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Pharmacology · Carbapenems

Meropenem–vaborbactam !

Meropenem paired with vaborbactam, a β-lactamase inhibitor that protects it from KPC carbapenemases; reserved for multidrug-resistant gram-negatives.

Updated 2026-11-01

  • Class: Carbapenems
  • Enzyme: KPC carbapenemase (vaborbactam) and penicillin-binding proteins (meropenem)
  • ATC code: J01DH52
  • WHO Model List of Essential Medicines

The figure shows vaborbactam bound to KPC-2, the bacterial carbapenemase it blocks; meropenem's own target, PBP3, is shown on the meropenem page.

Target in 3D: KPC carbapenemase (vaborbactam) and penicillin-binding proteins (meropenem). PDB structure 6TD0 (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

Meropenem acylates the penicillin-binding proteins and stops cell-wall cross-linking. Vaborbactam is a boronic-acid, non-β-lactam β-lactamase inhibitor: it blocks serine β-lactamases such as KPC, AmpC and ESBL, so meropenem is not destroyed. It does not inhibit metallo-β-lactamases.

  1. Vaborbactam blocks KPC and other serine β-lactamases
  2. Meropenem stays intact and reaches the PBPs
  3. Wall cross-linking stops and the bacterium lyses

Pharmacokinetics

Absorption
Intravenous only, as a prolonged infusion.
Elimination
Both components are cleared by the kidney.
Half-life
On the order of 1 hour.

Indications

Adverse effects

Common

  • Headache, nausea, diarrhoea
  • Redness, pain or swelling at the infusion site
  • Burning or tingling of hands or feet

Contraindications

  • Hypersensitivity to either component or anaphylaxis to β-lactams

Key interactions

Valproic acid / divalproex
Like other carbapenems, meropenem lowers valproate levels; seizures may return.
Hormonal contraceptives
May become less effective; another method is used during treatment.

What is monitored

  • Kidney function
  • Neurological status
  • Culture and susceptibility results

Administration and safety

  • Reconstituted and given as a long IV infusion as ordered; it may be continued at home after teaching.
  • Check that the product is the combination and not plain meropenem.

Nursing care

  • Ask about β-lactam allergy, seizures, brain lesions, kidney disease and valproic acid.
  • Counsel on a non-hormonal contraceptive method during treatment.
  • Teaching: it may affect alertness; report rash, diarrhoea or twitching.

Pregnancy and breastfeeding

Human data are limited; a pregnancy is reported to the treating team, which weighs benefit and risk.

Test yourself

Think of the answer, then tap the question to see it.

What does vaborbactam add to meropenem?

It inhibits serine β-lactamases such as KPC, restoring meropenem's activity against many carbapenemase producers.

Which carbapenemases does vaborbactam not block?

Metallo-β-lactamases.

Which contraception advice goes with meropenem–vaborbactam?

Hormonal contraceptives may be less effective, so a non-hormonal method is used during treatment.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Meropenem and Vaborbactam Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 58 (McGraw Hill, 2023); RCSB PDB - 6TD0: Crystal structure of vaborbactam bound to KPC-2 (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.