meropenem


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meropenem

 [mer″o-pen´em]
a broad-spectrumβ-lactam antibiotic effective against a wide variety of gram-positive and gram-negative organisms; used in treatment of intra-abdominal infections and bacterial meningitis.

meropenem

Meronem (UK), Merrem I.V.

Pharmacologic class: Carbapenem

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Inhibits bacterial cell-wall synthesis and penetrates gram-negative and gram-positive bacteria

Availability

Powder for injection: 500-mg and 1-g vials

Indications and dosages

Intra-abdominal infections

Adults: 1 g I.V. q 8 hours over 15 to 30 minutes by infusion or over 3 to 5 minutes as a bolus injection

Children weighing 50 kg (110 lb) or more: 1 g I.V. q 8 hours over 15 to 30 minutes by infusion or over 3 to 5 minutes as a bolus injection

Children ages 3 months and older weighing less than 50 kg (110 lb): 20 mg/kg q 8 hours over 15 to 30 minutes by infusion or over 3 to 5 minutes as a bolus injection

Bacterial meningitis

Children weighing 50 kg (110 lb) or more: 2 g I.V. q 8 hours over 15 to 30 minutes by infusion or over 3 to 5 minutes as a bolus injection

Children ages 3 month and older weighing less than 50 kg (110 lb): 40 mg/kg q 8 hours over 15 to 30 minutes by infusion or over 3 to 5 minutes as a bolus injection, to a maximum of 2 g q 8 hours

Complicated skin and skin-structure infections

Adults: 500 mg I.V. q 8 hours

Dosage adjustment

• Renal impairment

Off-label uses

• Acute pulmonary exacerbation caused by respiratory tract infection with susceptible organisms in cystic fibrosis patients

Contraindications

• Hypersensitivity to drug, its components, or other beta-lactams

Precautions

Use cautiously in:

• sulfite sensitivity, renal disease, seizure disorder

• pregnant or breastfeeding patients

• children.

Administration

• For I.V. bolus, add 10 or 20 ml of sterile water to 500-mg or 1-g vial, respectively, to yield a concentration of 50 mg/ml. Shake until clear. Administer single dose over 3 to 5 minutes.

• For intermittent I.V. infusion, piggyback vials can be reconstituted with compatible I.V. solution (0.9% sodium chloride or 5% dextrose) to yield a concentration of 2.5 to 50 mg/ml. Or vials can be reconstituted as for direct I.V. injection and added to compatible I.V. solution for further dilution. To reconstitute and administer ADD-Vantage systems, follow manufacturer's instructions. Infuse drug over 15 to 30 minutes.

• Use diluted solution immediately, if possible.

Adverse reactions

CNS: headache, insomnia, dizziness, drowsiness, weakness, seizures

CV: hypotension, phlebitis, palpitations, heart failure, cardiac arrest, myocardial infarction

GI: nausea, vomiting, diarrhea, constipation, tongue discoloration, oral candidiasis, glossitis, pseudomembranous colitis

GU: vaginal candidiasis

Hematologic: anemia, eosinophilia, leukopenia, bone marrow depression, thrombocytopenia, neutropenia

Musculoskeletal: myoclonus

Respiratory: chest discomfort, dyspnea, hyperventilation

Skin: rash, urticaria, pruritus, erythema at injection site

Other: altered taste, fever, pain, fungal infection, anaphylaxis

Interactions

Drug-drug. Probenecid: increased meropenem blood level

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, amylase, aspartate aminotransferase, bilirubin, blood urea nitrogen, eosinophils, gamma-glutamyl transpeptidase, lactate dehydrogenase, lipase: increased values

Hematocrit, hemoglobin, platelets, neutrophils, white blood cells: decreased values

International Normalized Ratio, partial thromboplastin time, prothrombin time: increased or decreased values

Patient monitoring

• Collect specimens for culture and sensitivity testing as needed. However, be aware that drug therapy may start pending results.

Monitor patient for hypersensitivity reaction or anaphylaxis. If either occurs, stop infusion immediately and initiate emergency treatment.

• Monitor for CNS irritability and seizures.

• In prolonged therapy, evaluate hematopoietic, renal, and hepatic function and watch for overgrowth of nonsusceptible organisms.

