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).

本研究旨在基于真实世界数据，评估美罗培南-瓦鲍巴坦（Meropenem-Vaborbactam, M-V）治疗碳青霉烯类耐药肠杆菌目（carbapenem-resistant Enterobacterales, CRE）感染的有效性与安全性。本研究系统检索了PubMed、Embase、Cochrane图书馆及Web of Science数据库，检索时限截至2024年10月31日。纳入标准为涉及10名及以上成人患者、接受美罗培南-瓦鲍巴坦治疗CRE感染的非选择性病例系列及注册登记数据相关真实世界证据。本研究采用随机效应模型开展荟萃分析，主要结局指标包括临床疗效与生存情况，具体为30天及90天生存率。在1862篇潜在相关文献中，最终有6项研究被纳入本次荟萃分析。合并后的临床成功率为75%（95%置信区间，Confidence Interval, CI：66%~82%），合并后的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，本研究未报告严重不良反应事件。综上，美罗培南-瓦鲍巴坦在真实世界场景下治疗CRE感染时，兼具良好的有效性与安全性。本研究已在PROSPERO平台注册（登记号：CRD42022370880）。