A patient with carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteremia requires treatment. Which combination has shown synergistic activity specifically due to inhibition of OXA-type carbapenemases?
- A Colistin + meropenem
- B Ceftazidime-avibactam
- C Meropenem-vaborbactam ✓
- D Aztreonam + avibactam
Correct answer: C. Meropenem-vaborbactam
Explanation
Vaborbactam is a cyclic boronic acid beta-lactamase inhibitor that specifically and potently inhibits class A Klebsiella pneumoniae carbapenemase (KPC) and some class C cephalosporinases, restoring meropenem activity. Ceftazidime-avibactam covers KPC and OXA-48 carbapenemases. Aztreonam+avibactam is used for metallo-beta-lactamase (MBL) producers because aztreonam resists MBL hydrolysis. Colistin+meropenem has synergy against some CRKP but is not mechanism-specific for OXA inhibition.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.