Real-World Efficacy and Safety of Meropenem-Vaborbactam in Patients With Moderate to Severe Renal Impairment

Document Type

Conference Proceeding

Publication Date

1-2026

Publication Title

Open Forum Infectious Diseases

Abstract

Background. Meropenem-vaborbactam (MEV) is a novel β-lactam β-lactamase inhibitor combination approved in the United States for the treatment of complicated urinary tract infections caused by resistant organisms. Its spectrum includes carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa. Limited data exist on the use of MEV in patients with reduced renal function. This study compared clinical characteristics and outcomes between patients with moderate to severe renal impairment and those with mild or no impairment. Methods. This was a real-world, multicenter, retrospective cohort study conducted between 2017 and 2025 in adult patients who received MEV for ≥72 hours. Patients with KDOQI CKD stages 3-5 or GFR < 60 mL/min/1.73m 2 or on chronic dialysis were assigned to the renal impairment (RI) group. All other patients were assigned to the non-impaired (NI) group. The primary outcome was clinical success, de fined as resolution or improvement in signs of infection without recurrence. Secondary outcomes included 30-day all-cause mortality, 30-day microbiologic recurrence, 30-day hospital readmission, and occurrence of treatment-emergent adverse events. Results. Seventy-two patients were included in the RI group and 151 patients were included in the NI group. The median baseline eGFR was 52.3 vs. 91.3 mL/ min/1.73m 2 in the RI and NI groups, respectively. Nearly half (47%) of patients in the RI group were receiving chronic dialysis. Clinical success was achieved in 76% of patients in the RI group compared to 79% in the NI group (p =0.60). Thirty-day allcause mortality was 20.8% in the RI group vs. 23.8% the in the NI group (p=0.62). Thirty-day microbiological recurrence and hospital readmission rates were similar between the two groups. Adverse events were rare in both groups and similar in incidence (2.8% vs. 2.6% in the RI and NI groups, respectively [p=0.96]). Conclusion. This study demonstrated the clinical outcomes of MEV when used in patients with moderate to severe renal impairment. Prospective randomized trials in this patient population are needed to validate these findings.

Volume

13

Issue

Suppl 1

First Page

S793

Last Page

S794

Comments

IDWeek 2025, October 19-22, 2025, Atlanta, GA

DOI

10.1093/ofid/ofaf695.1403

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