Meropenem-vaborbactam: a critical positioning for the management of infections by Carbapenem-resistant Enterobacteriaceae

Expert Rev Anti Infect Ther. 2022 Jun;20(6):809-818. doi: 10.1080/14787210.2022.2030219. Epub 2022 Jan 26.

Abstract

Introduction: The review aims to review the positioning of meropenem-vaborbactam in clinical practice, taking into consideration the characteristics of other available drugs, namely ceftazidime-avibactam, plazomicin, and colistin.

Areas covered: The search terms 'meropenem-vaborbactam' or RX7009 for the years 2006 until 2021 were used.

Expert opinion: Coupling of meropenem with the cyclic boronate derivative varobactam enhances considerably the in vitro intrinsic activity of meropenem against isolates producing KPC (Klebsiella pneumoniae-producing carbapenemase). The drug has linear elimination and the ratio of the area under the curve of the free drug to the minimum inhibitory concentration is the main pharmacodynamics variable determining bacterial clearance. Meropenem-vaborbactam is currently approved for the management of complicated urinary tract infections including acute pyelonephritis, complicated intraabdominal infections, and hospital-acquired pneumonia including ventilator-associated pneumonia.

Keywords: Meropenem-vaborbactam; carbapenem resistance; enterobacteria; klebsiella pneumoniae.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Azabicyclo Compounds / pharmacology
  • Bacterial Proteins
  • Boronic Acids
  • Carbapenem-Resistant Enterobacteriaceae*
  • Ceftazidime / pharmacology
  • Drug Combinations
  • Enterobacteriaceae Infections* / drug therapy
  • Humans
  • Klebsiella pneumoniae
  • Meropenem / pharmacology
  • Microbial Sensitivity Tests
  • beta-Lactamases

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Bacterial Proteins
  • Boronic Acids
  • Drug Combinations
  • vaborbactam
  • Ceftazidime
  • beta-Lactamases
  • Meropenem