election to exclude all of its Registrable Securities from such Registration Statement. 
 (c) Each Purchaser agrees that, upon receipt of
any notice from the Company or the Guarantors of either (i) the commencement of an Allowed Delay pursuant to Section 2(c)(ii) or (ii) the happening of an event pursuant to Section 3(h)
hereof, such Purchaser will immediately discontinue disposition of Registrable Securities pursuant to any Registration 

  
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Statement covering such Registrable Securities, until the Purchaser is advised by the Company or a Guarantor that such dispositions may again be made. 

(d) Each Purchaser covenants and agrees that it will comply with the prospectus delivery requirements of the Securities Act as applicable to it
or an exemption therefrom in connection with sales of Registrable Securities pursuant to any Registration Statement. 
 5.
Indemnification. 
 (a) Indemnification by the Company and the Guarantors. The Company and the Guarantors, jointly and
severally, will indemnify and hold harmless each Purchaser and its officers, directors, members, employees, investment advisers and agents, successors and assigns, and each other person, if any, who controls such Purchaser within the meaning of the
Securities Act (the “Purchaser Indemnified Parties”), against any losses, claims, damages or liabilities, joint or several, to which they may become subject under the Securities Act or otherwise, insofar as such losses, claims, damages or
liabilities (or actions in respect thereof) arise out of or are based upon: (i) any untrue statement or alleged untrue statement or omission or alleged omission of any material fact contained in any Registration Statement, any preliminary
Prospectus or final Prospectus, or any amendment or supplement thereof; (ii) any violation by the Company or a Guarantor or their agents of any rule or regulation promulgated under the Securities Act applicable to the Company or a Guarantor or
their agents and relating to action or inaction required of the Company or a Guarantor in connection with the performance of their obligations under this Agreement; or (iii) any failure to register or qualify the Registrable Securities included
in any such Registration Statement in any state where the Company, a Guarantor or their agents have affirmatively undertaken or agreed in writing that the Company or a Guarantor, as applicable, will undertake such registration or qualification on a
Purchaser’s behalf, and will reimburse such Purchaser, and each such Purchaser Indemnified Party for any documented, out-of-pocket legal or other expenses
reasonably incurred by them in connection with investigating or defending any such loss, claim, damage, liability or action; provided, however, that the Company and the Guarantors will not be liable in any such case if and to the extent that any
such loss, claim, damage or liability arises out of or is based upon (i) an untrue statement or alleged untrue statement or omission or alleged omission so made in conformity with information furnished by such Purchaser or any such controlling
person in writing specifically for use in such Registration Statement or Prospectus, (ii) the use by any Purchaser of an outdated or defective Prospectus after the Company or Iterum has notified such Purchaser in writing that such Prospectus is
outdated or defective, (iii) a Purchaser’s failure to send or give a copy of the Prospectus or supplement (as then amended or supplemented), if required (and not exempted) to the Persons asserting an untrue statement or omission or alleged
untrue statement or omission at or prior to the written confirmation of the sale of Registrable Securities, (iv) a Purchaser’s fraud or (v) the disposition of any Registrable Securities pursuant to any Registration Statement or
Prospectus covering such Registrable Securities during an Allowed Delay. 
 (b) Indemnification by the Purchasers. Each Purchaser
agrees, severally but not jointly, to indemnify and hold harmless, to the fullest extent permitted by law, the Company, the Guarantors, their respective directors, officers, employees, stockholders, shareholders and each person who controls the
Company or a Guarantor (within the meaning of the Securities Act) 

  
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against any losses, claims, damages, liabilities and expense (including reasonable attorney fees) resulting from any untrue statement of a material fact or any omission of a material fact
required to be stated in any Registration Statement or Prospectus or preliminary Prospectus or amendment or supplement thereto or necessary to make the statements therein not misleading, to the extent, but only to the extent that such untrue
statement or omission is made in conformity with any information furnished in writing by such Purchaser to the Company and the Guarantors specifically for inclusion in such Registration Statement or Prospectus or amendment or supplement thereto.
Except to the extent that any such losses, claims, damages, liabilities or expenses are finally judicially determined to have resulted from a Purchaser’s fraud, in no event shall the liability of a Purchaser be greater in amount than the dollar
amount of the proceeds (net of all expense paid by such Purchaser in connection with any claim relating to this Section 5 and the amount of any damages such Purchaser has otherwise been required to pay by reason of such
untrue statement or omission) received by such Purchaser upon the sale of the Registrable Securities included in such Registration Statement giving rise to such indemnification obligation. 

