Patient Characteristics and Clinical Outcomes Associated with Meropenem/Vaborbactam Treatment in Carbapenem-Resistant Enterobacterales Pneumonia

Document Type

Conference Proceeding

Publication Date

1-29-2025

Publication Title

Open Forum Infect Dis

Keywords

beta lactamase inhibitor, carbapenem, meropenem plus vaborbactam, adult, adverse drug reaction, aged, APACHE, bacteremia, Caucasian, clinical outcome, Clostridium difficile infection, Clostridium infection, cohort analysis, comparative study, conference abstract, coronavirus disease 2019, cross-sectional study, drug combination, drug therapy, Enterobacterales, female, hospitalization, human, intensive care unit, Klebsiella pneumoniae, major clinical study, male, mortality, multicenter study, observational study, pneumonia, prevalence, pseudomembranous colitis, recurrent disease, retrospective study, therapy, ventilator associated pneumonia

Abstract

Background. Carbapenem-resistant Enterobacterales (CRE) are a major public health threat due to increasing prevalence and limited effective treatment options. Meropenem/vaborbactam (M/V) is a beta-lactam/beta-lactamase inhibitor agent designed to treat CRE. There is a paucity of data related to patient characteristics and associated outcomes with the utilization of M/V in pneumonia due to CRE. The objective of this study was to describe real-world experience with M/V in this setting. Methods. This is a retrospective, observational, multicenter, cross-Sectional study of patients ≥ 18 years old who received M/V for ≥ 72 hours for clinically-diagnosed hospital-acquired (HAP) or ventilator-associated pneumonia (VAP) due to CRE between 6/2020-2/2024. The primary outcome was clinical success, defined as resolution or improvement in signs/symptoms of infection and without the need for additional therapy. The secondary outcomes included 30-day mortality, 30-day microbiologic recurrence, 30-day symptomatic recurrence and adverse drug reaction(s). Results. Sixty-two patients were included from six U.S. medical centers. The mean age (standard deviation [SD]) was 58.2 (15.4) years; patients were predominantly male (71.0%) and Caucasian (58.1%). At time of culture collection, the mean (SD) APACHE II score was 22.1 (7.8) and most patients (78.0%) were admitted to the intensive care unit. Klebsiella pneumoniae was the predominant species isolated in culture (43.5%). Notably, 65.6% were diagnosed with VAP, 32.3% had a COVID-19-related hospitalization and 29.0% developed secondary bacteremia. Patients received a median (interquartile range [IQR]) of 7.2 (6.1-12.0) days of M/ V, with 21.0% receiving systemic combination therapy. Clinical success was achieved in 69.4% of patients and 30-day mortality occurred in 33.9%. Microbiologic and symptomatic recurrence occurred in 11.2% and 8.1% of cases, respectively. One patient experienced Clostridioides difficile infection attributed to the use of M/V. Conclusion. Our study demonstrates promising clinical success with the use of M/V for treatment of pneumonia. Larger, comparative studies are needed in this population to identify patient factors associated with clinical success and assess M/V's efficacy compared to other available therapies.

Volume

12

First Page

S917

Last Page

S918

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