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# 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](https://durgical.com/en/pharmacology/classes/carbapenems/)
- Enzyme: KPC carbapenemase (vaborbactam) and penicillin-binding proteins (meropenem)
- ATC code: J01DH52
- WHO Model List of Essential Medicines

✂**KPC carbapenemase (vaborbactam) and penicillin-binding proteins (meropenem)**Meropenem–vaborbactam

ⓘ 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](https://www.rcsb.org/structure/6TD0) · Drag to rotate · pinch to zoom

## 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.

- Vaborbactam blocks KPC and other serine β-lactamases
- Meropenem stays intact and reaches the PBPs
- 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

- Complicated urinary tract infections, including pyelonephritis. [Acute pyelonephritis →](https://durgical.com/en/conditions/acute-pyelonephritis/)
- Reserved for multidrug-resistant gram-negatives, such as KPC-producing Enterobacterales. [MRSA and other multidrug-resistant organism infections →](https://durgical.com/en/conditions/mrsa-and-other-multidrug-resistant-organism-infections/)

## Adverse effects

### Common

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

### Serious (rare, important)

- Anaphylaxis
- Seizures, especially with brain lesions or kidney disease
- Clostridioides difficile diarrhoea

## 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.

## Memory aid

VABORbactam = «boron armour» for meropenem against KPC; but the armour has no defence against metallo-enzymes.

## 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/meropenem-vaborbactam/)

## Related drugs

- [Meropenem](https://durgical.com/en/pharmacology/meropenem/)
- [Imipenem–cilastatin](https://durgical.com/en/pharmacology/imipenem-cilastatin/)
- [Valproic acid](https://durgical.com/en/pharmacology/valproic-acid/)

## Related conditions

- [Acute pyelonephritis](https://durgical.com/en/conditions/acute-pyelonephritis/)
- [MRSA and other multidrug-resistant organism infections](https://durgical.com/en/conditions/mrsa-and-other-multidrug-resistant-organism-infections/)

[← Back to the class: Carbapenems](https://durgical.com/en/pharmacology/classes/carbapenems/)

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](https://medlineplus.gov/druginfo/meds/a617048.html) (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](https://www.rcsb.org/structure/6TD0) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/meropenem-vaborbactam/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/meropenem-vaborbactam/