通用中文 | 美罗培南/瓦博巴坦 | 通用外文 | meropenem / vaborbactam |
品牌中文 | 品牌外文 | VABOMERE | |
其他名称 | Vaborem | ||
公司 | Medicines(Medicines) | 产地 | 美国(USA) |
含量 | 1g/1g | 包装 | 6瓶/盒 |
剂型给药 | 针剂 注射 | 储存 | 室温 |
适用范围 | 复杂性尿路感染 抗菌素 |
通用中文 | 美罗培南/瓦博巴坦 |
通用外文 | meropenem / vaborbactam |
品牌中文 | |
品牌外文 | VABOMERE |
其他名称 | Vaborem |
公司 | Medicines(Medicines) |
产地 | 美国(USA) |
含量 | 1g/1g |
包装 | 6瓶/盒 |
剂型给药 | 针剂 注射 |
储存 | 室温 |
适用范围 | 复杂性尿路感染 抗菌素 |
The Medicines Company宣布,新型抗菌药Vabomere已获得美国FDA批准上市,用于治疗患有复杂性尿路感染(cUTI)的患者,其中包括由特定细菌感染引起的肾盂肾炎患者。
复杂性尿路感染大多发生在泌尿生殖道结构或功能异常的患者中,临床表现为无症状性尿路感染或无症状性菌尿。复杂尿路感染患者症状性感染的临床表现有很多种,严重时可导致菌血症和败血症。
Vabomere是一种含有美罗培南(meropenem)和vaborbactam的抗菌药物,可以抑制细菌的某种抗性机制,从而达到治疗尿路感染的目的。其中美罗培南是一种青霉烯抗菌药物,可以抑制细胞壁合成,从而产生杀菌作用;也能渗透大多数革兰氏阳性和革兰氏阴性细菌的细胞壁,以结合青霉素结合蛋白(PBP)靶标。另一种组分vaborbactam是一种β-内酰胺酶抑制剂,它本身没有任何抗菌活性,但是可以保护美罗培南不受某些丝氨酸β-内酰胺酶的降解,比如肺炎克雷伯杆菌碳青霉烯酶(KPC),同时不会降低美罗培南的活性。
批准日期:2017年8月30日 公司:The Medicines Company
VABOMERE™(meropenem and vaborbactam)注射剂,用于静脉注射
最初的美国批准:2017
作用机制
VABOMERE是一种抗菌药物[见微生物学]。
指征和用法
VABOMERE(美罗培南和vaborbactam)是一种青霉烯类抗生素美洛培南和β-内酰胺酶抑制剂vaborbactam的组合,用于治疗18岁及以上患有复杂性尿路感染(cUTI)的患者,包括由指定的易感细菌引起的肾盂肾炎。
为减少耐药细菌的发展,维持VABOMERE等抗菌药物的有效性,VABOMERE只能用于治疗或预防已被证实或疑似易感染的感染。
剂量和给药
在8小时内每8小时静脉输注VABOMERE 4克(美罗培南2克和vaborbactam 2克),历时3小时,长达14天,18岁及以上患者,估计肾小球滤过率(eGFR)≥50mL/min/1.73m2。
eGFR小于50mL/min/1.73m2的肾功能损害患者建议调整剂量。
eGFRa(mL/min/1.73m2)
VABOMERE的推荐剂量方案
(美罗培南和vaborbactam)b,c,d
加药间隔
30至49
VABOMERE 2克(美罗培南1克,巴比巴胺1克)
每8小时
15至29
VABOMERE 2克(美罗培南1克,巴比巴胺1克)
每12小时
少于15
VABOMERE 1克(美罗培南0.5克,巴比巴胺0.5克)
每12小时
a按照肾脏疾病饮食调整(MDRD)公式计算; b所有剂量的VABOMERE静脉注射3小时以上; c肾功能损害调整剂量应在血液透析治疗后进行; d治疗的总时间长达14天。
请参阅完整处方信息,获取有关构成所供干粉及随后所需稀释的说明。
有关药物兼容性请参阅完整处方信息。
用量形式和强度
VABOMERE 2克(美罗培南和vaborbactam)注射液,以无菌粉剂形式供应,含有美罗培南1克(相当于1.14克美罗培南三水合物)和vaborbactam1克单剂量小瓶。
禁忌症
已知对VABOMERE(美罗培南和巴比巴胺)成分过敏或对β-内酰胺过敏反应。
警告和注意事项
使用VABOMERE报告超敏反应。接受β-内酰胺类抗菌药物治疗的患者有严重的偶发致命性过敏反应(过敏性反应)。如果出现急性过敏症状,请停止输液。
已有报道用美罗培南(VABOMERE的一个组分)治疗癫痫和其他不良中枢神经系统的经验。
几乎所有的全身性抗菌药物,包括VABOMERE,都报道了艰难梭菌相关的腹泻。评估患者是否发生腹泻。
美洛培南与丙戊酸或双丙戊酸钠的共同施用降低了丙戊酸的血清浓度,潜在地增加了突破性癫痫发作的风险。
不良反应
在VABOMERE治疗的患者中发生率最高的不良反应最多的是头痛,静脉炎/输液部位反应和腹泻。
包装规格/储存和处理
VABOMERE 2克(美罗培南和vaborbactam)注射液为白色至淡黄色的无菌粉末,用于单剂量透明玻璃瓶(NDC 65293-009-01),用橡胶塞(不是用天然橡胶胶乳 )和一个铝的海外。 每个小瓶由6个小瓶(NDC 65293-009-06)提供。
每个小瓶含有1克美罗培南(相当于1.14克美罗培南三水合物),1克伏巴综合征和0.575克碳酸钠。
将VABOMERE样品瓶存放在20°C至25°C(68°F至77°F)的环境中。 偏差允许在15°C到30°C(59°F到86°F)之间[见USP,Controlled
meropenem / vaborbactam
Overview
Vaborem (previosly Vabomere) is an antibiotic used in adults to treat the following infections, including when they have spread into the blood (bacteraemia):
· complicated (difficult-to-treat) infections of the urinary tract, including kidneys;
· complicated abdominal infections of the tissues and organs in the belly (intra-abdominal infections);
· lung infections caught in hospital (hospital-acquired pneumonia), including ventilator-associated pneumonia (pneumonia caught from a ventilator, which is a machine that helps a patient to breathe).
