Introduction: infections due to carbapenem-resistant Enterobacterales (CRE) constitute a worldwide threat and are associated with significant mortality, especially in fragile patients, and costs. Meropenem-vaborbactam (M/V) is a combination of a group 2 carbapenem with a novel cyclic boronic acid-based β-lactamase inhibitor which has shown good efficacy against KPC carbapenemase-producing Klebsiella pneumoniae, which are amongst the most prevalent types of CRE.Areas covered: This article reviews the microbiological and pharmacological profile and current clinical experience and safety of M/V in the treatment of infections caused by CRE.Expert opinion: M/V is a promising drug for the treatment of infections due to KPC-producing CRE (KPC-CRE). It exhibited an almost complete coverage of KPC-CRE isolates from large surveillance studies and a low propensity for resistance selection, retaining activity also against strains producing KPC mutants resistant to ceftazidime-avibactam. Both meropenem and vaborbactam have a favorable pharmacokinetic profile, with similar kinetic properties, a good intrapulmonary penetration and are efficiently cleared during continuous veno-venous hemofiltration (CVVH). According to available data, M/V monotherapy is associated with higher clinical cure rates and lower rates of adverse events, especially in terms of nephrotoxicity, if compared to "older" combination therapies.

Novelli, A., Del Giacomo, P., Rossolini, G. M., Tumbarello, M., Meropenem/ vaborbactam: a next generation β-lactam β-lactamase inhibitor combination, <<EXPERT REVIEW OF ANTI-INFECTIVE THERAPY>>, 2020; (na): N/A-N/A. [doi:10.1080/14787210.2020.1756775] [http://hdl.handle.net/10807/151598]

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

Del Giacomo, Paola;Tumbarello, Mario
2020

Abstract

Introduction: infections due to carbapenem-resistant Enterobacterales (CRE) constitute a worldwide threat and are associated with significant mortality, especially in fragile patients, and costs. Meropenem-vaborbactam (M/V) is a combination of a group 2 carbapenem with a novel cyclic boronic acid-based β-lactamase inhibitor which has shown good efficacy against KPC carbapenemase-producing Klebsiella pneumoniae, which are amongst the most prevalent types of CRE.Areas covered: This article reviews the microbiological and pharmacological profile and current clinical experience and safety of M/V in the treatment of infections caused by CRE.Expert opinion: M/V is a promising drug for the treatment of infections due to KPC-producing CRE (KPC-CRE). It exhibited an almost complete coverage of KPC-CRE isolates from large surveillance studies and a low propensity for resistance selection, retaining activity also against strains producing KPC mutants resistant to ceftazidime-avibactam. Both meropenem and vaborbactam have a favorable pharmacokinetic profile, with similar kinetic properties, a good intrapulmonary penetration and are efficiently cleared during continuous veno-venous hemofiltration (CVVH). According to available data, M/V monotherapy is associated with higher clinical cure rates and lower rates of adverse events, especially in terms of nephrotoxicity, if compared to "older" combination therapies.
2020
Inglese
Novelli, A., Del Giacomo, P., Rossolini, G. M., Tumbarello, M., Meropenem/ vaborbactam: a next generation β-lactam β-lactamase inhibitor combination, <<EXPERT REVIEW OF ANTI-INFECTIVE THERAPY>>, 2020; (na): N/A-N/A. [doi:10.1080/14787210.2020.1756775] [http://hdl.handle.net/10807/151598]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/151598
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