(c) Conduct of Indemnification Proceedings. Any person entitled to indemnification hereunder shall (i) give prompt written notice
to the indemnifying party of any claim with respect to which it seeks indemnification and (ii) permit such indemnifying party to assume the defense of such claim with counsel reasonably satisfactory to the indemnified party; provided that any
person entitled to indemnification hereunder shall have the right to employ separate counsel and to participate in the defense of such claim, but the fees and expenses of such counsel shall be at the expense of such person unless (a) the
indemnifying party has agreed to pay such fees or expenses, (b) the indemnifying party shall have failed to assume the defense of such claim and employ counsel reasonably satisfactory to such person or (c) in the reasonable judgment of any
such person, based upon written advice of its counsel, a conflict of interest exists between such person and the indemnifying party with respect to such claims (in which case, if the person notifies the indemnifying party in writing that such person
elects to employ separate counsel at the expense of the indemnifying party, the indemnifying party shall not have the right to assume the defense of such claim on behalf of such person); and provided, further, that the failure of any indemnified
party to give written notice as provided herein shall not relieve the indemnifying party of its obligations hereunder, except to the extent that such failure to give notice shall materially adversely affect the indemnifying party in the defense of
any such claim or litigation. It is understood that the indemnifying party shall not, in connection with any proceeding in the same jurisdiction, be liable for fees or expenses of more than one separate firm of attorneys at any time for all such
indemnified parties. No indemnifying party will, except with the consent of the indemnified party, which shall not be unreasonably withheld or conditioned, consent to entry of any judgment or enter into any settlement that does not include as an
unconditional term thereof the giving by the claimant or plaintiff to such indemnified party of a release from all liability in respect of such claim or litigation. 

(d) Contribution. If for any reason the indemnification provided for in the preceding paragraphs (a) and (b) is unavailable to
an indemnified party or insufficient to hold it harmless, other than as expressly specified therein, then the indemnifying party shall contribute to the amount paid or payable by the indemnified party as a result of such loss, claim, damage or
liability in such proportion as is appropriate to reflect the relative fault of the indemnified party and the indemnifying party, as well as any other relevant equitable considerations. No person guilty of fraudulent misrepresentation within the
meaning of Section 11(f) of the Securities Act 

  
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shall be entitled to contribution from any person not guilty of such fraudulent misrepresentation. Except to the extent that any such losses, claims, damages, liabilities or expenses are finally
judicially determined to have resulted from the applicable holder of Registrable Securities’ fraud, in no event shall the contribution obligation of a holder of Registrable Securities be greater in amount than the dollar amount of the proceeds
(net of all expenses paid by such holder in connection with any claim relating to this Section 5 and the amount of any damages such holder has otherwise been required to pay by reason of such untrue or alleged untrue
statement or omission or alleged omission) received by it upon the sale of the Registrable Securities giving rise to such contribution obligation. 

6. Pre-emptive Rights. 

(a) Subject to the terms and conditions of this Section 6 and applicable securities or blue sky laws, if Iterum
proposes to offer or sell any New Securities, Iterum shall first offer such New Securities to each Major Investor in accordance with the terms hereof. A Major Investor shall be entitled to apportion the right of first offer hereby granted to it in
such proportions as it deems appropriate, among (i) itself and other Major Investors, (ii) its Affiliates and (iii) its beneficial interest holders, such as limited partners, members or any other Person having “beneficial
ownership,” as such term is defined in Rule 13d-3 promulgated under the Exchange Act, of such Major Investor. 

(b) Iterum shall give notice (the “Offer Notice”) to each Major Investor, stating (i) its bona fide intention to offer or
sell such New Securities, (ii) the number of such New Securities to be offered, and (iii) the price and terms, if any, upon which it proposes to offer such New Securities. 

(c) By written notification to Iterum within thirty (30) days after the Offer Notice is delivered to a Major Investor, such Major Investor
may elect to purchase or otherwise acquire, at the price and on the terms specified in the Offer Notice, up to that portion of such New Securities which equals the Major Investor’s Applicable Percentage. The failure of any such Major Investor
to deliver such written notice within such time period shall be deemed an election by such Major Investor not to exercise its purchase rights with respect to such Offer Notice. To the extent that Iterum offers two (2) or more New Securities or
other securities in units, the Major Investors must purchase such units as a whole and will not be given the opportunity to purchase only one of the securities making up such unit. 

(d) Iterum shall sell all applicable New Securities to electing Major Investors on a date to be mutually determined by Iterum and the Major
Investors, which date shall be during the ten (10) day period commencing at the expiration of the initial thirty (30) day election period; provided, however, that such ten (10) day period shall be extended automatically if any
approvals or consents of any Governmental Entities are required to consummate the transaction and such approvals or consents are not received within such ten (10) day period for up to an additional one hundred twenty (120) days as long as
such approvals or consents remain outstanding and the parties are continuing to exercise commercially reasonable efforts to obtain them. 

