Drug Index

Meropenem

 
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Mechanism :

Meropenem is a broad-spectrum carbapenem antibiotic. It is active against Gram-positive and Gram-negative bacteria. The bactericidal activity of meropenem results from the inhibition of cell wall synthesis. Meropenem readily penetrates the cell wall of most Gram-positive and Gram-negative bacteria to reach penicillin-binding- protein (PBP) targets.


Indication :

• Wide spectrum antibiotic used to treat both Gram-positive and Gram-negative infections including pseudomonas spp. resistant to other antibiotics. Use to treat infections like meningitis, pneumonia and intra-abdominal infections, complicated skin/skin structure infections.


Contraindications :

Contraindicated in patients with known hypersensitivity to any component of this product or to other drugs in the same class or in patients who have demonstrated anaphylactic reactions to b-lactams.


Dosing :

Newborn:

<32 weeks of gestation and <14 days of life:

20 mg/kg IV every 12 hours.

<32 weeks of gestation and >14 days of life or >32 weeks of gestation and <14 days of life:

20 mg/kg IV every 8 hours.

>32 weeks of gestation and >14 days of life: 30 mg/kg IV every 8 hours.

Double the dose in meningitis and severe infection.

Children:

Urinary tract Infection, soft tissue infection and skin infections:

10 mg/kg/dose IV every 8 hours. Max: 500 mg/dose.

Pneumonia, peritonitis, neutropenia, septicemia:

20 mg/kg/dose every 8 hours. Max: 1 gm/dose.

Meningitis and life threatening infections:

40 mg/kg IV every 8 hours. Max: 2 gm/dose.


Adverse Effect :

Commonly seen adverse reactions are constipation, local irritation at injection site, rashes, diarrhea, pseudo-membranous colitis (rarely), reversible neutropenia, apnoea, glossitis, pruritus, thrombocytopenia, eosinophilia, and thrombocythemia. Elevated LFTs may occur, Adverse CNS effects such as seizures have been reported.


Interaction :

Probenecid: Competes with meropenem for active tubular secretion and thus inhibits the renal excretion of meropenem.
Valproic acid: There is evidence that meropenem may reduce serum levels of valproic acid to subtherapeutic levels.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50500 mg – 2 g every 12 hours
10-20500 mg – 1 g every 12 hours or 500 mg every 8 hours
<10500 mg – 1 g every 24 hours

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. Dose as in GFR<10 mL/ min
HDDialysed. Dose as in GFR<10 mL/ min or 1–2 g post dialysis
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDDialysed. 0.5–1 g every 8 hours or 1 g every 12 hours
CVVHDF1 g every 12 hours

Hepatic Dose :

No dose adjustments are recommended.
04/12/2020 18:26:25 Meropenem
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