Real-world, Multicenter Experience With Meropenem-Vaborbactam for Gram-Negative Bacterial Infections Including Carbapenem-Resistant

Sara Alosaimy
Abdalhamid M Lagnf
Taylor Morrisette
Marco R Scipione
Jing J Zhao
Sarah C J Jorgensen
Ryan Mynatt
Travis J Carlson
Jinhee Jo
Kevin W Garey
David Allen
Kailynn DeRonde
Ana D Vega
Lilian M Abbo
Veena Venugopalan
Vasilios Athans
Stephen Saw
Kimberly C Claeys
Mathew Miller
Kyle C Molina
Michael Veve
Wesley D Kufel
Lee Amaya, Beaumont Health Resident
Christine Yost, Beaumont Health
Jessica Ortwine
Susan L Davis
Michael J Rybak


Background: We aimed to describe the clinical characteristics and outcomes of patients treated with meropenem-vaborbactam (MEV) for a variety of gram-negative infections (GNIs), primarily including carbapenem-resistant Enterobacterales (CRE).

Methods: This is a real-world, multicenter, retrospective cohort within the United States between 2017 and 2020. Adult patients who received MEV for ≥72 hours were eligible for inclusion. The primary outcome was 30-day mortality. Classification and regression tree analysis (CART) was used to identify the time breakpoint (BP) that delineated the risk of negative clinical outcomes (NCOs) and was examined by multivariable logistic regression analysis (MLR).

Results: Overall, 126 patients were evaluated from 13 medical centers in 10 states. The most common infection sources were respiratory tract (38.1%) and intra-abdominal (19.0%) origin, while the most common isolated pathogens were CRE (78.6%). Thirty-day mortality and recurrence occurred in 18.3% and 11.9%, respectively. Adverse events occurred in 4 patients: nephrotoxicity (n = 2), hepatoxicity (n = 1), and rash (n = 1). CART-BP between early and delayed treatment was 48 hours (

Conclusions: Our results support current evidence establishing positive clinical and safety outcomes of MEV in GNIs, including CRE. We suggest that delaying appropriate therapy for CRE significantly increases the risk of NCOs.