It can also be used for infections caused by Gram-negative bacteria when other treatments might not work.
Vaborem contains the active substances meropenem and vaborbactam.
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How is Vabomere used?
Vabomere can only be obtained with a prescription.
Vabomere is given by infusion (drip) into a vein over 3 hours. It is given every 8 hours and the duration of treatment depends on the type of infection and its severity.
For more information about using Vabomere, see the package leaflet or contact your doctor or pharmacist.
How does Vabomere work?
The active substances in Vabomere, meropenem and vaborbactam, work in different ways. Meropenem belongs to the carbapenem class of antibiotics, which belongs to the wider group of antibiotics known as beta-lactams. It works by interfering with the activity of certain proteins that bacteria need to build their cell walls. This action weakens the bacterial cell walls which can then collapse, ultimately causing the bacteria to die. Meropenem has been authorised in the EU since the 1990s.
Vaborbactam is a beta-lactamase inhibitor, which means that it blocks the action of bacterial enzymes called beta-lactamases. These enzymes break down beta-lactam antibiotics such as meropenem and stop them from working. By blocking the action of these enzymes, vaborbactam allows meropenem to act against bacteria that would otherwise be resistant to it.
What benefits of Vabomere have been shown in studies?
Vabomere was found effective at treating infections in two studies. The first study, involving patients with complicated urinary tract infection (including kidney infection), compared Vabomere with a combination of piperacillin (another beta-lactam antibiotic) and tazobactam (a beta-lactamase inhibitor). Tests for bacteria in the urine found that 67% (128 out of 192) of patients treated with Vabomere were cured, compared with 58% (105 out of 182) of patients treated with piperacillin and tazobactam.
The second study involved patients with complicated urinary tract infection (including kidney infection), complicated intra-abdominal infections, lung infections caught in hospital and bacteraemia. Vabomere was compared with the doctor’s choice of the best available antibiotic treatment. Of those treated with Vabomere, overall 60% (21 out of 35) of patients were cured, compared with 32% (6 out of 19) of patients receiving best available antibiotic treatment. Fewer patients treated with Vabomere (14%) died within 4 weeks compared with those receiving best available antibiotic treatment (26%).
What are the risks associated with Vabomere?
The most common side effects with Vabomere (which may affect up to 1 in 10 people) are headache, diarrhoea, inflammation of the vein around the infusion site and nausea (feeling sick). For the full list of side effects of Vabomere, see the package leaflet.
Vabomere must not be used in patients who are hypersensitive (allergic) to any carbapenem antibiotic or in patients who have had a severe allergic reaction to the broader class of beta-lactam antibiotics (such as penicillins and cephalosporins). For the full list of restrictions, see the package leaflet.
Why is Vabomere authorised in the EU?
The European Medicines Agency noted that there were limited options for treating infections with bacteria that carry beta-lactamases. Vaborbactam allows meropenem to work in many such infections by blocking certain beta-lactamases. However, the Agency recognised that Vabomere cannot deal with all types of bacteria resistant to meropenem. No special concerns about side effects have been raised by the addition of vaborbactam to meropenem. The Agency decided that Vabomere’s benefits are greater than its risks and it can be authorised for use in the EU.
What measures are being taken to ensure the safe and effective use of Vabomere?
Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Vabomere have been included in the summary of product characteristics and the package leaflet.
As for all medicines, data on the use of Vabomere are continuously monitored. Side effects reported with Vabomere are carefully evaluated and any necessary action taken to protect patients.
Other information about Vabomere
Vabomere received a marketing authorisation valid throughout the EU on 20 November 2018.