  
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 (e) Upon the expiration of the offering period described in
Section 6(d), Iterum will be free to sell, during the one hundred twenty (120) day period commencing at the expiration of, as applicable, the initial thirty (30) day election period following delivery of an
Offer Notice (as may be extended in accordance with Section 6(d)), any New Securities that the Major Investors have not elected to purchase, at a sale price not less than, and on other terms no less favorable to Iterum
than, those offered to the Major Investors as set forth in the Offer Notice, provided, that such one hundred twenty (120) day period shall be extended automatically if any approvals or consents of any Governmental Entities are required to
consummate the transaction and such approvals or consents are not received within such one hundred twenty (120) day period for up to an additional one hundred twenty (120) days as long as such approvals or consents remain outstanding and
the parties are continuing to exercise commercially reasonable efforts to obtain them. Any New Securities offered or sold by Iterum after such one hundred twenty (120) day period (as such period may be extended in accordance with the
immediately preceding sentence) must be reoffered to the Major Investors pursuant to this Section 6. 
 (f) The
election by a Major Investor not to exercise its subscription rights under this Section 6 in any one instance shall not affect its right (other than in respect of a reduction in its Applicable Percentage) as to any
subsequent proposed issuance of New Securities under this Section 6. The provisions of this Section 6 shall apply equally to any issuance or sale by the Company, any of the Guarantors or any of
their controlled Affiliates of equity securities that would be deemed New Securities if issued by Iterum which, for the avoidance of doubt, shall not include any issuance of New Securities by a wholly owned Subsidiary to its parent or to another
wholly owned Subsidiary of such parent. Subject to the terms of this Section 6, any sale of New Securities by Iterum or any other entity covered by the preceding sentence without first giving the Major Investors the rights
described in this Section 6 shall be null and void and of no force and effect. 
 (g) Notwithstanding the terms set
forth in this Section 6, if the Board determines in good faith that Iterum must issue New Securities on an expedited basis without prior compliance with the terms of this Section 6 in order to
avoid material harm to Iterum or any of its Affiliates (an “Expedited Issuance”), then, subject to compliance with the terms of the immediately following sentence, Iterum may effect and consummate such Expedited Issuance without
complying with the terms set forth in this Section 6 and shall not be deemed to be in breach of this Section 6 as a result thereof. As promptly as practicable following the consummation of such
Expedited Issuance, Iterum and the Major Investors shall comply with the terms of this Section 6 in respect of the New Securities issued in such Expedited Issuance such that all Major Investors have the opportunity to
participate in such Expedited Issuance of New Securities and be put in the same place (including in respect of the percentage ownership of the equity securities of Iterum) they would have been had such Expedited Issuance been effected in accordance
with the terms of this Section 6. 
 (h) Notwithstanding the terms set forth in this
Section 6, Iterum may issue New Securities pursuant to the provisions of this Section 6(h) and without compliance with the other provisions of this Section 6 (each such
transaction or series of related transactions, an “Excused Issuance”); provided that, in any twelve month period, without compliance with the other provisions of this Section 6, (A) the Company may not
issue New Securities pursuant to 

  
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the provisions of this Section 6(h) (other than Exempted Securities) which exceed (in the aggregate with all other Excused Issuances during such 12 month period) 5% of
the issued and outstanding Ordinary Shares on a Fully Diluted Basis and (B) the Company may not issue New Securities pursuant to the provisions of this Section 6(h) (other than Exempted Securities) in exchange for
consideration (whether in cash or other property) the value of which exceeds (in the aggregate with all other Excused Issuances during such 12 month period) $5,000,000. Notwithstanding the foregoing, the Company may only consummate two
(2) Excused Issuances for so long as this Agreement is in effect. 
 (i) The provisions of this Section 6 (i)
shall not apply to the issuance of Exempted Securities and (ii) shall terminate and be of no further force or effect as of such time that the Major Investors collectively, and together with their Affiliates, have an Applicable Percentage of
less than 10%. 
 7. Board Matters. 