• If diarrhea occurs, check for pseudomembranous colitis and obtain stool cultures.

• Obtain hearing tests in child being treated for bacterial meningitis.

Patient teaching

• Advise patient to report such adverse reactions as CNS irritability, diarrhea, rash, shortness of breath, or pain at infusion site.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

meropenem

A CARBAPENEM antibiotic drug. A brand name is Meronem.
References in periodicals archive ?
Preclinical results showed that cefepime/VNRX-5133 showed potent in vitro activity against all Enterobacteriaceae, with an MIC90of 0.5 mg/L, compared to cefepime, levofloxacin, meropenem, and piperacillin-tazobactam (MIC90 values >128, >4, 4, >64 mg/L, respectively).
Meropenem Comprehensive Study by Type (Injection, Freeze-dried powder), Application (Hospital use, Clinic, Others), Distribution Channel (Online, Offline) Players and Region - Global Market Outlook to 2024
In the ventilated HABP sub-group, a favorable response for ZERBAXA in 28-day all-cause mortality was observed, 24.2% for ZERBAXA and 37.0% for meropenem, respectively.
Augmentation of the inhibition zone around imipenem and meropenem disk by at least 7 mm in the presence of EDTA was considered to be a positive result in disk difusion, whereas an 8-fold (three dilutions) reduction in the minimum inhibitory concentration (MIC) of imipenem or meropenem by EDTA was indicative of the production of MBL in dilution test.
Test an indicator carbapenem (meropenem) against all clinically significant Enterobacteriaceae isolates
Similar findings were recorded by Srivastava et al.9 The current study showed that the gram-negative isolates as E.coli were found to be sensitive to Tazobactam/Pipearcillin, Meropenem and Cefoperazone and highly resistant to Cefotaxime which is similar to the result acquired by Waqar et al., in 2010.10 In our study Extended spectrum beta lactamase (ESBL) producing Escherichia coli was found to be resistant to most of the antibiotics except cefoperazone, meropenem, and piperacillin/tazobactam.
aeruginosa in Medellin exceed those reported in other main cities of Colombia, such as Bogota, with 22% and 28% of isolates resistant to imipenem and meropenem respectively (15).
Idrar kulturunde imipenem, meropenem ve amika-sine duyarli, diger p-laktam antibiyotiklere ve kinolonlara direncli Gram-negatif comaklar E.
Antimicrobial agent MIC range ([micro]g/mL) Amikacin 2-64 Cefepime 1-64 Ceftazidime 1-64 Ceftriaxone 1-64 Ciprofloxacin 0.25-128 Colistin 0.25-128 Ertapenem 0.5-8 Gentamicin 1-16 Imipenem 0.25-16 Meropenem 0.25-16 Piperacillin/tazobactam 4-128 Tigecycline 0.5-8 Antimicrobial agent KPC-Kp Amikacin 4 Cefepime [greater than or equal to]64 Ceftazidime 16 Ceftriaxone [greater than or equal to]64 Ciprofloxacin 64 Colistin [greater than or equal to]128 Ertapenem [greater than or equal to]8 Gentamicin [greater than or equal to]16 Imipenem 8 Meropenem [greater than or equal to]16 Piperacillin/tazobactam [greater than or equal to]128 Tigecycline 2 Antimicrobial agent E.
Adverse events were common in both the combination and meropenem groups (53% vs.
We observed an increase in multidrug (penicillin, macrolide, and meropenem)-resistant pneumococcal isolates of serotype 15A and sequence type (ST) 63 (serotype 15A-ST63), which is not covered by PCV13.
The following antibiotic discs were tested: ceftazidime (30 [micro]g), cefepime (30 [micro]g), piperacillin-tazobactam (100 [micro]g/10 [micro]g), Imipenem (10 [micro]g), Meropenem (10 [micro]g), Gentamicin (10 [micro]g), Amikacin (30 [micro]g), Ampicillin-sulbactam (10 [micro]g/10 [micro]g), Cotrimoxazole (25 [micro]g), aztreonam (30 [micro]g), Ciprofloxacin (5 [micro]g), Norfloxacin (30 [micro]g) (for urinary isolates), Polymyxin B (300 units), and Colistin (10 [micro]g).