Meropenem–vaborbactam for adults with complicated urinary tract and other invasive infections

Abstract

ABSTRACTIntroduction: Complicated urinary tract infections are increasingly caused by multidrug-resistant organisms. Carbapenem-resistant Enterobacteriaceae (CRE) constitute a rising threat among uropathogens with significant morbidity and mortality. Meropenem–vaborbactam is a novel carbapenem and cyclic boronic acid-based beta-lactamase inhibitor combination with potent activity against subtypes of CRE.Areas covered: This article reviews mechanisms of carbapenem resistance, existing treatment options for CRE, and the current evidence to support the use of meropenem–vaborbactam for the treatment of infections caused by subtypes of CRE including complicated urinary tract infections.Expert commentary: Meropenem–vaborbactam is a superior treatment option for infections secondary to Klebsiella pneumoniae carbapenemase (KPC)-producing CRE. It is associated with higher rates of treatment success and lower rates of toxicity than traditional agents and demonstrates a potentially higher barrier to acquired antimicrobial resistance than ceftazidime–avibactam. At present, meropenem–vaborbactam should be regarded as a preferred treatment option for invasive infections secondary to KPC-producing CRE.