(a) For so long as the Major Investors collectively, and together with their Affiliates, have an Applicable Percentage of at least 5%, in the
case of the following clause (i)(x) in this sentence, and 12.5%, in the case of clause (i)(y) in this sentence: (i) promptly, and in any event no more than five (5) Business Days following the written request of the Major Investors, Iterum
shall cause the Board to be expanded to consist of (x) nine (9) members or (y) ten (10) members (such number being sufficient to allow the Investor Designees to be appointed to the Board pursuant to Section 7(b))
and (ii) Iterum shall cause the Board to consist of not more than ten (10) members without the prior written consent of the Major Investors (which shall not be unreasonably withheld). The obligation of Iterum to cause the Board to consist
of not more than ten (10) members as provided in the immediately preceding sentence shall terminate and be of no further force or effect as of such time that the Major Investors collectively, and together with their Affiliates, have an
Applicable Percentage of less than 5%. 
 (b) For so long as the Major Investors, collectively, and together with their Affiliates, have an
Applicable Percentage of at least 12.5%, the Major Investors shall have the right to designate two (2) directors to the Board, and for so long as the Major Investors, collectively, and together with their Affiliates, continue to have an
Applicable Percentage of at least 5% but less than 12.5%, the Major Investors shall have the right to designate one (1) director to the Board, in each case in accordance with the terms of this Section 7. Any directors
designated by the Major Investors in accordance with this Section 7 shall be referred to as “Investor Designees”. The right to designate one or more Investor Designees shall terminate and be of no further
force or effect as of such time that the Major Investors collectively, and together with their Affiliates, have an Applicable Percentage of less than an applicable threshold percentage referenced in the first sentence of this
Section 7(b). At any point in which the Major Investors are entitled to designate an Investor Designee, the Major Investors may provide written notice (a “Designation Notice”) to Iterum naming the
applicable Investor Designee(s) and demanding that the applicable Investor Designee(s) be appointed to the Board. Subject to subsections (i) and (j) of this Section 7, promptly, and in any event within five
(5) Business Days, following receipt of the Designation Notice, Iterum shall cause the Investor Designees to be appointed to the Board and to be members of the class of directors for the purposes of Article 152 of Iterum’s Constitution,
which was subject to reelection at Iterum’s most recent annual 

  
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meeting of shareholders. Following the delivery of a Designation Notice and prior to the appointment of the Investor Designees to the Board, Iterum shall not (and shall cause its Subsidiaries not
to) take or approve any action outside of the ordinary course of business including (without limitation) in respect of (i) strategic transactions, joint ventures and collaborations, (ii) the sale or acquisition of assets whether by merger,
consolidation or otherwise, (iii) issuance of equity other than under employee incentive plans, (iv) incurrence or prepayment of debt, (v) declaration or payment of any dividend or distribution, or (vi) the initiation or
suspension of any clinical trials. With respect to any vote of the Board, each director shall have one (1) vote and approval of all matters shall require the affirmative vote of a majority of directors. 

(c) Subject to the terms of this Section 7, from and after the date hereof, Iterum shall take all action within its
power to cause the covenants set forth in Section 7(a) and Section 7(b) to be fulfilled in all respects including: (i) causing the Investor Designees to be named in any proxy statement of
Iterum with respect to the election of members of their relevant class of the Board, (ii) soliciting the votes of shareholders in respect of the Investor Designees in the same manner and with the same level of effort as with the solicitation in
respect of other members of the Board, (iii) seeking to amend any organizational documents of Iterum necessary to give effect to the Major Investors’ rights hereunder as may reasonably be requested by the Major Investors and (iv) take
all actions permitted by applicable law to cause the Investor Designees to be members of the Board (including the appointment of the Investor Designees to the Board). 

(d) Subject to clause (e) immediately below, in the event that an Investor Designee ceases to serve on the Board for any reason (including
the death, disability or resignation of such person), the Major Investors shall be entitled to appoint a new Investor Designee in the place of such person, and the terms of this Section 7 shall apply equally to such
replacement. 
 (e) In the event that the Applicable Percentage of the Major Investors (and their Affiliates) falls below a threshold set
forth in Section 7(b) such that the Major Investors shall lose the right to designate one or more Investor Designees, if one or more Investor Designee has been designated, the Major Investors shall identify which of the
Investor Designees shall no longer be an Investor Designee (such person, a “Departing Designee”), and which Investor Designee(s) (if any) will remain as such; for the avoidance of doubt, the terms of this
Section 7 shall continue to apply to any Investor Designee who is not a Departing Designee. In the event of a Departing Designee, the Major Investors shall cause the removal or resignation of such Departing Designee prior
to the next annual meeting of Iterum shareholders (regardless of whether the term of the class of directors of which he or she is a part expires at such annual meeting), and the provisions of Section 7(b) and
(c) shall not apply to such Departing Designee, and in connection therewith (x) Iterum shall not be required to name such Departing Designee on its proxy statement or solicit votes in favor of such Departing Designee and (y) no
holder of Ordinary Shares shall be required to cause the Ordinary Shares owned by such shareholder or its Affiliates to be voted in favor of the reelection of such Departing Designee. 

(f) The Investor Designees, in addition to all current directors, will be required to: (i) comply with all policies, procedures,
processes, codes, rules, standards and 

  
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guidelines applicable to members of the Board (including with respect to confidentiality); and (ii) complete the Company’s standard director and officer questionnaire and other
reasonable and customary director onboarding documentation reasonably requested by the Company in connection with the election of Board members and applicable generally to all such Board members. 

