Real-world effectiveness and safety of meropenem–vaborbactam in the treatment of carbapenem-resistant enterobacterales (CRE) infections: a systematic review and meta-analysis

This study aimed to evaluate the effectiveness and safety of Meropenem-Vaborbactam(M-V) for treating carbapenem-resistant Enterobacterales (CRE) infections based on real-world data. A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted, considering studies up to October 31, 2024. Real-world evidence from registries and nonselected case series involving 10 or more adult patients treated with Meropenem-Vaborbactam for CRE infections was included. Meta-analyses using a random-effects model were performed, with the primary outcomes being clinical efficacy and survival, including 30-day and 90-day survival rates. Out of 1862 potentially relevant publications, six studies were included in the meta-analysis. The pooled clinical success rate was 75% (95% CI, 66%–82%), and the pooled 30-day and 90-day survival rates were 75% (95% CI, 71%–78%) and 69% (95% CI, 61%–76%), respectively. Importantly, no serious adverse effects were reported. In conclusion, Meropenem-Vaborbactam demonstrated both efficacy and safety in treating CRE infections in real-world settings. This study was registered with PROSPERO (CRD42022370880).

这项研究旨在基于真实世界数据评估美罗培南-瓦博巴坦（Meropenem-Vaborbactam，M-V）治疗碳青霉烯耐药肠杆菌科（carbapenem-resistant Enterobacterales，CRE）感染的有效性与安全性。研究人员对PubMed、Embase、Cochrane Library及Web of Science数据库进行了系统检索，纳入截至2024年10月31日发表的相关研究。纳入标准为来自注册库的真实世界证据，以及包含10例或以上接受美罗培南-瓦博巴坦治疗CRE感染的成年患者的非选择性病例系列。本研究采用随机效应模型（random-effects model）开展荟萃分析（meta-analysis），主要结局指标为临床疗效与生存率，包括30天及90天生存率。在1862篇潜在相关文献中，共6项研究被纳入荟萃分析。合并临床成功率为75%（95%置信区间：66%–82%），合并30天及90天生存率分别为75%（95%置信区间：71%–78%）与69%（95%置信区间：61%–76%）。值得注意的是，研究未报告严重不良反应事件。结论表明，美罗培南-瓦博巴坦在真实世界场景下治疗CRE感染具有良好的有效性与安全性。本研究已在PROSPERO平台注册，注册号为CRD42022370880。