Vabomere (meropenem/vaborbactam) / Melinta Therap, Menarini - LARVOL DELTA

Assessing Clinical Effectiveness of Ceftolozane/Tazobactam, Ceftazidime/Avibactam, and Meropenem/Vaborbactam in Bacteremia: A Systematic Review and Meta-Analysis. (PubMed, Antibiotics (Basel)) - " This meta-analysis provides supporting evidence for the clinical effectiveness of C/T, C/A, and M/V in bacteremia reinforcing the role of BL/BLIs in antimicrobial stewardship as viable options for resistant infections. However, further randomized controlled trials (RCTs) are warranted to validate these results and refine treatment strategies for bacteremia."

Journal • Retrospective data • Review • Infectious Disease

Stewardship Challenges, PK/PD Evidence, and Prescribing Appropriateness for Recently Approved Antibiotics in Pediatric Practice. (PubMed, Antibiotics (Basel)) - "This review explores the landscape of the most recent antibiotics, including advanced cephalosporins (ceftaroline, cefiderocol, and ceftobiprole), novel beta-lactam/beta-lactamase inhibitor combinations (e.g., ceftazidime/avibactam, meropenem/vaborbactam), and long-acting lipoglycopeptides. Furthermore, we emphasize the role of antimicrobial stewardship through the "3 D's" rule and the evolution of Therapeutic Drug Monitoring (TDM) from reactive safety controls to proactive, model-informed precision dosing (MIPD). Finally, we advocate for a multidisciplinary synergy between pediatricians and pharmacologists as the cornerstone for optimizing outcomes and preserving the efficacy of the future antibiotic pipeline."

Journal • PK/PD data • Review • Pediatrics

Novel β-Lactam/β-Lactamase Inhibitors Versus Best Available Therapy on the Mortality-Related Carbapenem-Resistant Enterobacterales Infection: A Systematic Review and Meta-Analysis. (PubMed, Antibiotics (Basel)) - "Innovative BL/BLI combinations lower all-cause mortality compared to BAT. This effect is extremely reliant on the comparator regimen composition, the specific BL/BLI drug, and the underlying resistance mechanism. These data support a precision medicine approach guided by rapid molecular diagnostics. These findings underscore the urgent need for novel agents against MBL-producing strains, including the recently approved aztreonam-avibactam."

Journal • Retrospective data • Review • Infectious Disease • Pneumonia • Septic Shock

Carbapenem-Associated Hepatitis and Hepatic Failure: A FDA Adverse Event Reporting System (FAERS) Pharmacovigilance Analysis (ACG 2026) - "Future investigations should aim to confirm causality and elucidate the underlying pathophysiology, while also evaluating combination drugs like meropenem-vaborbactam. ADRs for both hepatitis and hepatic failure were analyzed. Doripenem had no relevant ADRs and was excluded from the data analysis. Meropenem, imipenem, and ertapenem all showed statistically significant RORs with hepatitis and hepatic failure."

Adverse events • Hepatology • Infectious Disease • Inflammation • Liver Failure

When the Dam Breaks: Flood Syndrome Complicated by Klebsiella Pneumoniae Carbapenemase-Producing Enterobacter Cloacae Bacteremia in Decompensated Cirrhosis (ACG 2026) - "Postoperatively, he developed ileus requiring nasogastric decompression and oliguric AKI (peak creatinine 4.99) managed with albumin, midodrine, and octreotide...Meropenem-vaborbactam and vancomycin were initiated...Multidisciplinary coordination is essential for optimizing outcomes. Figure: Abdominal wall, status post umbilical hernia repair"

Cardiovascular • Fibrosis • Gastroenterology • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Pneumonia • Portal Hypertension • Septic Shock

Phenotypic screening for metallo-β-lactamases and extended-spectrum β-lactamases in Pseudomonas aeruginosa using the VITEK-2 AST-N443 and Phoenix NMIC-486 cards. (PubMed, Microbiol Spectr) - "However, these groups exhibit distinct susceptibility patterns to novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations, including ceftolozane/tazobactam (C/T), ceftazidime/avibactam (C/A), imipenem/relebactam (I/R), and meropenem/vaborbactam (M/V)...Antimicrobial susceptibility testing was performed using the VITEK-2 AST-N443 and Phoenix NMIC-486 cards on 135 whole-genome-sequenced international CRPA isolates resistant by disc diffusion to ceftazidime, cefepime, imipenem, and/or meropenem...Our study identifies reliable screening cut-offs for MBL- and ESBL-production in CRPA using standard VITEK 2 and Phoenix automated AST panels. This readily available approach may accelerate detection, support routine laboratory workflows, reduce unnecessary confirmatory testing, and facilitate earlier targeted therapy and infection-control interventions in laboratories using these systems worldwide without requiring additional specialized testing or infrastructure."