(g) As a condition to the issuance or sale of any New Securities, Iterum shall cause any recipient of New Securities representing, together
with its Affiliates, an Applicable Percentage of 10% or more acquired from Iterum in a private placement to execute a joinder to this Agreement or another instrument satisfactory to the Major Investors, in each case in which such recipient of New
Securities agrees to be bound by the terms of this Section 7 and Section 5.5 of the Purchase Agreement. As a condition to the transfer, sale, assignment or other disposition of Ordinary Shares or
securities convertible into or exchangeable for Ordinary Shares (including the Exchange Notes) by any Purchaser party to this Agreement other than the Wellington Entities (other than a registered public secondary sale or a bona fide pro rata
distribution to the limited partners of such Purchasers), such Purchaser shall cause the transferee to execute a joinder to this Agreement or another instrument satisfactory to the Major Investors and Iterum, in each case in which such transferee
agrees to be bound by the terms of this Section 7 and Section 5.5 of the Purchase Agreement. The provisions of this Section 7(g) shall cease to apply (x) with respect
to the agreement to be bound by Section 5.5 of the Purchase Agreement, when all approvals described in such Section have been received, and (y) with respect to all other provisions of this
Section 7(g), when the Major Investors cease to be entitled to designate Investor Designees in accordance with this Section 7. As a condition to the transfer, sale, assignment or other disposition
of RLNs by any Purchaser party to this Agreement other than the Wellington Entities (other than a registered public secondary sale or a bona fide pro rata distribution to the limited partners of such Purchasers), such Purchaser shall cause the
transferee to execute a joinder to this Agreement or another instrument satisfactory to the Major Investors providing the acknowledgments and agreements set forth in Section 9(m) and (n). 

(h) Subject to applicable law and listing requirements, the Investor Designees shall be entitled to be a member of any committee of the Board
(including an executive or similar committee). 
 (i) Notwithstanding anything to the contrary in this Agreement, neither the Board nor any
committee of the Board shall be under any obligation to nominate or recommend an Investor Designee if, as determined in good faith by the other directors of the Board or any applicable committee thereof based on advice of outside counsel, service by
such nominee as a director would reasonably be expected to violate applicable law or the rules or regulations of the primary stock exchange or quotation system on which the Ordinary Shares are listed or quoted. Accordingly, if such requirements are
not met and/or such good faith determination is made by the other directors of the Board or applicable committee thereof, the Major Investors shall promptly take all appropriate action to cause any such Investor Designee to resign from the Board,
and shall, if required, vote its voting securities in favor of removal of any Investor Designee and any applicable meeting of shareholders. 

(j) Any person designated by the Major Investors as an Investor Designee must: (i) qualify as “independent” pursuant to Nasdaq
listing standards and satisfy the 

  
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requirements of all applicable Nasdaq and SEC rules and regulations (including all independence and other criteria required for membership of any committee of the Board on which the Investor
Designee is proposed to serve), and (ii) possess the requisite financial and business experience to serve as a director of Iterum (it being understood that each of the executives and investment professionals employed by the Major Investors or
their Affiliates shall be deemed to possess such experience). If the Board and all applicable committees of the Board reasonably determine that an Investor Designee satisfies the criteria in the foregoing sentence, the Board shall nominate and
appoint such Investor Designee to the Board. 
 (k) For so long as the Major Investors, collectively, and together with their Affiliates,
have the Applicable Percentages set forth in Section 7(b), in the event that any institutional shareholder of Iterum has appointed or designated a person to serve on the board of directors or similar governing body of any
Subsidiary of Iterum (a “Subsidiary Board”), the Major Investors shall be entitled to designate a number of Investor Designees to the Subsidiary Board equal to the greater of (x) one Investor Designee or (y) such other
number of Investor Designees such that the proportionate representation of Investor Designees on such Subsidiary Board approximates, as closely as possible, the proportionate representation of Investor Designees on the Board. 

(l) Commencing upon the delivery of a Designation Notice, each of the Purchasers other than the Wellington Entities covenants and agrees solely
with Iterum that such Purchaser shall, cause the voting of all such Ordinary Shares or other outstanding voting equity securities owned (whether beneficially or of record) by them or otherwise available to be voted by them or any of their Affiliates
from time to time (whether at any annual or extraordinary general meeting of the shareholders, by written consent or otherwise), in favor of the election of the Investor Designees to the Board and against any proposal to remove such Investor
Designees. Notwithstanding any other provision in this Agreement (but without limiting the obligations of Iterum under this Section 7), if the agreement of any Purchaser to vote or cause to be voted Ordinary Shares or other
equity securities in favor of the election of an Investor Designee pursuant to this Section 7 would be deemed to cause the offering of Notes to Purchasers to constitute a change of control in violation of applicable Nasdaq,
SEC or other rules, or otherwise violate applicable Nasdaq, SEC or other rules, such agreement shall not be deemed effective until such time as such violation ceases to exist. 

