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.
- Nausea or vomiting
- Rash (includes diaper-area moniliasis in pediatric patients)
- Inflammation at injection site
- Oral moniliasis (≤2% in pediatric patients)
- Injection-site reaction
- Phlebitis or thrombophlebitis
- Septic shock
- Erythema multiforme
- Hypersensitivity reaction
- Pleural effusion
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
Hypersensitivity to IV components, beta-lactams, or other drugs in this class.
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
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
- 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.
- Oral contraceptives
- Cholera Vaccine, Live
- Valproic Acid
- Using alcohol or tobacco with certain medicines may also cause interactions to occur.
Resource Person: Lobna Adi (Clinical Pharmacist)