Journal • Infectious Disease

Aztreonam-avibactam Activity against Enterobacterales from Asia Pacific and Latin American Medical Centres: Summary of 5 years of Surveillance prior to Clinical Use (2020-2024). (PubMed, Int J Antimicrob Agents) - "The results of this investigation provide a baseline for monitoring the activity of aztreonam-avibactam in APAC and LATAM and emphasize the importance of surveillance programs to monitor the emergence of resistance markers."

Journal • Infectious Disease • Pneumonia

Managing KPC infections in daily practice: when BLBLIs are interchangeable - and when they are not. (PubMed, Curr Opin Infect Dis) - "BLBLI with KPC activity interchangeability is clinically reasonable only in selected, microbiologically confirmed, low-risk scenarios. In complex infections, therapy should be guided according to resistance mechanism, infection site, pharmacokinetics/pharmacodynamics (PK/PD) parameters, and host factors."

Journal • Infectious Disease • Pneumonia • Respiratory Diseases

Carbapenem-resistant Gram-negative pathogens: molecular epidemiology, diagnostic advances, and emerging therapeutic strategies. (PubMed, Front Microbiol) - "At the same time, new drugs have been developed, such as ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol and combinations of aztreonam, offering increased treatment options, but with emerging resistance an issue. This mini review covers the molecular epidemiology of CR-GNPs, the latest developments and challenges in diagnosing these infections, new therapeutic options, and future perspectives on genomic surveillance, antimicrobial stewardship, and precision medicine strategies to address the increasing threat of carbapenem resistance."

Journal • Review • Infectious Disease • Pneumonia

A comparative analysis of performance and time-to-result for VITEK REVEAL versus MicroScan during antimicrobial susceptibility testing for gram-negative bacteremia. (PubMed, Microbiol Spectr) - "High agreement rates were observed for most antimicrobials, including amikacin, ceftazidime-avibactam, and meropenem-vaborbactam, each showing 100% EA and CA. VITEK REVEAL performed consistently across key Enterobacterales and non-fermenters, including resistant phenotypes and β-lactam/β-lactamase inhibitor agents, underscoring its utility in diverse clinical scenarios. By providing susceptibility results 26-32 h earlier than MicroScan, this system may contribute to nimbler clinical decision-making, allowing for better antimicrobial stewardship practices."

Clinical • Journal • Infectious Disease • Pneumonia

Antimicrobial activity of aztreonam/avibactam and molecular characterization of Enterobacterales not susceptible to ceftazidime/avibactam and/or meropenem/vaborbactam from US medical centres (2016-2024). (PubMed, J Antimicrob Chemother) - "Aztreonam/avibactam demonstrated potent activity against isolates not susceptible to ceftazidime/avibactam and/or meropenem/vaborbactam as well as against CRE isolates, including MBL producers. The activities of other β-lactamase inhibitor combinations and cefiderocol were adversely affected by the alarming increase of MBL producers in some US hospitals."

Journal

Targeting KPC-Producing Klebsiella pneumoniae Biofilms: Genomic Profiles, Clinical Outcomes and Novel Combinations. (PubMed, Microorganisms) - "Ceftazidime/avibactam (CAZ/AVI), meropenem/vaborbactam (MEM/VAB), and imipenem/relebactam (IMI/REL) were tested alone or combined with fosfomycin (FOS), cefepime (FEP), meropenem (MEM), or imipenem (IMI) using checkerboard assays. Conversely, FOS-based regimens were significantly less effective against biofilms. These findings provide a clinical rationale for selecting optimized dual regimens to eradicate biofilms, offering a critical therapeutic strategy to preserve vascular devices when catheter removal is unfeasible."