8. Confidentiality. Each Purchaser agrees that such Purchaser will keep confidential and will not disclose or divulge any confidential
information obtained from the Company pursuant to the terms of this Agreement (including notice of the Company’s intention to file a registration statement), unless such confidential information (a) is known or becomes known to the public
in general (other than as a result of a breach of this Section 8 by such Purchaser), (b) is or has been independently developed or conceived by such Purchaser without use of the Company’s confidential information, or
(c) is or has been made known or disclosed to such Purchaser by a third party without a breach of any obligation of confidentiality such third party may have to the Company; provided, however, that a Purchaser may disclose confidential
information (i) to its attorneys, accountants, consultants and other professionals to the extent necessary to obtain their services in connection with matters related to the Company; (ii) to any prospective purchaser of any Registrable
Securities from such Purchaser, if such prospective purchaser agrees to be bound by the provisions of this Section 8; (iii) to any Affiliate or its or 

  
 - 19 - 

 
their general or limited partners, members, stockholders, employees, officers or directors, in the ordinary course of business, provided that such Purchaser informs such person that such
information is confidential and directs such person to maintain the confidentiality of such information; or (iv) as may otherwise be required by law, regulation, rule, court order, arbitration order or subpoena, provided that such Purchaser
promptly notifies the Company of such disclosure and takes reasonable steps to minimize the extent of any such required disclosure. Each Purchaser acknowledges and agrees that the securities laws of the United States and other jurisdictions contain
prohibitions on the trading in the securities of Iterum while in possession of material nonpublic information regarding Iterum, and agrees to comply with such restrictions. 

9. Miscellaneous. 
 (a)
Amendments and Waivers. This Agreement (other than Sections 6 and 7) may be amended only by a writing signed by the Company, the Guarantors and the Required Purchasers. Other than with respect to Sections 6 and 7, the Company
and the Guarantors may take any action herein prohibited, or omit to perform any act herein required to be performed by it, only if the Company and the Guarantors shall have obtained the written consent to such amendment, action or omission to act
of the Required Purchasers. Any amendment to Sections 6 or 7, or the defined terms used therein, shall be made by a writing signed by the Company, the Guarantors and the Major Investors; provided that consent of a Purchaser is required in the
event that any such amendment would adversely affect the rights of such Purchaser in a material and disproportionate manner relative to the Major Investors or relative to other Purchasers hereunder. The Company and the Guarantors may take any action
prohibited by Section 6 or 7, or omit to perform any act required by Section 6 or 7 to be performed by it, only if the Company and the Guarantors shall have obtained the written consent to such
amendment, action or omission to act of the Major Investors. 
 (b) Notices. All notices and other communications provided for or
permitted hereunder shall be made as set forth in Section 6.1 of the Purchase Agreement. 
 (c) Assignments and Transfers by
Purchasers. The provisions of this Agreement shall be binding upon and inure to the benefit of the Purchasers and their respective successors and assigns. A Purchaser may transfer or assign, in whole or from time to time in part, to one or more
persons its rights hereunder in connection with the transfer of Registrable Securities by such Purchaser to such person, provided that such Purchaser complies with all laws applicable thereto and the provisions of the Purchase Agreement, the
Indenture, the Notes, the RLN Indenture and the RLNs and provides written notice of assignment to the Major Investors, the Company and the Guarantors prior to such assignment being effected, and such transferee agrees in writing and as a condition
to the receipt of Registrable Securities to be bound by all of the provisions contained herein. 
 (d) Assignments and Transfers by the
Company. This Agreement may not be assigned by the Company or the Guarantors (whether by operation of law or otherwise) without the prior written consent of the Required Purchasers, which must include the Major Investors for so long as the Major
Investors (collectively and together with their Affiliates) own at least 10% of the outstanding Notes and at least 10% of the outstanding RLNs; provided, however, that in the event that the Company or a Guarantor is a party to a merger,
consolidation, share exchange 

  
 - 20 - 

 
or similar business combination transaction in which the Ordinary Shares are converted into the equity securities of another Person, from and after the effective time of such transaction, such
Person shall, by virtue of such transaction, be deemed to have assumed the obligations of the Company or such Guarantor, as applicable, hereunder, and the term “Company”, “Iterum”, “Subsidiary Guarantor(s)” or
“Guarantor(s)”, as applicable, shall be deemed to refer to such Person and the term “Registrable Securities” shall be deemed to include the securities received by the Purchasers in connection with such transaction unless such
securities are otherwise freely tradable by the Purchasers after giving effect to such transaction. 
 (e) Benefits of the Agreement.
The terms and conditions of this Agreement shall inure to the benefit of and be binding upon the respective permitted successors and assigns of the parties. Nothing in this Agreement, express or implied, is intended to confer upon any party other
than the parties hereto or their respective successors and assigns any rights, remedies, obligations, or liabilities under or by reason of this Agreement, except as expressly provided in this Agreement. 

