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Meropenem/vaborbactam: a next generation β-lactam β-lactamase inhibitor combination

Andrea Novelli1, Paola Del Giacomo2, Gian Maria Rossolini3

  • 1Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Florence , Florence, Italy.

Expert Review of Anti-Infective Therapy
|April 17, 2020
PubMed
Abstract

Insights

Meropenem-vaborbactam (M/V) offers effective treatment for carbapenem-resistant Enterobacterales (CRE) infections, including KPC-producing strains. This combination therapy shows high efficacy and a favorable safety profile compared to older treatments.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Carbapenem-resistant Enterobacterales (CRE) infections pose a significant global health threat, linked to high mortality and healthcare costs.
  • Meropenem-vaborbactam (M/V) is a novel combination therapy targeting CRE, particularly effective against KPC carbapenemase-producing Klebsiella pneumoniae.

Purpose of the Study:

  • To review the microbiological and pharmacological profile of M/V.
  • To summarize current clinical experience and safety data for M/V in treating CRE infections.

Main Methods:

  • Review of microbiological data on M/V efficacy against CRE isolates.
  • Analysis of pharmacokinetic properties of meropenem and vaborbactam.
  • Evaluation of clinical trial data and surveillance studies on M/V safety and efficacy.

Main Results:

  • M/V demonstrates broad coverage against KPC-CRE isolates and low resistance selection potential.
  • Meropenem and vaborbactam exhibit favorable pharmacokinetics, including good lung penetration and efficient clearance during CVVH.
  • M/V monotherapy is associated with higher clinical cure rates and reduced adverse events, notably nephrotoxicity, compared to older regimens.

Conclusions:

  • M/V is a promising therapeutic option for KPC-CRE infections.
  • The drug's efficacy, favorable pharmacokinetic profile, and safety suggest it is a valuable addition to the treatment armamentarium against challenging CRE infections.
Keywords:
Carbapenem-Resistant Enterobacterales (CRE)KPC carbapenemaseKPC-producing Klebsiella pneumoniaemeropenem-vaborbactam (M/V)

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