Clinical data • Journal • Infectious Disease • Pneumonia

Antibiotic Treatment of Severe Infections with Multiresistant Bacteria. (PubMed, Dtsch Arztebl Int) - "The treatment should be tailored in consideration of the site of infection, the antibiotic sensitivity profile, the resistance mechanism, and the clinical situation. New reserve antibiotics should be used selectively and in the framework of antimicrobial stewardship."

Clinical guideline • Journal • Infectious Disease • Pneumonia • Respiratory Diseases

Real-world use of novel β-lactams in immunologically vulnerable patients: insights from an Italian retrospective cohort. (PubMed, JAC Antimicrob Resist) - "Adult patients receiving NBLs (cefiderocol, ceftazidime/avibactam, ceftolozane/tazobactam, imipenem/relebactam or meropenem/vaborbactam) were included. In a real-world Italian cohort spanning 5 years, NBLs were widely used in immunologically vulnerable patients, a population often underrepresented in pivotal antibiotic trials, with K. pneumoniae carbapenemase-producing K. pneumoniae and P. aeruginosa as predominant pathogens. Unadjusted comparisons showed similar clinical outcomes despite greater baseline severity among non-vulnerable patients, a hypothesis-generating finding warranting confirmation in adjusted, prospective studies."

Journal • Real-world evidence • Retrospective data • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Pneumonia • Rheumatology • Solid Organ Transplantation • Transplantation

Pharmacokinetics, safety and population pharmacokinetics/pharmacodynamics analysis of meropenem-vaborbactam in Chinese healthy participants. (PubMed, Front Pharmacol) - "The corresponding cumulative fraction of response ranged from 98.67 to 100% across ESBL-producing and KPC-producing Enterobacterales, including bla KPC variants resistant to ceftazidime-avibactam. The standard meropenem-vaborbactam regimen (2 g/2 g every 8 h, 3-h intravenous infusion) demonstrated favorable PK and safety profiles, with PK/PD analyses supporting the appropriateness of the standard regimen in Chinese participants, consistent with global findings. These results provide PK/PD support for the standard regimen and warrant further evaluation in Chinese patients with CRE infections."

Journal • PK/PD data • Infectious Disease • Pneumonia

Activity of Aztreonam-avibactam and Ceftazidime-Avibactam against Enterobacterales and Pseudomonas aeruginosa causing infections in patients hospitalized in hematology, oncology, and transplant units from United States medical centres (2019-2024). (PubMed, Diagn Microbiol Infect Dis) - "Aztreonam-avibactam, ceftazidime-avibactam, and meropenem-vaborbactam were highly active against Enterobacterales (99.9-99.4% susceptible), including MDR isolates (99.6-98.1% susceptible), but only aztreonam-avibactam exhibited good activity against CRE (95.8% susceptible). The most active agents against P. aeruginosa were ceftazidime-avibactam (95.7% susceptible), ceftolozane-tazobactam (94.8% susceptible), and tobramycin (91.5% susceptible). Piperacillin-tazobactam and meropenem were active against 81.4% and 82.5% of P. aeruginosa, respectively, and aztreonam-avibactam inhibited 78.6% of P. aeruginosa at ≤8 mg/L."

Journal • Hematological Disorders • Infectious Disease • Nephrology • Oncology • Pneumonia • Respiratory Diseases • Transplantation

TAILOR: Targeted Versus Standard Peri-operative Antibiotic Prophylaxis in Patients Colonized With Carbapenemase Producing Enterobacterales Undergoing Liver Transplantation (clinicaltrials.gov) - P3 | N=168 | Not yet recruiting | Sponsor: IRCCS Azienda Ospedaliero-Universitaria di Bologna

New P3 trial • Transplantation

Rapid MALDI-TOF MS antimicrobial susceptibility testing with the MBT FAST assay. (PubMed, J Clin Microbiol) - "Essential agreement (EA), defined as MICs within ±1 two-fold dilution step of the standard method, was as follows: amoxicillin/clavulanic acid 96.3%, amikacin 97.5%, aztreonam 95.5%, ceftazidime/avibactam 95.5%, ceftazidime 94.6%, cefepime 92.2%, ciprofloxacin 91.8%, colistin 92.2%, ceftriaxone 95.5%, cefotaxime 94.2%, gentamicin 95.5%, imipenem 91.8%, levofloxacin 97.9%, meropenem 87.2%, meropenem/vaborbactam 94.2%, piperacillin/tazobactam 90.9%, trimethoprim/sulfamethoxazole 90.9%, temocillin 93.3%, and tobramycin 97.5%. In a diverse collection of Enterobacteriaceae tested against a panel of 19 antibiotics, the assay provided reliable minimum inhibitory concentration results after 6 h and showed high agreement with standard broth microdilution. Because MALDI-TOF MS instruments are widely used in clinical microbiology laboratories, this approach could make rapid phenotypic susceptibility testing easier to integrate into routine workflows."