(f) Counterparts. This Agreement may be executed in several counterparts, and by each Party on separate counterparts, each of which and
any photocopies or other electronic transmission (including by PDF) thereof shall be deemed an original, but all of which together shall constitute one and the same agreement. 

(g) Titles and Subtitles. The titles and subtitles used in this Agreement are used for convenience only and are not to be considered in
construing or interpreting this Agreement. 
 (h) Severability. Any provision of this Agreement that is prohibited or unenforceable in
any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof but shall be interpreted as if it were written so as to be enforceable to the
maximum extent permitted by applicable law, and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other jurisdiction. To the extent permitted by applicable law, the
parties hereby waive any provision of law which renders any provisions hereof prohibited or unenforceable in any respect. 
 (i) Further
Assurances. The parties shall execute and deliver all such further instruments and documents and take all such other actions as may reasonably be required to carry out the transactions contemplated hereby and to evidence the fulfillment of the
agreements herein contained. 
 (j) Entire Agreement. This Agreement is intended by the parties as a final expression of their
agreement and intended to be a complete and exclusive statement of the agreement and understanding of the parties hereto in respect of the subject matter contained herein. This Agreement supersedes all prior agreements and understandings between the
parties with respect to such subject matter. 
 (k) Specific Performance. Without limiting remedies that may be available at law or in
equity, and without limiting Section 2(e)(ii), the parties acknowledge that any failure 

  
 - 21 - 

 
by any party to comply with their obligations under Section 6 or Section 7 hereof would result in material irreparable injury to the Major
Investors for which there is no adequate remedy at law, that it will not be possible to measure damages for such injuries precisely and that, in the event of any such failure, the Major Investors may specifically enforce the parties’
obligations under Section 6 or Section 7 without the need to show actual damages and without the need to post a bond or other security. 

(l) Governing Law; Consent to Jurisdiction; Waiver of Jury Trial. This Agreement shall be governed by and construed in accordance with
the internal laws of the State of New York without regard to the choice of law principles thereof. Each Party agrees that all legal proceedings concerning the interpretations, enforcement and defense of the transactions contemplated by this
Agreement (whether brought against a Party hereto or its respective Affiliates, directors, officers, shareholders, employees or agents) shall be commenced exclusively in the state and federal courts sitting in the City of New York. Each Party hereby
irrevocably submits to the exclusive jurisdiction of the state and federal courts sitting in the City of New York, borough of Manhattan, for the adjudication of any dispute hereunder or in connection herewith or with any transaction contemplated
hereby or discussed herein, and hereby irrevocably waives, and agrees not to assert in any suit, action or other proceeding, any claim that it is not personally subject to the jurisdiction of any such court, that such suit, action or proceeding is
improper or is an inconvenient venue for such proceeding. Each Party hereby irrevocably waives personal service of process and consents to process being served in any such suit, action or other proceeding by mailing a copy thereof via registered or
certified United States mail or overnight delivery (with evidence of delivery) to such Party at the address in effect for notices to it under this Agreement and agrees that such service shall constitute good and sufficient service of process and
notice thereof. Nothing contained herein shall be deemed to limit in any way any right to serve process in any other manner permitted by law. THE PARTIES HEREBY WAIVE ALL RIGHTS TO A TRIAL BY JURY. 

(m) Standstill. Each of the Purchasers covenants and agrees, that in the event that one or more Purchasers are, or are deemed to be,
‘acting in concert’ (within the meaning of the Irish Takeover Rules), at any time in the future when the aggregate holding of the parties acting in concert exceeds 30% of the share capital of Iterum, no such Purchaser shall acquire shares
in Iterum or the Company in circumstances which would trigger a requirement for a mandatory offer under the Irish Takeover Rules and such Purchasers shall enter into a customary standstill agreement with customary terms, conditions and indemnities
giving further effect to provisions of this Section 9(m). 
 (n) Acknowledgement of Holder Representative.
Each Purchaser hereby expressly acknowledges and agrees to the appointment of the Holders’ Representative, the rights provided thereto, and the obligations of the Purchasers in connection therewith (including the obligations of the Purchasers
to indemnify and hold the Holders’ Representative harmless) pursuant to RLN Indenture. 
 [remainder of page intentionally left blank]

  
 - 22 - 

 IN WITNESS WHEREOF, the parties have executed this Agreement or caused their duly authorized
officers to execute this Agreement as of the date first above written. 
  

