From the Guidelines
Vabomere (meropenem and vaborbactam) is indicated for the treatment of complicated urinary tract infections (cUTIs), including pyelonephritis, caused by susceptible gram-negative bacteria in adult patients, particularly those producing Klebsiella pneumoniae carbapenemase (KPC). The standard dosing regimen is 4 grams (2g meropenem/2g vaborbactam) administered intravenously over 3 hours every 8 hours for 7-14 days, with dosage adjustments required for patients with renal impairment 1. Vabomere works through a dual mechanism: meropenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, while vaborbactam is a beta-lactamase inhibitor that protects meropenem from degradation by certain carbapenemases, particularly KPC enzymes. This combination allows Vabomere to maintain activity against bacteria that have developed resistance to carbapenems alone. Some key points to consider when using Vabomere include:
- It should be reserved for infections with documented or highly suspected resistant pathogens to preserve its effectiveness and minimize further antimicrobial resistance development 1.
- The choice of antibiotic treatment for cUTI caused by CRE should be based on susceptibility testing and local epidemiology 1.
- Meropenem-vaborbactam may be considered as the first choice in specific types of infections, such as pneumonia, due to its high intrapulmonary penetration ratios 1.
- Local epidemiology and the emergence of ceftazidime/avibactam resistance in KPC-producing isolates should be considered when choosing between meropenem-vaborbactam and ceftazidime/avibactam 1.
From the FDA Drug Label
VABOMERE (meropenem and vaborbactam) is a combination of meropenem, a penem antibacterial, and vaborbactam, a beta-lactamase inhibitor, indicated for the treatment of patients 18 years and older with complicated urinary tract infections (cUTI) including pyelonephritis caused by designated susceptible bacteria.
The indication for Vabomere (meropenem and vaborbactam) use is for the treatment of complicated urinary tract infections (cUTI), including pyelonephritis, in patients 18 years and older, caused by designated susceptible bacteria 2.
From the Research
Indication for Vabomere Use
The indication for Vabomere (meropenem and vaborbactam) use is for the treatment of complicated urinary tract infections (cUTI), including pyelonephritis, caused by susceptible microorganisms such as Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae species complex 3, 4, 5, 6.
Key Points
- Vabomere is a combination of a carbapenem (meropenem) and a beta-lactamase inhibitor (vaborbactam) 3.
- It is effective against Gram-negative pathogens, including Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae 5, 6.
- The recommended dosage is 2g/2g administered intravenously every 8 hours 3, 4.
- Vabomere has been shown to be noninferior to piperacillin-tazobactam in clinical trials, with some studies demonstrating superiority 4, 5.
Clinical Use
- Vabomere is approved for use in patients 18 years or older with cUTI, including pyelonephritis 6.
- It is not currently indicated for the treatment of infections caused by carbapenem-resistant Enterobacteriaceae, although some studies suggest it may be effective in this setting 6, 7.
- The pharmacokinetics and pharmacodynamics of vaborbactam in combination with meropenem have been evaluated in animal and in vitro models, with the 24-h free vaborbactam AUC/meropenem-vaborbactam MIC ratio being the best predictor of antibacterial activity 7.