Not all carbapenem-resistant Pseudomonas aeruginosa strains are alike: tailoring antibiotic therapy based on resistance mechanisms DOI
Marco Falcone,

Valentina Galfo,

Giusy Tiseo

et al.

Current Opinion in Infectious Diseases, Journal Year: 2024, Volume and Issue: 37(6), P. 594 - 601

Published: Aug. 16, 2024

Purpose of review To correlate the resistance mechanisms and susceptibility to new antibiotics in Pseudomonas aeruginosa . Recent findings Definition antibiotic is still debated. Carbapenem-resistant (CRPA) difficult-to-treat resistant (DTR-PA) are used but which them better with risk mortality remains Mechanisms underlying complex may be combined, resulting unpredictable phenotype cross-resistance. Thus, not all CRPA alike tailoring therapy on challenging. Summary Current guidelines recommend use antipseudomonal agents for or DTR-PA infections they don’t provide specific information how mechanisms. This useful understand involved have practical implications helping clinicians select an appropriate regimen. Several now available their rational important avoid development future resistance. The knowledge local epidemiology most common guide empirical therapy, targeted should re-evaluated as soon testing profile selected according phenotype.

Language: Английский

Outcomes and Predictors of Mortality in Patients With KPC-Kp Infections Treated With Meropenem Vaborbactam: An Observational Multicenter Study DOI Creative Commons
Mario Tumbarello, Francesca Raffaelli, Maddalena Giannella

et al.

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(6)

Published: May 8, 2024

Abstract Background Meropenem-vaborbactam is a recent and promising option for the treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp) infections, including those resistant to ceftazidime-avibactam. Methods We conducted retrospective analysis observational data from 19 Italian hospitals on use outcomes patients treated with meropenem-vaborbactam at least ≥24 hours KPC-Kp infections. Crude propensity-weighted multiple Cox regression models were performed ascertain risk factors independently associated 30-day mortality. Results The cohort included 342 adults bloodstream infections (n = 172) nonbacteremic 170), which 107 lower respiratory tract 30 complicated urinary 33 involving other sites. Most (62.3%) managed monotherapy, or in combination 1 active drug (usually fosfomycin, tigecycline, gentamicin) (37.7%). mortality rate was 31.6% (108/342). In model, septic shock infection onset, Charlson comorbidity index ≥ 3, dialysis, concomitant COVID-19, INCREMENT score 8. Administration within 48 onset negative predictor All predictors, except administration hours, remained significant when model repeated after adjustment propensity receipt therapy. Conclusions Despite limits study, derived this multicenter provide additional evidence efficacy treating severe even used as monotherapy.

Language: Английский

Citations

8
Meropenem–Vaborbactam for Treatment of Carbapenem-Resistant Enterobacterales: A Narrative Review of Clinical Practice Evidence DOI Creative Commons
Matteo Bassetti, Daniele Roberto Giacobbe, Antonio Vena

et al.

Infectious Diseases and Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: April 12, 2025

Among drug-resistant bacteria, carbapenem-resistant Enterobacterales (CRE) are a major clinical challenge with limited options for treatment. In the last several years, new treatment have emerged CRE, including meropenem-vaborbactam (MVB). MVB was studied clinically in TANGO-I and TANGO-II trials, which evaluated combination complicated urinary tract infections different types of CRE infections, respectively. To date, data on efficacy remain limited, but needed to understand drug routine practice. Eight retrospective studies investigated use CRE. these analyses, overall success rate varied from 60 75%, while mortality rates at 30 days ranged about 15 30%. Most investigations involved patients KPC-producing strains, also Gram-negative 80% were addition, number small case series reports describing MVB. both series/reports, there appeared be no safety concerns. Collectively, shown that can considered promising severe Klebsiella pneumoniae carbapenemase (KPC)-producing-CRE is safe well tolerated.

Language: Английский

Citations

0
Meropenem/Vaborbactam—A Mechanistic Review for Insight into Future Development of Combinational Therapies DOI Creative Commons

Trae Hillyer,

Woo Shik Shin

Antibiotics, Journal Year: 2024, Volume and Issue: 13(6), P. 472 - 472

Published: May 21, 2024

Beta-lactam antibiotics have been a major climacteric in medicine for being the first bactericidal compound available clinical use. They continually prescribed since their development 1940s, and application has saved an immeasurable number of lives. With such immense use, rise antibiotic resistance truncated efficacy these compounds. Nevertheless, synergism combinational therapy allowed drugs to burgeon once again. Here, meropenem with vaborbactam—a recently FDA-approved beta-lactam therapy—is reviewed terms structure rationale, activity gamut, pharmacodynamic/pharmacokinetic properties, toxicity provide insight into future analogous therapies.

