MEROZA XP is a sterile, lyophilized powder for intravenous (IV) infusion, combining Meropenem (a carbapenem antibiotic) and Vaborbactam (a beta-lactamase inhibitor). It is used for treating serious multidrug-resistant Gram-negative infections, including those caused by carbapenem-resistant Enterobacteriaceae (CRE).
Composition
Each vial contains:
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Meropenem – 1 g
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Vaborbactam – 1 g
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Excipients:Â Sodium carbonate (for pH adjustment)
Mechanism of Action
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Meropenem:
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Binds to penicillin-binding proteins (PBPs), disrupting bacterial cell wall synthesis.
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Broad-spectrum activity against Gram-positive, Gram-negative, and anaerobic bacteria.
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Vaborbactam:
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A non-beta-lactam beta-lactamase inhibitor that protects Meropenem from degradation by Klebsiella pneumoniae carbapenemase (KPC) and other resistant enzymes.
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Dosage & Administration
Standard Adult Dose:
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4 g (2 g Meropenem + 2 g Vaborbactam) every 8 hours via IV infusion (over 3 hours for optimal efficacy).
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Infusion Time: Extended infusion (3 hours) recommended for CRE infections.
Renal Dose Adjustment:
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CrCl 30–49 mL/min: 2 g (1g + 1g) every 8 hours
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CrCl 15–29 mL/min: 2 g (1g + 1g) every 12 hours
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Hemodialysis: Administer after dialysis
Pediatric Use:
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Safety & efficacy not established in children.
Uses (Indications)
MEROZA XP is approved for:
✔ Complicated urinary tract infections (cUTIs), including pyelonephritis
✔ Hospital-acquired pneumonia (HAP) & ventilator-associated pneumonia (VAP)
✔ Intra-abdominal infections (with metronidazole for anaerobes)
✔ Bacteremia caused by CRE (Carbapenem-Resistant Enterobacteriaceae)
Storage
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Unreconstituted powder: Store at 20–25°C, protect from moisture.
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Reconstituted solution:
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Stable for 1 hour at room temperature or 24 hours refrigerated (2–8°C).
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Do not freeze.
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Recommendations
✔ Administer as a slow IV infusion (over 3 hours) to maximize efficacy.
✔ Monitor renal function, liver enzymes, and CBC during prolonged therapy.
✔ Not effective against MRSA or Acinetobacter (consider additional coverage if suspected).
Important Note
Contraindications:
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Hypersensitivity to carbapenems (e.g., imipenem, ertapenem).
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Severe anaphylactic reactions to beta-lactams.
Side Effects:
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Common:Â Diarrhea, headache, nausea, elevated liver enzymes.
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Serious: Seizures (in high doses), C. difficile colitis, hypersensitivity.
Drug Interactions:
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Valproic acid:Â Meropenem reduces valproate levels (risk of seizures).
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Probenecid:Â Increases Meropenem concentration (avoid concurrent use).
Pregnancy & Lactation:
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Category BÂ (use only if clearly needed).
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Breastfeeding:Â Safety unknown (caution advised).
Reviews
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