- Treatment of infections caused by susceptible organisms
- Broad spectrum cover of hospital-acquired infections (particularly in the setting of intra-abdominal sepsis)
PRESENTATION AND ADMINISTRATION:
500 mg and 1 gm vials of white powder
Add 10 mL of water for injection to 500 mg vial or 20 mL of water for injection to a 1 gm vial. Shake vigorously until liquid is clear (approximately 3 minutes). The reconstituted solution has an approximate concentration of 50 mg/mL. Inject required dose slowly over 5 minutes.
Initial reconstitution should be prepared as soon as possible before use although solutions reconstituted with water for injection are stable for 8 hours at 25 degrees or 24 hours at 4 degrees.
Can be added to 50-200 mL of compatible IV fluid for administration by infusion over 15-30 minutes.
Compatible with the following IV fluids:
Normal saline, 5% or 10% glucose , Glucose and sodium chloride 2.5% or 10%, mannitol 5%, glucose and 0.15% KCl
Store at room temperature
1 gm TDS
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose in renal impairment
|<10||250 mg - 1 gm OD|
|10-20||250 mg - 1 gm BD or 500 mg TDS|
|>20-50||500 mg - 1 gm BD|
Dose in renal replacement therapy
|CAPD||250 mg - 1 gm OD|
|HD||250 mg - 1 gm OD|
|CVVHDF||250 mg - 1 gm BD or 500 mg TDS|
DOSAGE IN PAEDIATRICS:
20-40 mg/kg TDS
Meropenem is a carbapenem antibiotic. The bactericidal activity of meropenem results from the inhibition of cell wall synthesis. Meropenem has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:
- Enterococcus faecalis (excluding vancomycin-resistant isolates)
- Staphylococcus aureus (beta-lactamase and non-beta-lactamase producing, methicillin- susceptible isolates only)
- Streptococcus agalactiae
- Streptococcus pneumoniae (penicillin-susceptible isolates only)
- Streptococcus pyogenes
- Viridans group streptococci.
- Escherichia coli
- Haemophilus influenzae (beta-lactamase and non-beta-lactamase-producing)
- Klebsiella pneumoniae
- Neisseria meningitidis
- Pseudomonas aeruginosa
- Proteus mirabilis.
- Bacteroides fragilis
- Bacteroides thetaiotaomicron
- Peptostreptococcus species
- Hypersensitivity to carbapenems
Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving therapy with beta-lactams. These reactions are more apt to occur in patients with a history of sensitivity to multiple allergens.
There have been reports of patients with a history of penicillin hypersensitivity who have experienced severe hypersensitivity reactions when treated with another beta-lactam. Before initiating therapy with meropenem, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, other beta-lactams, and other allergens.
Seizures and other adverse CNS experiences have been reported during treatment with meropenem. These experiences have occurred most commonly in patients with CNS disorders (e.g. brain lesions or history of seizures) or with bacterial meningitis and/or compromised renal function. This risk of seizures is lower than the risk with imipenem. In patients with renal dysfunction, thrombocytopaenia has been observed but no clinical bleeding reported.
No tests in addition to routine ICU tests are required
Drug/Laboratory Test Interactions:
IMPORTANT DRUG INTERACTIONS IN ICU:
There is evidence that meropenem may reduce serum levels of valproic acid to subtherapeutic. Monitor levels in patients receiving sodium valproate and meropenem at the same time.
Body as a Whole:
Pain, abdominal pain, chest pain, fever, back pain, abdominal enlargement, chills, pelvic pain
Heart failure, heart arrest, tachycardia, hypertension, myocardial infarction, pulmonary embolus, bradycardia, hypotension, syncope
Oral moniliasis, anorexia, diarrhoea, nausea/vomiting, cholestatic jaundice/jaundice, flatulence, ileus, hepatic failure, dyspepsia, intestinal obstruction
Anaemia, hypochromic anaemia, hypervolemia
Peripheral oedema, hypoxia
Insomnia, agitation/delirium, confusion, dizziness, seizure (see PRECAUTIONS), nervousness, paraesthesia, hallucinations, somnolence, anxiety, depression, asthenia
Respiratory disorder, dyspnoea, pleural effusion, asthma, increased cough, pulmonary oedema
Skin and appendages:
Urticaria, sweating, skin ulceration
Dysuria, kidney failure, vaginal moniliasis, urinary incontinence