meropenem/vaborbactam

Action and Spectrum

Actions and Spectrum:

meropenem is a broad-spectrum antibiotic that belongs to the class of drugs called carbapenems. It works by inhibiting the growth and reproduction of bacteria by disrupting their cell wall. Meropenem is effective against a wide range of gram-negative and gram-positive bacteria, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Streptococcus pneumoniae.

vaborbactam is a beta-lactamase inhibitor, which is a drug that helps prevent bacteria from producing enzymes that can break down antibiotics. When used in combination with meropenem, vaborbactam helps to prevent antibiotic resistance and improve the effectiveness of the treatment.

The combination of meropenem/vaborbactam is used to treat serious bacterial infections, such as urinary tract infections, intra-abdominal infections, and infections of the blood, bones, and joints. It is typically administered intravenously and is usually given in a hospital setting.

The spectrum of action of meropenem/vaborbactam is broad and is effective against a wide range of gram-negative and gram-positive bacteria, including those that are resistant to other antibiotics. This is particularly useful in the treatment of multi-drug resistant infections and is usually considered as a last resort option for treatment.

Drug Interaction

Adverse Reaction

Frequency Defined 

1-10% 

Diarrhea (3.3%)

Phlebitis/infusion site reactions (4.4%)

Hypersensitivity (1.8%)

Increased ALT (1.8%)

Headache (8.8%)

Nausea (1.8%)

Increased AST (1.5%)

Hypokalemia (1.1%)

Pyrexia (1.5%)

>1%

Pharyngitis

Chest discomfort

Vulvovaginal candidiasis

Leukopenia

Creatinine phosphokinase increase

Oral candidiasis

Decreased appetite

Hyperglycemia

Hyperkalemia

Black Box Warning

Black Box Warning

The Black Box Warning for this drug states that it should not be used in patients with a known allergy to meropenem, vaborbactam or any other components of the product.

Contraindication / Caution

Contraindication/Caution:

meropenem/vaborbactam is contraindicated in patients with a known hypersensitivity to the drug or any of its components. Caution should be exercised in patients with a history of allergic reactions to other beta-lactam antibiotics. It is also not recommended for use in patients with a history of seizures, as the vaborbactam component may increase the risk of seizures.

It should be used with caution in patients with renal impairment, as the dosage may need to be adjusted. It is also not recommended for use in patients with a history of seizures, as the vaborbactam component may increase the risk of seizures. It should be used with caution in patients with renal impairment, as the dosage may need to be adjusted. It should not be used in pregnancy and breastfeeding without the advice of a physician.

Pregnancy / Lactation

Pregnancy warnings:   

US FDA pregnancy category: N/A

Lactation:  

Excreted into human milk is Yes (meropenem); Unknown (vaborbactam)

Pregnancy Categories:        

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology: 

meropenem and vaborbactam are two antibiotics that are used in combination to treat serious bacterial infections.

Pharmacodynamics: 

meropenem is a carbapenem antibiotic that works by inhibiting the bacterial cell wall synthesis, which leads to the death of the bacteria. It is active against a wide range of gram-negative and gram-positive bacteria, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Streptococcus pneumoniae.

vaborbactam is a beta-lactamase inhibitor that works by blocking the enzymes (beta-lactamases) that bacteria produce to inactivate carbapenem antibiotics like meropenem. By inhibiting these enzymes, vaborbactam enhances the activity of meropenem against bacteria that produce beta-lactamases.

Together, meropenem and vaborbactam provide broad-spectrum coverage against a wide range of gram-negative and gram-positive bacteria, including those that are resistant to other antibiotics. This combination is particularly useful for treating infections caused by multidrug-resistant bacteria, such as carbapenem-resistant Enterobacteriaceae (CRE).

Pharmacokinetics:  

Absorption 

meropenem/vaborbactam is administered intravenously (IV) and is rapidly and completely absorbed into the bloodstream.

Distribution 

meropenem and vaborbactam distributed throughout the body, with high concentrations found in the urine, bile, and cerebrospinal fluid (CSF). Vaborbactam has a higher volume of distribution than meropenem.

Metabolism 

meropenem is not metabolized, but vaborbactam is metabolized by the liver.

Excretion 

meropenem and vaborbactam are primarily excreted through the kidneys. The elimination half-life of meropenem is approximately 1 hour, while the elimination half-life of vaborbactam is approximately 2.5 hours.

Adminstartion

Administration: 

IV administration

meropenem and vaborbactam are antibiotics that are administered together to treat certain types of bacterial infections, such as those caused by carbapenem-resistant Enterobacteriaceae. The two medications are typically given intravenously, and the dose and duration of treatment will depend on the specific infection being treated and the patient’s medical history and condition.

Patient Information Leaflet

Patient information leaflet

Generic Name: meropenem/vaborbactam

Why do we use meropenem/vaborbactam?

meropenem/vaborbactam is used to treat certain types of bacterial infections that have become resistant to other antibiotics. meropenem is a carbapenem antibiotic, which means it targets a wide range of bacteria, including those that are resistant to other antibiotics. vaborbactam is a beta-lactamase inhibitor, which helps to protect meropenem from being broken down by certain enzymes that bacteria produce to resist antibiotics.

By combining these two medications, the effectiveness of the treatment is increased, making it more likely to be effective against resistant bacteria. It is used to treat infections such as urinary tract infections, intra-abdominal infections, and complicated skin and skin structure infections.