Journal

TANGOKIDS: Dose-finding, Pharmacokinetics, and Safety of VABOMERE in Pediatric Subjects With Bacterial Infections (clinicaltrials.gov) - P1 | N=39 | Completed | Sponsor: Rempex (a wholly owned subsidiary of Melinta Therapeutics, LLC) | Active, not recruiting ➔ Completed | Trial completion date: Dec 2026 ➔ Jul 2026 | Trial primary completion date: Dec 2026 ➔ Jul 2026

Trial completion • Trial completion date • Trial primary completion date • Infectious Disease • Pediatrics

Epidemiology of KPC-producing Enterobacterales isolated from 2019 to 2023 in France. (PubMed, J Antimicrob Chemother) - "KPC-producing K. pneumoniae referred to the French NRC show marked clonal diversification. The emergence of resistant isolates and convergent resistance-virulence profiles underscore the need for sustained genomic surveillance."

Journal • Infectious Disease • Pneumonia

Changing molecular epidemiology and resistance patterns of carbapenem-resistant Klebsiella pneumoniae in California long-term acute care hospitals. (PubMed, J Infect Dis) - "The comparison of clinical CRKP isolates collected from the same healthcare network and separated by nearly a decade revealed increasing ST diversity, mainly due to the introduction of numerous epidemic lineages, which coincided with differing patterns of circulating resistance-associated genotypes and antibiotic resistance."

Journal • Infectious Disease • Pneumonia • ST14

Emergence of mutHV76G in carbapenem-resistant Klebsiella pneumoniae disrupts DNA mismatch repair and results in a hypermutator phenotype. (PubMed, Antimicrob Agents Chemother) - "Through extensive genomic and experimental work, we found that this single change produced a hypermutator strain capable of quickly developing resistance to several key antibiotics, including ceftazidime-avibactam and meropenem-vaborbactam, and also reduced susceptibility to cefiderocol. Importantly, the same types of mutations that appeared under laboratory conditions also emerged during infection. Our findings show how hypermutation can compromise even the newest antibiotics and highlight the need for surveillance of DNA repair defects in antibiotic-resistant K. pneumoniae."

Journal • Mismatch repair • Gene Therapies • Infectious Disease • Pneumonia

Characterization of IMI-4 carbapenemase-producing Enterobacter sp. isolated from humans and a companion animal in French Indian Ocean territories. (PubMed, J Antimicrob Chemother) - "Companion animals may play a role in the persistence and spread of mobile genetic elements that confer carbapenem resistance in diverse Enterobacter species."

Journal • Infectious Disease

LOCAL/2024/CR-03: Defining Antibiotic Levels in Intensive care patients (DALI-2) protocol (clinicaltrialsregister.eu) - P4 | N=200 | Recruiting | Sponsor: Centre Hospitalier Universitaire De Nimes | Not yet recruiting ➔ Recruiting

Enrollment open • Trial initiation date • Critical care • Infectious Disease

Addressing therapeutic options for KPC-3-producing ST307-Klebsiella pneumoniae: insights from in vitro evolution and mutant prevention strategies. (PubMed, Antimicrob Agents Chemother) - "Imipenem-relebactam exerted stronger collateral effects than meropenem-vaborbactam, extending cross-resistance to aztreonam-avibactam and cefepime-taniborbactam, while cefiderocol activity remained largely preserved. Ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam impose distinct evolutionary pressures on KPC-ST307-Kp, resulting in divergent resistance pathways and collateral resistance profiles. CZA + MER may offer a more sustainable strategy by preventing resistance emergence and limiting cross-resistance to last-line agents."

Journal • Preclinical • Infectious Disease • Pneumonia