			
	COMPANY:
	
	ITERUM THERAPEUTICS BERMUDA LIMITED

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	ITERUM:
	
	ITERUM THERAPEUTICS PLC

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SUBSIDIARY GUARANTOR:
	
	 ITERUM THERAPEUTICS

INTERNATIONAL LIMITED

 
			
		
	By:	 	      

	Name:

 
			
	Title:
	
	SUBSIDIARY GUARANTOR:
	
	ITERUM THERAPEUTICS US LIMITED

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	SUBSIDIARY GUARANTOR:
	
	ITERUM THERAPEUTICS US HOLDING LIMITED

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	PURCHASERS:
	
	ADVENT LIFE SCIENCES LLP

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	ADVENT LIFE SCIENCES FUND II LP
	
	By: Advent Life Sciences LLP, its General Partner

 
			
		
	By:	 	  

	Name:
	Title:

 
			
	
	ARIX BIOSCIENCE HOLDINGS LIMITED

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	CANAAN X L.P.
	
	By: Canaan Partners X LLC, its general partner

 
			
		
	By:	 	      

	Name:

 
			
	Title:

			
	FRAZIER HEALTHCARE VII, L.P.
	
	By: FHM VII, LP, its general partner
	By: FHM VII, LLC, its general partner

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	FRAZIER HEALTHCARE VII-A, L.P.
	
	By: FHM VII, LP, its general partner
	By: FHM VII, LLC, its general partner

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	NEW LEAF VENTURES III, L.P.
	
	By: New Leaf Venture Associates III, L.P.
	Its: General Partner
	
	By: New Leaf Venture Management III, L.L.C.
	Its: General Partner

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	NEW LEAF BIOPHARMA OPPORTUNITIES II, L.P.
	
	By: New Leaf BPO Associates II, L.P.
	Its: General Partner
	
	By: New Leaf BPO Management II, L.L.C.
	Its: General Partner

 
			
		
	By:	 	      

	Name:
	Title:

  

			
	SOFINNOVA VENTURE PARTNERS IX, L.P.
	
	By: Sofinnova Management IX, L.L.C.
	       its General Partner

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	DOMAIN PARTNERS IX, L.P.
	
	By: One Palmer Square Associates IX, L.L.C.

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	PIVOTAL BIOVENTURE PARTNERS FUND I, LP
	
	By: Pivotal bioVenture Partners Fund I GP, LP
	By: Pivotal bioVenture Partners Fund I GP U.G.P., Ltd.

 
			
		
	By:	 	      

	Name:
	Title:

			
	
	SALTHILL INVESTORS (BERMUDA) L.P.
	
	 By: Wellington Management Company LLP,

       as investment adviser

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SALTHILL PARTNERS, L.P.

 
			
	
	 By: Wellington Management Company LLP,

       as investment adviser

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SARISSA CAPITAL OFFSHORE MASTER FUND LP

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SARISSA CAPITAL CATAPULT FUND LLC

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SARISSA CAPITAL HAWKEYE FUND LP

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	RA CAPITAL HEALTHCARE FUND, L.P.
	
	By: RA Capital Healthcare Fund GP, LLC
	Its General Partner

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	BLACKWELL PARTNERS LLC – SERIES A

 
			
		
	By:	 	      

	Name:
	Title:

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	2B LLC
	By: SilverArc Capital Management, LLC acting as Investment manager.

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	683 CAPITAL PARTNERS, LP

 
			
		
	By:	 	      

	Name:
	Title:

			
	CVI INVESTMENTS, INC.
	
	By: Heights Capital Management, Inc., its authorized signatory

 
			
		
	By:	 	    

	Name:
	Title:

 
			
	
	EMPERY MASTER ONSHORE, LLC
	
	By: Empery Asset Management LP, its authorized agent

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	EMPERY TAX EFFICIENT, LP
	
	By: Empery Asset Management LP, its authorized agent

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	EMPERY TAX EFFICIENT II, LP
	
	By: Empery Asset Management LP, its authorized agent

 
			
		
	By:	 	      

	Name:
	Title:

			
	NORTH SOUND TRADING, LP

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	LINCOLN PARK CAPITAL FUND, LLC
	
	By: Lincoln Park Capital, LLC
	By: Rockledge Capital Corporation

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	S.H.N FINANCIAL INVESTMENTS LTD

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SABBY VOLATILITY WARRANT MASTER FUND, LTD. 

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	SILVERARC CAPITAL ALPHA FUND I, L.P.
	
	By: SilverArc Capital Management, LLC acting as Investment manager.

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	SILVERARC CAPITAL ALPHA FUND II, L.P.
	
	By: SilverArc Capital Management, LLC acting as Investment manager.

 
			
		
	By:	 	      

	Name:
	Title:

 
			
	
	GARY D. COHN

 
			
		
	By:	 	      

	Name: Gary D. Cohn

 EXHIBIT A 

Plan of Distribution

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