Meropenem

Aka: Meropenem, Merrem

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II. Indications

  1. See Carbapenem
  2. Conditions
    1. Complicated Skin and Soft Tissue Infections
    2. Intraabdominal Infections (Appendicitis, peritonitis)
    3. Meningitis (over age 3 months)
      1. Meropenem is the only Carbapenem FDA approved for Meningitis

III. Mechanism

  1. See Carbapenem

IV. Dosing

  1. Adult (and child weighing >50 kg)
    1. High Dose: 2000 mg IV every 8 hours
      1. Indicated in Meningitis (not FDA approved)
    2. Medium Dose: 1000 mg IV every 8 hours
      1. Indicated in complicated intra-abdominal and Pseudomonas infections
      2. Also used in Hospital Acquired Pneumonia, complicated UTI, Malignant Otitis Externa (not FDA approved)
    3. Low Dose: 500 mg IV every 8 hours
      1. Indicated in Skin and Soft Tissue Infections
    4. Adjust dose in impaired Renal Function
      1. CrCl 26 to 50 ml/min: Give indicated dose every 12 hours
      2. CrCl 10 to 25 ml/min: Give 50% of indicated dose every 12 hours
      3. CrCl <10 ml/min: Give 50% of indicated dose every 24 hours
  2. Child over age 3 months (and weight<50 kg)
    1. High Dose: 40 mg/kg IV every 8 hours
      1. Indicated in Meningitis
    2. Medium Dose: 20 mg/kg IV every 8 hours
      1. Indicated in complicated intra-abdominal and Pseudomonas infections
    3. Low Dose: 10 mg/kg IV every 8 hours
      1. Indicated in Skin and Soft Tissue Infections
  3. Infant age 2 weeks to 3 months (for complicated intra-abdominal infection)
    1. Gestational Age <32 weeks: 20 mg/kg IV every 8 hours
    2. Gestational Age >32 weeks: 30 mg/kg IV every 8 hours
  4. Infant age <2 weeks (for complicated intra-abdominal infection)
    1. Gestational Age <32 weeks: 20 mg/kg IV every 12 hours
    2. Gestational Age >32 weeks: 20 mg/kg IV every 8 hours

V. Drug Interactions

  1. See Carbapenem

VI. Adverse Effects

  1. See Carbapenem
  2. Seizures
    1. Unlike other Carbapenems, does not appear to significantly increase Seizure risk in Meningitis
    2. Norrby (1999) Scand J Inf Dis 31(1):3-10 +PMID: 10381210 [PubMed]
  3. Thrombocytopenia
    1. May oocur with Meropenem (Merrem) in patients with renal dysfunction

VII. Safety

  1. Unknown safety in pregnancy and Lactation

VIII. Resources

  1. Meropenem (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3b952a55-6ef7-45c8-be21-16eefe37ec2e

IX. References

  1. LiverTox (2017), accessed online 1/2/2023
    1. https://www.ncbi.nlm.nih.gov/books/NBK548705/
  2. Hamilton (2020) Tarascon Pharmacopeia
  3. (2012) Presc Lett, Resource #231205, Comparison of CarbapenemAntibiotics
  4. Zhanel (2007) Drugs: 67(7): 1027-52 [PubMed]

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