Language: Английский

Citations

3
Real-world effectiveness and safety of meropenem–vaborbactam in the treatment of carbapenem-resistant enterobacterales (CRE) infections: a systematic review and meta-analysis DOI Creative Commons
Dongcai Jin, Danyang Hu, Yu Jin

et al.

Journal of Chemotherapy, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 9

Published: Feb. 13, 2025

This study aimed to evaluate the effectiveness and safety of Meropenem-Vaborbactam(M-V) for treating carbapenem-resistant Enterobacterales (CRE) infections based on real-world data. A systematic search PubMed, Embase, Cochrane Library, Web Science was conducted, considering studies up October 31, 2024. Real-world evidence from registries nonselected case series involving 10 or more adult patients treated with Meropenem-Vaborbactam CRE included. Meta-analyses using a random-effects model were performed, primary outcomes being clinical efficacy survival, including 30-day 90-day survival rates. Out 1862 potentially relevant publications, six included in meta-analysis. The pooled success rate 75% (95% CI, 66%–82%), rates 71%–78%) 69% 61%–76%), respectively. Importantly, no serious adverse effects reported. In conclusion, demonstrated both settings. registered PROSPERO (CRD42022370880).

Language: Английский

Citations

0
Systematic Review and Meta-Analysis of Clinical Efficacy and Safety of Meropenem-Vaborbactam versus Best-Available Therapy in Patients with Carbapenem-Resistant Enterobacteriaceae Infections DOI Open Access

Alexandra Bucătaru,

Adina Turcu-Știolică, Daniela Călina

et al.

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(17), P. 9574 - 9574

Published: Sept. 4, 2024

Antimicrobial resistance is increasingly concerning, causing millions of deaths and a high cost burden. Given that carbapenemase-producing Enterobacterales are particularly concerning due to their ability develop structural modifications produce antibiotic-degrading enzymes, leading levels, we sought summarize the available data on efficacy safety regarding combination meropenem-vaborbactam (MV) versus best therapy (BAT). Articles related our objective were searched in PubMed Scopus databases inception July 2024. To assess quality studies, used Cochrane risk-of-bias tool, RoB2. The outcomes pooled as risk ratio (RR) 95% confidence interval (95%CI). A total four published studies involved: one retrospective cohort study three phase 3 trials, including 432 patients treated with MV 426 BAT (mono/combination polymyxins, carbapenems, aminoglycosides, colistin, tigecycline; or ceftazidime-avibactam; piperacillin-tazobactam). No significant difference clinical response rate was observed between comparators at TOC (RR = 1.29, 95%CI [0.92, 1.80], p 0.14) EOT 1.66, [0.58, 4.76], 0.34) visits. associated similar microbiological 1.63, [0.85, 3.11], assessment 1.16, [0.88, 1.54], 0.14). In analysis 28-day all-cause mortality lower for than control groups 0.47, [0.24, 0.92], 0.03). adverse events (AEs) 0.79, [0.53, 1.17], 0.23). Additionally, fewer renal-related AEs 0.32, [0.15, 0.66], 0.002). treatment discontinuation 0.76, [0.38, 1.49], 0.42) drug-related 0.56, [0.28, 1.10], 0.09) comparators. conclusion, presents promising therapeutic option treating CRE infections, demonstrating responses other comparators, potential advantages AEs.

Language: Английский

Citations

2
Bacteremic nosocomial pneumonia caused by Gram-negative bacilli: results from the nationwide ALARICO study in Italy DOI
Giusy Tiseo,

Valentina Galfo,

Sergio Carbonara

et al.

Infection, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 6, 2024

Language: Английский

Citations

1
Not all carbapenem-resistant Pseudomonas aeruginosa strains are alike: tailoring antibiotic therapy based on resistance mechanisms DOI
Marco Falcone,

Valentina Galfo,

Giusy Tiseo

et al.

Current Opinion in Infectious Diseases, Journal Year: 2024, Volume and Issue: 37(6), P. 594 - 601

Published: Aug. 16, 2024

Purpose of review To correlate the resistance mechanisms and susceptibility to new antibiotics in Pseudomonas aeruginosa . Recent findings Definition antibiotic is still debated. Carbapenem-resistant (CRPA) difficult-to-treat resistant (DTR-PA) are used but which them better with risk mortality remains Mechanisms underlying complex may be combined, resulting unpredictable phenotype cross-resistance. Thus, not all CRPA alike tailoring therapy on challenging. Summary Current guidelines recommend use antipseudomonal agents for or DTR-PA infections they don’t provide specific information how mechanisms. This useful understand involved have practical implications helping clinicians select an appropriate regimen. Several now available their rational important avoid development future resistance. The knowledge local epidemiology most common guide empirical therapy, targeted should re-evaluated as soon testing profile selected according phenotype.

Language: Английский

Citations

0