Meropenem-vaborbactam

Administration

• Type: Carbapenem+beta lactamase inhibitor
• Dosage Forms: 2 gram (1 gram each) solution reconstituted
• Routes of Administration: IV
• Common Trade Names: Vabomere

Adult Dosing

Complicated UTI (including pyelonephritis)

• 4 g IV q8h (administered over 3 hours)

Special Populations

Pregnancy Rating

Unknown

Lactation risk

• Meropenem is present in breast milk

Renal Dosing

• eGFR >50: none
• eGFR 30 to 49: 2 g q8h
• eGFR 15 to 29: 2 g q12h
• eGFR <15: 1 g q12h
• ESRD on HD: Administer after HD on dialysis days

Hepatic Dosing

None

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• DVT (<1%)
• Increased risk of seizures

Common

• Phlebitis
• Headache
• Hypokalemia
• Diarrhea
• Increased ALT/AST
• Infusion site reaction

Pharmacology

• Half-life: Meropenem 1.2 hours; Vaborbactam 1.68 hours
• Metabolism:
• Excretion: Meropenem (urine); Vaborbactam (urine)

Mechanism of Action

• Meropenem inhibits bacterial cell wall synthesis
• Vaborbactam is a beta-lactamase inhibitor that protects meropenem from degradation by KPC

Comments

• Cost: 1 g: ~$200