Meropenem IV (Carbapenem) | Drug Digest

Meropenem IV (Carbapenem) is a wide spectrum antibiotic that inhibits bacterial cell-wall synthesis by binding to penicillin-binding proteins, resistant to most beta-lactamases. It is used in adults and children 3 months of age and older.


Meropenem is indicated for:

1. Complicated Skin/Skin Structure Infections

  • 500 mg IV q8hr; not to exceed 2 g IV q8hr;
  • ≥3 months: 10 mg/kg IV q8hr; not to exceed 500 mg IV q8hr)

2. For the treatment of bacterial meningitis

  • 2 g IV every 8 hours, in combinarion with vancomycin
  • ≥3 months: 40 mg/kg IV q8hr; not to exceed 2 g IV q8hr

3. Complicated Intra-abdominal Infections

  • 1 g IV q8hr; not to exceed 2 g IV q8hr
  • ≥3 months: 20 mg/kg IV q8hr; not to exceed 1 g q8hr

4. Community-Acquired Pneumonia (Off-label)

  • 500 mg IV q8hr for ≤5 days in combination with fluoroquinolone

5. Febrile Neutropenia (Off-label)

  • 1 g IV q8hr


Note: Durarion of therapy varies from 3/5 to 14/20 days depending on the clinical presentation, progress of the patient and clinical judgment of the health-care provider.


Storage: Storage requirements for reconstituted solutions are dependent on the diluent used.

  • Do not freeze.
  • Refer to the manufacturer’s leaflet.


Adverse Effects:

1-10%:

  • Constipation
  • Diarrhea
  • Nausea or vomiting
  • Rash (includes diaper-area moniliasis in pediatric patients)
  • Headache
  • Inflammation at injection site
  • Sepsis
  • Oral moniliasis (≤2% in pediatric patients)
  • Bleeding
  • Apnea
  • Constipation
  • Glossitis
  • Injection-site reaction
  • Phlebitis or thrombophlebitis
  • Pruritus
  • Septic shock

<1%:

  • Agranulocytosis
  • Angioedema
  • Erythema multiforme
  • Hypersensitivity reaction
  • Hypokalemia
  • Leukopenia
  • Neutropenia
  • Pleural effusion
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis


Contraindications:

Hypersensitivity to IV components, beta-lactams, or other drugs in this class.


Pregnancy:

There are insufficient human data to establish whether there is a drug-associated risk of major birth defects or miscarriages with meropenem in pregnant women


Lactation:

Drug has been reported to be excreted in human milk; no information is available on effects of drug on breast-fed child or on milk production; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breast-fed child from therapy or from the underlying maternal condition


IV Incompatibilities:

  • Additive: Amphotericin B, metronidazole, multivitamins
  • Y-site: Amphotericin B, diazepam, metronidazole


Note: Dosage adjustments are required in renal impairment.


IV Administration: Administer IV infusion over 15-30 minutes; administer IV bolus over 3-5 minutes.


Drug interactions:

  • Oral contraceptives
  • Bupropion
  • Cholera Vaccine, Live
  • Valproic Acid
  • Probenecid
  • Using alcohol or tobacco with certain medicines may also cause interactions to occur.


Related: Piperacillin and Tazobactam for Injection | Drug Digest


Resource Person: Lobna Adi (Clinical Pharmacist)

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